Every fall, millions of Medicare beneficiaries allow their current plan to renew automatically. Sometimes that works out just fine — but other times, it leads to higher costs, lost doctors, or even a gap in coverage if your plan is discontinued.
Each year, thousands of seniors nationwide wake up in January and find out their Medicare plan no longer exists. It’s an awful surprise — and one that’s easy to avoid with a simple review before December 7.
Here’s what “doing nothing” really means during the Annual Enrollment Period (October 15 – December 7) — and how to stay protected from unwanted changes.
If You Keep Your Current Plan
When you take no action, your Medicare Advantage or Part D prescription plan usually renews automatically — but the details almost always change.
- Benefits, copays, and networks can change from year to year.
- Your plan ID number or pharmacy rules can reset, even if the plan name looks identical.
- If your plan was discontinued, your carrier may “walk” you into a new one automatically — often with different costs, coverage, or doctors.
That “walk-over” plan may not be the best fit for your needs, and sometimes it can even leave you without coverage until you select a new plan.
The Hidden Risks of Letting It Ride
- Higher drug costs when prescriptions move to a higher tier or require new prior authorizations.
- Lost doctor access if your physician, specialist, or hospital leaves the network.
- New deductible or copay structures that increase your out-of-pocket spending.
- Plan discontinuations that cause unexpected coverage gaps starting January 1.
- Reduced “extra benefits” such as dental, vision, hearing, or OTC credits — many carriers quietly cut these each year.
Real Example: Rita from Greenlawn
Rita decided not to review her plan for 2026 because “everything worked fine last year.” In January, she found out her endocrinologist was no longer in-network — and her prescription for Jardiance had jumped to a higher drug tier.
Her total out-of-pocket cost went up by $1,200 for the year.
A 10-minute plan review in November could have kept her same doctor and saved her that money.
What To Do If You Missed Something
If you realize something changed after December 7, don’t panic — you may still have options.
- Contact your agent or Medicare immediately.
You may qualify for a Special Enrollment Period (SEP) due to a move, plan termination, or other eligibility change.
If your plan was discontinued, Medicare typically allows extra time beyond December 7 to choose a new one. - Document what changed.
Write down which doctor, medication, or benefit was affected. - Talk to your doctor.
Ask if they can provide samples or temporary alternatives while we adjust your coverage. - Review next year’s plan documents carefully.
Look for new tier structures, copay schedules, and benefit changes.
The 10-Minute Annual Check That Prevents Headaches
- Confirm your doctors and hospitals will remain in-network next year.
- Review your prescriptions — verify the drug tier, any new prior authorizations, and preferred pharmacies.
- Compare total annual cost(premium + copays + drug costs) instead of just focusing on the monthly premium.
- Verify extra benefits you actually use — dental, vision, OTC, gym, etc.
- Save your plan’s customer service and agent’s phone number in your contacts for quick access.
Why It Matters
Medicare itself doesn’t change much from year to year — most updates are simple adjustments to premiums and deductibles.
The biggest changes come from private Medicare Advantage and Part D drug plans, which set their own networks, copays, and rules.
That’s why a quick annual review is so important:
- It protects your doctor relationships.
- It keeps your medications affordable.
- It prevents being “walked” into a plan you didn’t choose.
Before January 1 Sneaks Up… Let’s Double-Check Your Plan
A 10-minute conversation today could save you hundreds of dollars — or protect you from losing your doctor — next year.
Paul Barrett | The Modern Medicare Agency Call 631-358-5793 or visit paulbinsurance.com for a friendly, no-cost Medicare plan review.
At The Modern Medicare Agency, our goal is simple:
to make sure you start every year with confidence, clarity, and the right coverage.
