Two letters: your plan is changing, or your plan is going away

Thanks for having me, as always. And you're right that this one feels urgent in a way that some of our topics don't, because the calendar is already moving. September is when these letters go out, so if you're listening to this and you've got a thick envelope sitting on your counter from your Medicare plan, this episode is for you.

And that's the core of the problem. These two letters come from the same place, they're in similar envelopes, they both say things are changing. But one means your plan is adjusting its prices and benefits for next year. The other means your plan is leaving Medicare entirely. Those are very different situations with very different deadlines and very different consequences if you do nothing.

That one's called the Annual Notice of Change. Every Medicare Advantage plan and every drug plan is required to send one. You should have it by September 30th. It lays out what's changing for next year: the formulary, meaning which drugs are covered, the benefits, the premium. If this is the one you got, you're in the regular fall enrollment window, October 15 through December 7. You pick something new, it starts January 1. If you do nothing, you stay in your current plan at the new prices.

Exactly. You're not removed from the plan. You're just accepting whatever changes came with it. That may or may not be fine depending on what changed, and Ian says the next article in the series actually goes through that letter line by line because it's longer than it needs to be and the numbers people actually need are buried on page two.

The second type is a non-renewal notice. This is the plan saying we are leaving Medicare. And the clock on this one is different. Federal rules require a plan that's leaving to notify every enrollee by mail at least 90 calendar days before their coverage ends. January 1 is when most plan years end, so 90 days back from January 1 lands you right at the start of October. The letter should have already been sent.

Which is a detail worth sitting with. The insurance company knew since spring. They're required to tell Medicare by early June, and they're required to notify you by early October. So by the time you open that letter, the decision has been made for months. And the plan is also required to give you written descriptions of other options, or call you, or both. That's not optional for them.

Medicare's own language on this is pretty blunt: each year, insurance companies can decide to join or leave Medicare. That's it. They're not required to stay. And it happened in a significant way for 2026. KFF counted 3,373 Medicare Advantage plans available nationwide for 2026, which was a 9% decrease from 2025. The average person went from choosing among 34 plans with drug coverage down to 32.

And it plays out differently state by state. Arizona went from 149 Advantage plans in 2025 down to 133 for 2026. Nevada actually went the other direction, from 97 up to 105. So there's real variation. But the point is these contractions happen, and for 2027 the plan list isn't public yet. Ian's clear about that. Medicare says information for next year's plans will be available beginning in October.

Not fully. Until then, as Ian puts it, the only authority on your plan is your own letter. Which is why reading the letter carefully matters so much.

Ian quotes Medicare's enrollment guide on this directly, and I think it's worth getting the words right. If you don't join another Medicare Advantage plan before your current plan ends, you'll be enrolled in Original Medicare. That's the official language.

And where you end up is Original Medicare on January 1 with no drug coverage, no out-of-pocket cap, and no Supplement. And Ian ties it back to something he covered in an earlier part of this series: the day you have no drug coverage, the penalty clock starts running. So this isn't just an inconvenience. It's a financial trap that can follow you.

That's the whole reason Ian wrote this piece. The two letters look the same. They are not the same. And the stakes on the second one are high enough that it's worth being really clear about what it means and what you need to do.

The first is a Special Enrollment Period. When your plan's contract is not renewed, you get an extra window to make a change. Medicare says you can switch between December 8 and the last day of February of the following year. So you're not limited to the regular fall window that closes December 7. You have runway into February.

It is. But the second right is the one Ian says people miss, and it's the one I want to make sure we spend real time on. When an Advantage plan leaves Medicare or stops serving your area, you get a guaranteed-issue right for certain Medigap plans. That means a company cannot turn you down or charge you more because of your health.

Very hard under normal circumstances. But a plan leaving is one of the few situations where that door swings open on its own. The timing window is 60 days before your coverage ends up to 63 days after it ends. So you have to act within that window.

A big one. Medicare is explicit: you only have this right if you switch to Original Medicare rather than join another Medicare Advantage plan. If you hop directly to a different Advantage plan, the guaranteed-issue right is gone. Just like that.

And that's the kind of choice worth talking over with an advisor before you make it, because the rules around what you qualify for, exactly which Medigap plans apply, those specifics are detailed enough that I'd rather someone call the team at American Retirement Advisors and get it right than try to work it out alone.

Yes, don't throw it away. Medicare notes that you may need to include copies of these documents with your new Medigap application to prove you have the right to buy a policy. So that envelope that looks like junk mail is actually documentation. Keep it.

