Is Your Medicare Advantage Plan Going Away? Here's What To Know

• Thousands of Medicare Advantage enrollees will receive cancellation letters in the coming weeks, stating their plan ends December 31st, 2025.

• Insurance carriers constantly experiment with their plan offerings to see what works for their business and what customers prefer. When they decide to streamline, some plans get cut.

• NJ Life and Health can help you understand what to look for and what options you have!

Big Dates To Know

If you just received a letter saying you are going to lose your Medicare Advantage plan at the end of 2025, here is a general timeline of what to expect:

• September-October 2025: Cancellation letters arrive.

• October 1st: New 2026 plans become public on medicare.gov.

• October 15th - December 7th: Standard annual enrollment period.

• November 1st, 2025 - January 31st, 2026: Special enrollment period for people whose plans were cancelled.

• January 1st, 2026: Old plan ends, new coverage begins.

3 Potential Coverage Options

1. Choose a New Medicare Advantage Plan

Best for: People who want to stay in the Medicare Advantage system.

Benefits:

• Smooth transition.

• Plans are often more similar in cost than you may think.

• Can enroll during standard or extended enrollment periods.

  
  

2. Switch to Original Medicare + Supplement

Best for: People who no longer want Medicare Advantage.

Important to know:

• Requires medical underwriting in most states.

• Insurance companies can deny you for pre-existing conditions.

• Generally higher monthly costs but can potentially have a lower out-of-pocket costs overall.

• Some states and situations give you Guaranteed Issue rights, meaning there is no health questions or evaluation required for your policy.

  
  

3. Original Medicare Only

Not recommended due to significant coverage gaps and no out-of-pocket maximum. You could face exponentially costs for major medical events.

What to Evaluate in Any New Plan

Doctor Networks

Call your doctors' offices directly and ask:

• Which plans do they accept?

• Which plans do they prefer working with?

• Which create administrative problems?

Prescription Coverage

Every plan has a "formulary" - the list of covered drugs and their costs:

• Are your medications covered?

• What tier are they on? (affects your cost).

• Any quantity limits or prior authorization needed?

Cost Comparison

• Focus on copays for services you use most.

• Out-of-pocket maximums are federally regulated and similar across plans.

• Small cost differences often balance out across different services.

• Compare other benefits like Part B Givebacks, Gym Memberships, OTC Cards, and more.

How to Be Proactive

Annual Review Checklist:

• Verify your doctors are still in-network.

• Check if your prescriptions are still covered at the same or similar cost.

• Review any premium or benefit changes.

• Assess overall satisfaction with your current plan.

Get Professional Help

Licensed Medicare brokers like NJ Life and Health can:

• Compare all available options in your area.

• Help you avoid coverage gaps.

• Ensure you meet all deadlines.

• Provide ongoing annual reviews.

The Biggest Mistake People Make

Assuming everything stays the same. Medicare is constantly changing:

• Premiums go up or down

• Drug coverage lists change

• Doctor networks get updated

• Copays and benefits shift

  
  

The solution: Review your coverage every single year, whether your plan changes or not.

Author Bio

Ken Connolly is a licensed life and health insurance broker and host of the "Talking Retirement" podcast.

To learn more about Medicare, life insurance options and other supplemental health insurance options, talk to NJ Life and Health. Visit us https://www.njlifeandhealth.com/ or call their Toms River, NJ office at 848-226-6897.