What Happens If You Don't Change Your Medicare Plan?

If you take no action during Medicare's Annual Open Enrollment Period, your current Medicare Advantage or Part D plan typically renews. It will renew with its updated benefits and costs for the upcoming year, 2027. Always review your Annual Notice of Change to understand these updates.

Key takeaways

• Your current Medicare Advantage or Part D plan generally renews automatically if you do not choose a new one.
• Plans frequently change their benefits, costs, and network of providers each year.
• Always review your Annual Notice of Change (ANOC) letter to see all upcoming changes to your plan.
• Medicare's Annual Open Enrollment Period is the primary time to compare and switch plans.
• Missing these reviews can mean higher costs or lost benefits starting January 1.

What Happens if You Don't Act During Open Enrollment?

If you have a Medicare Advantage plan or a Medicare Part D prescription drug plan, your coverage usually renews automatically. This happens if you do not actively choose a new plan during the Annual Open Enrollment Period (AEP). This crucial period runs from October 15 through December 7 each year. For a deeper understanding of what you can change during this time, explore Medicare Annual Enrollment Period 2027: Your Choices for Next Year.

For those with Original Medicare (Medicare Part A and Part B) only, there is no automatic renewal of your core benefits. Original Medicare remains the same. However, you still have the opportunity to join a Part D plan or switch Part D plans during the AEP. Making an informed decision during this time is important. Many people let their plans auto-renew, but it is important to consider if that is the ideal choice for your evolving needs.

If you do not choose a new plan, your existing Medicare Advantage or Part D coverage simply continues into the new year. It will start on January 1 with all its updated terms. This means you accept any changes your plan has made for the coming year. You commit to that plan for the upcoming year unless you qualify for a Special Enrollment Period.

Why Does Your Current Plan Change for 2027?

Each year, Medicare Advantage and Part D plans reassess their offerings. This is a common practice to keep up with healthcare costs and beneficiary needs. They negotiate with providers and drug manufacturers, which can lead to adjustments in benefits or costs. Medicare requires plans to notify members of these changes every year.

These annual changes are outlined in a very important letter called the Annual Notice of Change, or ANOC. Your plan is required to send you this letter by September 30 each year. It is your official guide to what will be different about your plan in 2027.

The ANOC details all the updates for the upcoming plan year, 2027. These changes might include your monthly premium, annual deductibles, and copayments. They also cover your prescription drug formulary (the list of covered drugs) and the network of doctors and hospitals. Even supplemental benefits, like dental, vision, or gym memberships, can change. The ANOC provides a summary of these critical adjustments.

Why Review Your Annual Notice of Change (ANOC)?

Reviewing your ANOC is vital because making no choice is still making a choice. You are choosing to accept your plan's new terms for 2027. Even small changes can impact your out-of-pocket costs or access to your preferred doctors and medications. For example, your current plan's formulary (list of covered drugs) can change. It might remove a prescription drug you take or move it to a higher cost-sharing tier. This means you could pay more for that drug, or have to find a new one, as individual plan formularies and cost-sharing tiers vary.

Another common change is to the provider network. A doctor you see regularly might leave your plan's network, or a hospital might no longer be covered. If you do not check, you could face higher costs for those visits or need to find new healthcare providers. Ignoring your ANOC could lead to unexpected expenses starting January 1.

Your health needs might also change. A plan that worked well for you in 2026 might not be the ideal choice if your medical conditions or prescriptions have shifted. During the Annual Open Enrollment Period (October 15 – December 7), you have a chance to compare your current plan's updated benefits against all other plans available in your area. This comparison is vital to ensure your coverage remains well-suited to your needs. Our guide on Your Medicare ANOC for 2027: What Changes to Look For can help you understand this letter thoroughly.

How Do Prescription Drug Costs Change for 2027?

Medicare Part D plans update their formularies, drug tiers, and costs annually. This means a drug that was inexpensive in 2026 could cost more in 2027. Some drugs might even be removed from the plan's covered list. Formularies categorize drugs into different tiers, with lower tiers typically having lower copayments.

A plan's formulary is organized into different tiers. Each tier typically has a different cost-sharing level, with generic drugs often in lower tiers and brand-name or specialty drugs in higher tiers. A drug moving tiers means a change in how much you pay each time you fill that prescription. For example, a drug moving from Tier 2 (preferred brand) to Tier 4 (non-preferred brand) could significantly increase your out-of-pocket expense. Remember that drug tiers and their associated costs vary by plan and location.

The Medicare program sets a maximum deductible for Part D plans. For 2027, this maximum is $700. While individual plans might offer a lower deductible, or even none at all, they cannot exceed this program-set limit.

Under the Medicare program rules for 2027, once your total out-of-pocket spending for covered drugs reaches $2,400, your Part D plan must cover 100% of your covered drug costs for the rest of the calendar year. This protection is a program-wide rule, not a specific plan benefit claim, ensuring all plans offer this coverage once the cap is met. The "donut hole," or coverage gap, has been eliminated. This means you move directly from initial coverage to the out-of-pocket cap without a separate coverage gap phase.

