First, it's important to know that you don't have to make any change by Dec. 7. If your plan is continuing and you're happy with your coverage, you can absolutely remain in your current Medicare Advantage plan. Remember, though, that new plans are released every year, and even if your current plan continues into the next year, there still may be some changes to costs, benefits and/or your network.
However, the Annual Enrollment Period is important because it is the broadest scheduled enrollment period each year, providing you with the most flexibility to address your Medicare coverage. Any change you make during this window takes effect on January 1, 2026.
If you miss the December 7th deadline, you have less flexibility with enrollment periods until the next Annual Enrollment Period, unless you qualify for a Special Enrollment Period (SEP).
It's important that you evaluate your Annual Notice of Change (ANOC) letter that your insurance provider sends to you in September each year. This will have key plan information — it will alert you if your plan is being cancelled, if you're being moved into a different plan (called a "plan crosswalk"), or if your plan is continuing into the next year.
Even if your plan is continuing, it may still include changes. These may include:
Costs: Your current plan's premiums, copays, and deductibles may be shifting.
Formularies: The list of covered prescriptions may exclude a drug you rely on.
Network: Your doctor may be leaving your plan's network.
$2,100 Part D Cap: Starting in 2026, the maximum you will pay out-of-pocket for covered prescriptions under Part D is $2,100. Once you hit this cap, you pay nothing for covered Part D drugs for the rest of the year.
Negotiated Drug Prices Begin: This is the first year the negotiated prices for some high-cost, brand-name drugs (like those for heart conditions, diabetes, and cancer) will take effect, potentially lowering your cost for those specific medications.
Free Vaccines: All recommended adult vaccines covered under Part D continue to be $0 cost to you.
Insulin Cap Continues: Your monthly cost for covered insulin remains capped at $35 or less.
Projected Part B Premium Increase: The mandatory Medicare Part B premium (which you pay regardless of your Medicare Advantage 2026 plan) is projected to increase significantly for 2026. This potential hike means your total monthly Medicare cost may rise even if your MA plan premium drops.
Insurer Pullback: Major insurance carriers are scaling back their plan offerings or exiting specific counties. If your plan is discontinued, you must choose new coverage.
Action Needed: If you use the Medicare Plan Finder to enroll and find the provider directory information was inaccurate, a temporary Special Enrollment Period (SEP) will be available in 2026 to help you switch.
There's no denying that the additional benefits offered by many Medicare Advantage plans have played a factor in the popularity of Medicare Part C. Any removal or cuts to your existing benefits rightfully should require your attention.
However, it's important to ask yourself a few critical questions when you're faced with this situation, or if you're evaluating plans for the next year.
At the end of the day, the reduction trend of Medicare Advantage additional benefits is notable and should require your attention. However, your focus should include what you actually needed and used in the previous year, and how that fits your needs for the year ahead.
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