Question: I just received correspondence from my insurance company informing me my 2025 insurance is discontinuing and won’t be offered in 2026. What should I do?

Answer: Happy Insurance Season! It is the end of September and your plan is required to inform you about all of its changes for 2026. We have been talking all year about how 2025 changes to prescription drug coverage have impacted seniors and saved them so much more money on their medications. That means that insurance companies covering you have had to pay more. Such a change usually means we will be seeing some significant changes down the line – not only in the coverage offered, but in plans being discontinued. There will also be significant premium increases for many products.

Now what do we do with all that general information?

The answer to your question is, “It Depends!”

When your plan has been discontinued, you are given additional time to make your insurance decision for 2026. So, in addition to the normal Annual Enrollment Period from October 15 to December 7, you will have until Dec. 31 to enroll into a plan for January 1 with no gap in coverage. You also have the additional months of January and February to enroll in a new plan, but during these months you will have a gap in coverage of at least a month or up to two months. During such a coverage gap, you have only original Medicare, no drug coverage, because your plan will terminate as of January 1.

I have started to hear from a number of people that have received their Annual Notice of Change (ANOC) from their insurance company. This is a required notification that an insurance company must send to every individual to describe the insurance coverage changes in the upcoming year. Medicare Part D Prescription Drug Plans (PDP’s) and Medicare Advantage Plans (MA) are required to deliver that ANOC letter to you before September 30, 2025. Some insurance companies mail them out weeks before that.

Some insurance companies stick right to that September 30 required date.

In a situation like yours, the plan you have is not being offered in 2026, so you didn’t get an ANOC because there won’t be coverage offered to you for 2026. Instead, your notification informs you of that discontinued plan and advises you to look into alternative coverage by the end of year.

For those individuals whose plan is still offered, the ANOC packet includes information regarding current coverage (2025) and then next year’s coverage (2026). The ANOC must illustrate every change in coverage both price increases and price decreases. It also lists all of the items that don’t change.

When these packets arrive, I begin to hear from clients letting me know what they say and asking questions about what to do.

In 2026, many of the plans have a prescription drug deductible, which can be no more than $615. After meeting this deductible, you enter the Initial Coverage phase where your medications are divided into Tiers, and you pay the copay based on the Tier of your medication. In 2026, as you pay copays, they accumulate towards the maximum out of pocket which is $2100 in 2026. Once you have paid that $2100 amount your copays move to $0 for all covered medication for the remainder of the year.

Remember that each Insurance Plan classifies medications into “tiers.” The medications you take may be the same, but the Tier they are assigned to can change year-to-year. This will affect the price you pay for the medication: usually the higher to tier, the higher the copay. So review the ANOC packet to see if the medications you take have changed tiers.

If you have a Medicare Advantage Plan, your insurance will mail you an ANOC, but it will include much more information. It will cover the monthly premium for the plan, the Part D prescription drug benefit, AND the Health Insurance co-pay structures. So, there are a lot more changes that can be made to the plan. Your Medicare Advantage Plan may change the premium, as well as the amount you pay for doctor visits and for medical procedures. The Prescription Drug Benefit will also change.

It is important for you to begin researching your alternatives. If your plan has been terminated, any plan you enroll into from October 15 to December 31 will begin January 1 as I mentioned before. Take the extra time to evaluate your options. Meet with someone who understands the options and evaluates your needs fully.

Now you see why I get so excited about the October 1 information! There is so much new and exciting information to review!

For those of you that received the ANOC letter and packet of information you have a lot of useful information you should review. After reviewing the changes to your plan, you can make your decision to keep your plan or make a switch. If you want to change your insurance, you have that October 15 to December 7 timeframe to make that change.

If you decide to keep the plan you currently have you don’t have to do anything, it will just continue to cover you in the 2026 calendar year.

Happy Insurance Season!! It is definitely here!

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.