What Every Medicare Advantage Enrollee Must Do ASAP

If you, or someone you know, is enrolled in a Medicare Advantage plan, it is incredibly important to carefully review what is in store for 2026. The two largest insurers that offer Medicare Advantage plans, UnitedHealthcare and Humana, have both announced they are terminating or consolidating some plans for 2026.

This doesn’t mean if your plan is terminated you will be without coverage. But it does mean your coverage will change. And if you don’t take control over choosing your new coverage, you will be automatically defaulted into a plan that can leave you with greater financial responsibility for your health care bills.

Here’s what I want all Medicare Advantage (MA) enrollees to do right now.

Review your Annual Notice of Change. You should have received this sometime before October 1. You can also typically find this information by logging into your online account. I can’t tell you how important it is to review this document every year. Not just to confirm whether the plan will continue or be terminated. Even if your plan will continue in 2026, you need to make sure you understand what changes are in store for 2026. Are your doctors still in your MA network? The hospitals you prefer? Will your medications still be covered? Don’t assume anything.

If you are in an MA plan that is being terminated in 2026, you have two options. Please don’t just let the system default you into a plan. That’s financially dangerous. I want you to stand tall, do some research, and make an educated and informed decision on what type of Medicare coverage you want.

You have two choices:

1. Choose another Medicare Advantage Plan. You can work with a trusted Medicare broker/agent who shops across different providers, or you can do your own search using the Medicare

Please be a smart shopper. Focus on your potential future medical needs if you were to become seriously ill. (Or if you are currently managing a chronic situation.) The focus should be on the network of doctors and medical facilities that will be in-network. As far as I am concerned the fact that an MA plan dangles the “free” benefit of limited dental and vision care is just not as important. But I know that’s the enticing sales pitch. Please choose a plan that will give you the coverage you want and need in the event of a serious illness.

2. Switch to Original Medicare. If you have been underwhelmed by your MA plan, you have an interesting opportunity when it is terminated. Under special rules that apply only when an MA plan is terminated, you are eligible to switch to Original Medicare, and you will be allowed to purchase a supplemental Medigap policy without the insurer considering your pre-existing conditions. This is a very big deal, so I want to be clear: If your MA plan is terminated and you switch to Original Medicare, you can buy the crucial private supplemental insurance—called Medigap—that is a must have with Original Medicare, without having to worry that the insurer will deny coverage based on a preexisting condition, or charge you a very high premium.

You can work with a trusted Medicare insurance agent to help you shop for a Medigap policy. Or start at the federal Medicare website. Each state also has its own SHIP  service (State Health Insurance Assistance Program), a free, unbiased counseling service that can help you compare plans.

I want to slow down for a second and explain why I think Original Medicare is better, while also acknowledging it does have higher up-front monthly out-of-pocket costs.

There are two parts to all Medicare Plans: Medicare Part A and Medicare Part B. Part A is for hospital costs, and most people don’t pay a premium for Part A. Part B covers other medical expenses, including doctor's visits, tests, and outpatient procedures. (But not prescription drugs).

We all pay a monthly premium for Part B. If you are claiming your Social Security benefit, it is automatically deducted from your benefit each month.

The key difference between Medicare Advantage and Original Medicare is how much of your Part B costs are covered.

Original Medicare: Covers 80% of Part B expenses. The enrollee is responsible for the other 20%. And there is no annual cap on what that 20% can be. You have unlimited exposure. That’s why it is so very important to buy a supplemental insurance policy, called a Medigap policy, that will cover the 20% that Medicare does not pay for.  A good comprehensive Medigap policy may cost $250 or more a month, depending on the specific type of plan you choose (you have multiple options). You will also need to purchase a separate insurance policy to help cover your prescription drug costs. This is called a Medicare Part D plan. The average premium is typically around $35 a month.

Medicare Advantage. The 80/20 cost-sharing system is replaced by a different model: When you are enrolled in an MA plan your Part B expenses are covered, but they also come with deductibles and copays. The annual allowed maximum for all those Part B out-of-pocket costs in 2025 was $8,850, though plans can set that maximum out-of- pocket cost lower. Most MA plans do not charge extra for prescription drug coverage.

So right there, you see the first tradeoff. If you are healthy right now, an MA plan may seem better because you don’t need to buy a Medigap policy or a Part D Prescription Drug policy. There is no question that for healthy people, an MA plan looks like a big money saver.

But this is insurance, my friends. You should be focusing on the “what if.” What if you have a serious illness or a chronic disease? At that point, the cost of Original Medicare coverage with a separate Medigap policy and a Part D plan for prescription drug coverage —even if the combined premiums are $3,000 or $4,000 a year for your Medigap and Part D coverage—could be less than the maximum out-of-pocket you would be on the hook for with MA.

And that’s just the dollars and cents part of the comparison. As you know, because you are currently enrolled in MA, you are restricted to using in-network doctors and medical facilities. If you go out of network, your costs will be higher.  With Original Medicare, you are able to go to any doctor or facility in the country that accepts Medicare (most do). If you value the flexibility of being able to seek out care anywhere, you might want to consider Original Medicare.

Only you know what is best for you. My job here is to help you focus not just on the upfront cost today (MA will always look better if you are healthy), but to focus on the potential cost and the quality of care, if someday you need more medical care. At that point, Original Medicare (that you combine with a Medigap and Part D drug plan) could not only be less expensive, but will also give you maximum flexibility on the doctors and facilities you can use.

And for those of you facing an MA termination for 2026, you have a unique chance to make the switch to Original Medicare, if that’s what you want. As I mentioned earlier, when an MA plan is terminated, you get a “special enrollment period” that generally starts a month before the actual termination date of the plan and runs for about two months after. If you sign up for Original Medicare in that window, you can also get a Medigap policy without the insurer being able to deny you coverage (or quote you an insane premium) based on a pre-existing condition. This is called “guaranteed issue.”

I need you to be very careful. If you have received a termination notice from your MA plan and you do nothing, you will be automatically enrolled in Medicare Part A and Medicare Part B under Original Medicare. What you need to be aware of is that this is not good enough. You must still, on your own, go out and purchase a separate Medigap insurance policy that will cover all or part of the 20% of Part B expenses that Medicare does not pay for enrollees in Original Medicare. I also want you to purchase a Part D prescription drug plan.

What type of Medicare coverage is right for you is a personal choice. I appreciate that the upfront premium costs of Medigap and Part D Drug coverage are an extra expense today if you choose Original Medicare.

I just want to make sure that those of you who can afford the premium cost of a Medigap policy and a Part D prescription drug policy know that you have this underwriting window if your MA plan has been terminated: you can get the coverage without any concern about preexisting conditions. (And a special note if you live in Connecticut, Massachusetts, New York, or Maine: You can always purchase a Medigap policy with no medical underwriting. If you have MA and live in one of those states, and are happy with the coverage, you can stick with it. Or if it’s been terminated, you can enroll in a new MA plan. Because if you ever become dissatisfied with the MA plan, your state will allow you to switch to Original Medicare and buy Medigap insurance regardless of a preexisting condition.)