If you face high drug costs, the Medicare Prescription Payment Plan (MPPP) can help manage them. This program allows you to spread out-of-pocket drug costs over monthly bills for the remaining months of the calendar year. You can join if a single prescription is likely to cost $600 or more out of pocket in a month, as indicated by a pharmacy or your plan. Every Medicare drug plan (both stand-alone Part D plans and Medicare Advantage plans with drug coverage) must offer it. When you join, you pay $0 at the pharmacy counter for these costs. The plan then bills you in monthly installments. It does not lower your total drug costs, but it changes when you pay them.

What If Your Doctors or Hospitals Leave Your Plan?

Medicare Advantage plans have specific networks of doctors, hospitals, and other providers. These networks can change each year. A doctor who was in-network in 2026 might be out-of-network in 2027. This could mean significantly higher costs for your visits, or even no coverage at all, depending on your plan type. For example, HMO (Health Maintenance Organization) plans are typically structured to cover care from providers within their network, usually with exceptions only for emergencies. PPO (Preferred Provider Organization) plans often provide coverage for out-of-network care, though usually at a higher cost. The specific benefits, rules, and costs for out-of-network care always vary by plan and location. HMO, PPO, PFFS, MSA: How Each Medicare Advantage Plan Type Works explains the differences between these plan types.

It is important to check if your preferred doctors, specialists, and hospitals will still be part of your plan's network in 2027. You can usually find this information in your ANOC, often in a section detailing network changes. Confirming provider participation is a crucial step. You can do this by using your plan's online provider search tool, or by calling your doctor's office directly to ask if they will continue to accept your specific plan in the upcoming year. Your plan’s customer service line can also assist you with network verification.

Please note that these are general characteristics. Specific rules and costs for in-network and out-of-network care vary by plan and location. If you continue with your plan and find your doctor is no longer in network, you might need to change doctors. If you visit an out-of-network provider, you could be responsible for a greater share of the cost, even the full bill. These details depend on your specific plan's rules and whether it's an emergency, as specific benefits and costs vary by plan and location.

What If Your Plan Leaves Medicare?

In some situations, a Medicare Advantage or Part D plan might decide to leave Medicare. The plan might also stop serving your geographic area. This is a significant event and is different from the usual annual changes outlined in an ANOC. If this happens, your plan will send you a specific non-renewal notice. This is also called a termination notice or a service-area reduction notice. This notice tells you that your plan will no longer be available in your area starting January 1.

This type of notice opens a Special Enrollment Period (SEP) for you. This SEP runs from December 8 through the last day of February of the next year. It gives you extra time to choose a new Medicare plan. If you have a Medicare Advantage plan that leaves Medicare or your area, and you do nothing during this SEP, you will be moved to Original Medicare (Part A and Part B) on January 1. If your ending plan included drug coverage (either a stand-alone Part D plan or a Medicare Advantage plan with drug coverage), that drug coverage will end. To avoid a gap in your prescription drug coverage, you must join a new plan with drug coverage by December 31.

This specific situation also grants you a guaranteed issue right for certain Medigap policies. If you switch to Original Medicare, you can buy a Medigap policy without medical underwriting. This means an insurer cannot refuse to sell you a policy, charge you more due to health problems, or make you wait for coverage for pre-existing conditions. This guaranteed issue right ensures you can obtain a Medigap policy to supplement Original Medicare, providing a stable option for coverage. This right is available from the date you receive the non-renewal notice until 63 days after your plan coverage officially ends. The federal right covers Medigap Plans A, B, D, and G. If you were eligible for Medicare before January 1, 2020, Plans C and F are also included. This is a special protection, distinct from the one-time 6-month Medigap Open Enrollment Period you have when you first turn 65 and enroll in Part B. For more details on this important period, see Your One-Time Medigap Open Enrollment: Why This 6-Month Window Matters.

Consequences of Not Reviewing and Deciding

Choosing to do nothing during Open Enrollment means you automatically accept whatever changes your current plan makes for 2027. This can lead to several unwelcome surprises that impact your finances and your healthcare access. You might face higher monthly premiums for your plan or increased deductibles for your medical or drug costs. For instance, the 2027 maximum Part D deductible is $700. If your plan increases its deductible to this amount and you do not realize it, your initial drug costs at the start of the year will be higher than expected.

Your favorite doctors might no longer be in your plan's network, forcing you to pay more out-of-pocket or to find new providers. Key prescription drugs might no longer be covered at all, or they could move to a much higher cost-sharing tier. For example, if you had a 14-month gap in creditable drug coverage after your Initial Enrollment Period, and the 2027 national base beneficiary premium is $41.33, your Part D late enrollment penalty would be 14% of $41.33, which is about $5.79. This is rounded to $5.80 and added to your monthly Part D premium for as long as you have Part D coverage. This penalty is permanent, showing the lasting impact of enrollment choices. You can learn more about avoiding this penalty in Medicare Part D: Avoiding Late Enrollment Penalties.

Additionally, you could miss out on new or improved benefits offered by other plans available in your area. These could include better dental, vision, or hearing coverage, or plans with lower overall out-of-pocket limits. Some plans might offer new features like gym memberships or transportation benefits that could work well for you. The decision to renew or change your plan is a personal one. It should always be based on your specific health needs, financial budget, and personal preferences for your healthcare.

Have questions? Call 1-877-443-3251 to talk it through with a licensed insurance agent. You never pay the agent; the plans they represent do, and the decision stays yours.

We do not offer every plan available in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. Medicare has neither reviewed nor endorsed this information.