Medicare Plan Renewal: Details on Timing, Regulations, and Exceptions
In most cases, Medicare Advantage (MA) plans automatically renew each year, but there are instances when this may not happen. It's essential to understand the circumstances that could lead to a non-renewal and the steps you need to take to ensure continuous healthcare coverage.
**Automatic Renewal** Generally, Medicare Advantage plans automatically renew each year, provided the plan remains available and you do not take any action to change or drop your coverage. You do not need to actively renew your plan unless you wish to make a change during the annual enrollment period.
**When a Plan Might Not Renew Automatically** The primary reason a Medicare Advantage plan would not renew automatically is if the plan is discontinued or if the private insurer’s contract with Medicare ends. Other reasons could include the plan being restructured or your eligibility status changing (such as moving out of the plan’s service area).
**What You Must Do** If your Medicare Advantage plan is not renewing automatically, you need to take action. You will be notified by your plan provider when this occurs. Here’s what happens next:
- **Choose a New Plan:** You can select a new Medicare Advantage plan, switch to Original Medicare (Part A and Part B), or enroll in a Part D prescription drug plan if needed. - **Deadlines:** You typically have a limited window (often called a Special Enrollment Period) to make a change without penalty if your plan is ending. This is to avoid a gap in coverage. - **Notification:** You will receive a notice from your plan or Medicare explaining why your plan is ending and the steps you need to take to select new coverage. - **No Action Required if Switching to Original Medicare:** If you do nothing, you will be automatically enrolled in Original Medicare (Part A and Part B) to avoid a gap in coverage, but you will need to choose a new Part D plan if you want prescription coverage.
**Annual Review Is Recommended** Even if your plan renews automatically, experts recommend reviewing your coverage every year during the Annual Enrollment Period (October 15–December 7). Medicare plans can change their premiums, benefits, and provider networks annually, so checking ensures your plan still meets your needs. If you are happy with your coverage, no action is required.
**Key Points**
- Most Medicare Advantage plans renew automatically unless discontinued by the insurer or if you change your coverage. - If your plan does not renew, Medicare or your plan provider will notify you, and you must select a new plan; if you do nothing, you’ll be enrolled in Original Medicare. - Review your coverage each year during the Annual Enrollment Period, even if your plan renews automatically. - Special Enrollment Periods are available if you lose coverage due to plan discontinuation, allowing you to enroll in a new plan without penalty.
For the most accurate and current information, contact your plan provider or Medicare directly if you are unsure about the status of your plan. Late enrollment penalties vary by Medicare part, but they may include penalties for Part A, Part B, Part D, and Medicare Advantage enrollment.
- If the Medicare Advantage plan you are enrolled in is discontinued or if the private insurer's contract with Medicare ends, it may not renew automatically.
- In the event that your Medicare Advantage plan does not renew automatically, you need to choose a new plan, switch to Original Medicare, or enroll in a Part D prescription drug plan, if necessary.
- During the Special Enrollment Period, you can make a change to your coverage without penalty if your plan is ending to avoid a gap in healthcare coverage.
- Experts recommend reviewing your Medicare coverage annually, even if it renews automatically, during the Annual Enrollment Period (October 15–December 7), to ensure it still meets your needs.
