Time is running out to pick your new plan. Expect fewer bells and whistles, says expert
By Deborah Jeanne Sergeant
Medicare health plans have a few changes for 2026. For one, your plan may no longer be available at all.
Many local carriers have eliminated plans, which means enrollees lose their coverage except for basic Medicare on Dec. 31.
To prevent this from happening, those whose plans end in 2025 will need to select a new plan by Dec. 7. Only if the carrier’s plan continues in 2026 will it automatically continue the next year.
“If you miss the Dec. 7 deadline there is another enrollment period, January, February and March of 2026 but, you have to already be enrolled in a Medicare Advantage plan to be able to change to another Medicare Advantage plan,” said Theresa Cangemi, independent agent, certified senior adviser, Medicare insurance specialist licensed in New York and Florida and founder of Retirement Health Plans Made Simple in Brewerton.
“If your Medicare Advantage plan is ending Dec. 31, you will have an extension to change your insurance plan until Dec. 31 for effective date of Jan. 1, 2026.”
Cangemi said that among the changes in store for 2026, Aetna Medicare Premier (PPO) will now be called Aetna Medicare Signature (PPO) H5521 077.
Another name change is the current Aetna Medicare Value (HMO-POS), which will be known as Aetna Medicare Signature (HMO) H3312 048.
There’s also Aetna Medicare Discover Value (PPO), which will be known as the Aetna Medicare Premier (PPO) H5521 340 and the Aetna Medicare Premier (PPO), which will be called the Aetna Medicare Enhanced (PPO) H5521 520.
Cangemi also advised that “Excellus [BlueCross BlueShield] says that if you want dental for 2026, it requires a new enrollment application.”
Because of cutbacks, many insurance companies are changing their formularies, meaning that some drugs previously covered may not be covered at the same level as in 2025.
Some subscribers may need to select a plan that covers their most expensive prescription and paying for their less expensive medication out of pocket. As another option, patients can discuss their medication with their prescribing providers to determine if they have unnecessary polypharmacy—taking medication they no longer need—and considering changing medication to one that is covered by their new insurance plan.
People who “snowbird” in the South for the winter should obtain coverage based upon where they live for at least six months and a day annually.
Working with an insurance broker specializing in Medicare can simplify the selection process. Their services are free to consumers and brokers are paid the same amount of money regardless of which plan you select. Check with the broker about whether the new plan will include:
• Coverage for all of your prescriptions. Know your medications’ names and doses before calling.
• Your primary care provider, dentist, eye doctor and any other specialists. Provide their names and contact details.
• Any special things you want such as gym membership.
Don’t anticipate as many bells and whistles; many insurers are trying to reduce coverage for extras like over-the-counter benefits and restoratives benefits.