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Question: I got notification that my Prescription Drug Plan coverage will no longer be offered in 2027. What should I do now?
Answer: It sounds like you have Original Medicare, a Medicare Supplement Plan (Medigap) and a stand-alone Prescription Drug plan (PDP).
Let's review some of the changes that are happening to the PDP's in 2027.
In 2026 there are ten (10) Stand Alone Prescription Drug Plans (PDP). In 2027 one (1) of those plans is being discontinued. The PDP plan that is no longer available is HealthSpring Extra. The premium for that plan was over $90 a month and it was not very popular, so this may not impact many individuals, but it does certainly impact you!
Individuals who are currently enrolled in this plan for 2026 have additional time to find and enroll in a new plan, from October 15 to February 28, 2027. Enrolling in a new plan during the Annual Enrollment Period, (AEP) would mean your coverage begins 1-1-27. Enrolling into your new plan between December 8 and December 31, also means your new coverage would begin 1-1-27. If you wait until after 1-1-27, you will not have prescription drug coverage for January and potentially February 2027. There wouldn't be a penalty, but you would be without drug coverage for that period of time.
Most of the 9 remaining plans have increased their premiums. Some of these increases are significant monthly increases to their premiums, with the highest premium on a PDP plan going up to $238.30. One very popular plan lowered the monthly premium, Wellcare Value Script is currently $42.40 and it goes down to $37.30 in 2027. The other plan that lowered the premium is Wellcare Classic, in 2026 this plan cost $45.70 and in 2027 this plan costs $40.30.
The PDP changes each year can be in the form of the monthly premiums, the way your medications are placed in tiers, what those tiers cost, and the pharmacy network. If you take very little medication or no medication, it may be hard to pay these higher premiums, but maybe you have that Wellcare Value Script which is going to cost less.
The information on the new 2027 plans are available via the medicare.gov website, as well as 1-800-MEDICARE. These are both available 24 hours a day, seven days a week now. You have the opportunity to change your coverage choice between October 15 and December 7. So, anytime is the perfect time.
There are agencies and programs available locally to help you find new insurance such as, Office For the Aging (716-753-4582), Southwestern Independent Living Center (716-661-3070). Insurance companies also have staff available (Brokers and Insurance Agents) to help you make your decisions. Remember that a broker can ONLY talk about the products they offer (that they sell).
In reviewing the minimum standard plan for 2027, it is important to remember, your plan’s coverage can be different (better or not as good). The minimum coverage allows for a $700 deductible. Next is the initial coverage stage. The initial coverage period ends when you have spent $2400 in medication copays. At $2,400 in medication copays, you enter the catastrophic coverage, and during this phase your copays for all your medications will be $0 for the rest of the year. Most individuals do not take enough medication to spend the $2,400 to reach the catastrophic coverage.
If your plan is no longer available in 2027 you must evaluate the alternatives and enroll in something new to begin Jan. 1, 2027. For most of you, your current Prescription Drug coverage is available in 2027, but it is definitely worth evaluating. I have counseled many people who are paying too much for their coverage or who stay with a plan that doesn't cover their medications adequately.
If your plan is no longer available you actually have some extra time to make your new choice, but if you wait and make a choice after Jan 1, 2027 your coverage will be delayed to the first of the following month.
You know I never recommend waiting! Good luck and Happy Insurance Season to you!
Janell Sluga is a Geriatric Care Manager helping seniors in our community access services and insurance. To reach her, please email editorial@post-journal.com.