What Happens If My Medicare Advantage Plan Is Discontinued in 2027?

If you recently received a notice saying your Medicare Advantage will no longer be available in 2027, don’t panic. You are not losing Medicare.

Medicare plans can change from year to year. Insurance companies may discontinue a particular Medicare Advantage plan, leave a county, reduce their service area, or decide not to renew their Medicare contract.

If your plan is ending December 31, 2026, you will need to make a decision about your coverage for 2027.

Here are the most important things to know.

1. Read the Notice From Your Medicare Plan

If your plan will not be available next year, your insurance company should send you a Plan Non-Renewal Notice explaining that your coverage is ending.

Don’t throw this letter away.  KEEP IT ON HAND.

Keep the notice because it explains your rights and may also serve as proof that your coverage is terminating.

2. Your Medicare Isn’t Going Away

A Medicare Advantage plan terminating does not mean you’re losing Medicare.

You still have Medicare Parts A and B.

Instead, you need to decide how you want to receive your Medicare coverage beginning January 1, 2027.

Generally, you have two main options:

Option 1: Choose another Medicare Advantage plan

You can review the Medicare Advantage plans available in your county for 2027 and enroll in a different medicare advantage plan.

When comparing plans, don’t look at the premium alone. Make sure you check:

• Your doctors and hospitals
• Prescription drug coverage
• Pharmacy network
• Copays and coinsurance
• Maximum out-of-pocket costs
• Dental, vision and hearing benefits
• Prior authorization requirements
• Plan network

A plan that looks similar to your old plan may work very differently.

Option 2: Return to Original Medicare

Depending on your circumstances, you may also choose to return to Original Medicare (Parts A and B).

You may then want to consider a Medicare Supplement (Medigap) policy and a standalone Part D prescription drug plan.

3. You May Have Special Medicare Supplement Rights

This is one of the most important things to understand if your Medicare Advantage plan is terminating.

Under certain circumstances, when your Medicare Advantage coverage ends because the plan is leaving Medicare or is no longer available in your area, you may have a guaranteed issue right to purchase a Medicare Supplement policy.

A guaranteed issue right can mean that an insurance company:

• Must sell you an eligible Medicare Supplement policy
• Cannot deny you because of your health
• Must cover your pre-existing conditions
• Cannot charge you more because of your health history

This can create an opportunity for someone who normally might not qualify medically for a Medicare Supplement.

However, guaranteed issue rules have specific requirements and deadlines, so it’s important to determine whether your particular situation qualifies before making a change.

4. Don’t Miss Your Special Enrollment Period

When a Medicare Advantage isn’t renewed, Medicare provides a Special Enrollment Period (SEP).

For a plan whose contract isn’t renewed at the end of the year, Medicare says the SEP runs from December 8 through the last day of February of the following year.

That means you may have additional time beyond the normal Annual Enrollment Period (October 15th – December 7th) to select replacement coverage.

However, we generally recommend reviewing your options well before your current plan terminates so that your new coverage can be coordinated for January 1.

5. Don’t Automatically Choose the Plan That Looks Most Similar

This is a common mistake.

If your current Medicare Advantage plan is going away, another plan from the same insurance company isn’t automatically your best replacement.

The new plan could have:

• A different doctor network
• Different hospital coverage
• Higher copays
• Different prescription coverage
• A different maximum out-of-pocket limit
• Different prior authorization requirements

Instead, use the plan termination as an opportunity to review all of your Medicare options for 2027.

6. Review Your Prescription Drugs

If your plan includes prescription drug coverage, make sure every medication you take is checked against the new plan’s 2027 formulary.

Two Medicare plans can cover the exact same prescription very differently.

Also check your preferred pharmacy. A pharmacy that was preferred under your old plan may not have the same status under your new plan.

7. Check Your Doctors Before Enrolling

If you’re considering another Medicare Advantage plan, verify that your doctors, specialists and preferred hospitals participate in the new plan’s network.

Don’t assume that because your doctor accepted your old Medicare Advantage plan, they will accept the new one.

This is especially important if you’re currently receiving treatment or regularly see specialists.

What Happens If I Do Nothing?

If your Medicare Advantage plan isn’t renewed and you don’t enroll in another Medicare Advantage plan before your coverage ends, You will be returned to Original Medicare A & B.

But that doesn’t necessarily mean you should simply do nothing.

You may need to arrange prescription drug coverage and determine whether you qualify for a Medicare Supplement policy. Going without appropriate Part D coverage can also potentially lead to a late-enrollment penalty later.

Don’t Wait Until December 31

If you’ve been notified that your Medicare plan will terminate at the end of 2026, now is the time to understand your options.

At Professional Insurance Solutions, we help Utah Medicare beneficiaries compare their available Medicare options, including Medicare Advantage, Medicare Supplement and prescription drug plans.

We’ll help you review your doctors, prescriptions, costs and benefits so you can make an informed decision about your 2027 coverage.

Professional Insurance Solutions
Tyler Haskell, CFP®  801-369-3090
Medicare Planning Specialist