That's right. Sixty days before coverage ends to 63 days after. If coverage ends December 31, you're working backwards and forwards from that date. The 63 days after gets you into early March, but you don't want to be scrambling at the end of that window. The time to start is when the letter arrives.

The first is a notice that a plan is full. Plans can actually limit enrollment when the number of people who want to join exceeds what the plan can handle. Medicare only approves those limits when the health and safety of beneficiaries is at risk, for example when the provider network can't serve more people. If you're already in the plan, you stay in. If you're trying to get in, the plan has to tell you how the waiting process works, but wanting in doesn't get you in.

Possible, yes. Which is one more reason not to wait until the last few days of the window to make a decision.

This one's subtle and Ian flags it carefully. It's called a crosswalk, which is the technical term for when your plan is being folded into another plan. The rules say crosswalks are generally prohibited between different contracts or different plan types. So for example you can't automatically be moved from an HMO to a PPO.

That's what Ian warns about. He says if your plan is ending and the notice invites you into a different kind of plan from the same company, that move is not automatic. And more importantly, it may actually be a non-renewal notice written in friendly language. If it is, every right we just talked about applies to you. The guaranteed-issue window, the Special Enrollment Period, all of it.

And that's worth doing. If you're not sure which kind of letter you're holding, that is a very good question for one of our advisors. The difference between a crosswalk and a non-renewal has real consequences and the language in those letters isn't always obvious.

That's the part I found most practical, actually. The first thing they do is read the letter before they read the plan. Because the letter decides everything. Is this a change or a departure? That question has to be answered first.

Two dates go on the calendar immediately. The 63-day Medigap window, measured from the day coverage ends, and then that February deadline Betty just mentioned -- that end-of-month cutoff for the Special Enrollment Period. Both get marked the same day. And then the advisor asks the underwriting question out loud before you pick another Advantage plan, because choosing a new Advantage plan quietly forfeits the guaranteed-issue right and most people don't know that's happening.

Which is just being honest. There's a version of this conversation where someone tries to walk you through 2027 options right now, and they can't do it accurately. The plans aren't published yet. What you can do right now is understand your rights, understand your deadline, and get your questions answered so you're ready when that information becomes available in October.

That's the whole thing. Because it's preventable. Every person who ends up in that situation got there by not knowing which letter they had or not acting in time. And Ian wrote this piece to close that gap.

Foothills Library in Glendale at 10:30 in the morning, and Mustang Library in Scottsdale at 2:30 in the afternoon. No cost to you. Ian's note about it is nice: he says each room seats well over a hundred people, you can sit in the back, nobody is going to pressure you or scare you or intimidate you. Bring your letter. That's the whole ask.

You can register at 123easymedicare.com/medicare-workshop or call 877-220-1089. And if you can't make it out there, the advisors are a phone call away at 602-281-3898.

And if it doesn't work for you, the articles keep coming. This is part six of a series and Ian is walking through all of it piece by piece. The next one goes through the Annual Notice of Change in detail, the lines that actually matter, the two meters people confuse. There's a lot more in this series.

Two letters, completely different situations. Letter one, the Annual Notice of Change, means your plan is adjusting for next year. You're in that same fall enrollment window we just talked about -- the one that gets you a January 1 start. Doing nothing means you stay in your plan at new prices. Letter two, the non-renewal, means your plan is leaving. Doing nothing means you fall straight into that trap Ian already warned us about -- no coverage, penalty clock ticking, no out-of-pocket cap to protect you. That is not a soft landing.

That guaranteed-issue protection we just described, where your health history simply can't be used against you, sits inside that same window we just mapped out, starting about two months out and stretching 63 days past the day your coverage actually wraps up. And you've also got a Special Enrollment Period running through the end of February. But here's the catch: that protection vanishes the moment you sign up for a new Advantage plan, so the order you make these decisions in really matters. Keep the letter, don't throw it away, and don't rush into the first option that presents itself.

The safest move is to get a set of actual human eyes on it before the deadline. Someone who reads these letters for a living will spot in five minutes what takes the rest of us an hour of Googling.

The wording in those letters can be warm and reassuring while the underlying situation is a non-renewal. So reading it carefully, or having someone read it with you, matters.

The advisors are at 602-281-3898, and that number's on the screen too if you're watching the video version. For folks in the Phoenix area, though, October 2nd is worth circling on the calendar. The workshop is really the most direct way to get a real conversation going, and we already gave you the link to grab your spot a few minutes ago, so go back and snag that if you need it.