If your Medicare Advantage Plan or Medicare drug plan isn’t renewing, you’re not losing Medicare. You can pick a new plan during the Annual Enrollment Period (Oct 15 – Dec 7) or a Special Enrollment Period that runs through the end of February. If you’re in an Advantage plan and do nothing, you’re moved to Original Medicare, which doesn’t include drug coverage, and you may have a guaranteed right to buy a Medigap policy.
Sourced from Medicare.gov’s Special Enrollment Periods page, the Medicare & You handbook (CMS Pub. No. 10050), Medicare’s Choosing a Medigap Policy guide, and 42 CFR 422.506.
- A plan leaving Medicare doesn't end your Medicare. It ends that plan, and you choose what replaces it.
- Choosing during the Annual Enrollment Period (by Dec 7) lets new coverage start January 1. A Special Enrollment Period runs from Dec 8 through the last day of February, but waiting can leave a gap.
- Doing nothing in an Advantage plan means Original Medicare. Drug coverage needs a separate plan, which Medicare arranges for affected members who get Extra Help.
- If you move to Original Medicare, you may have a time-limited guaranteed right to buy certain Medigap policies. Keep the plan's letter and its envelope.
What the letter means
The Medicare & You handbook puts it plainly: each year, Medicare Advantage Plans can choose to leave Medicare or change their coverage, costs and service area. If a plan stops participating, “you’ll have to join another Medicare Advantage Plan or return to Original Medicare.”
Federal rules require an Advantage plan that isn’t renewing to tell its members by mail at least 90 days before the nonrenewal takes effect (42 CFR 422.506). For a plan ending December 31, Medicare.gov says that Plan Non-Renewal Notice generally arrives in October, which puts it right at the start of the Annual Enrollment Period (AEP).
A quick scope note: this post is about the plan leaving. If your plan is simply changing for next year, you’ll get an Annual Notice of Change instead, which is a different letter covered in what to review before AEP closes. If you’re the one moving, or a plan contract ends in the middle of the year, different windows apply.
Why a plan can leave one county and not the next
This is where the Charlotte area makes things less obvious. A Medicare Advantage Plan’s service area is set county by county, so a plan can stop serving Mecklenburg while it’s still offered in a neighboring county, or the reverse. Standalone Part D drug plans work differently: their service areas are set by larger regions, not by county.
So when a neighbor in another county says their plan isn’t going anywhere, that tells you nothing about yours. Go by your own letter.
What happens on January 1 if you do nothing
| If you’re in… | And you don’t choose anything | What to watch |
|---|---|---|
| A Medicare Advantage Plan that includes drug coverage | You’re enrolled in Original Medicare (Parts A and B) | Original Medicare doesn’t come with a drug plan. Join a separate one, or if you get Extra Help, Medicare will enroll you unless you choose replacement coverage yourself. |
| A Medicare Advantage Plan without drug coverage | You’re enrolled in Original Medicare | Consider whether you want a drug plan and supplemental coverage. |
| A standalone Medicare drug plan | You have no Medicare drug coverage for the new year | If you get Extra Help, Medicare reassigns you to a new drug plan unless you choose one yourself. |
Medicare follows up in January too, with a CMS Non-Renewal Action Notice reminding affected people who still need Medicare drug coverage to join a plan.
The windows you have to choose
People with Medicare can make changes during the AEP, and a change made by December 7 takes effect January 1, with no gap. For year-end nonrenewal or a service-area reduction, CMS’s enrollment guidance gives a Special Enrollment Period from December 8 through the last day of February, with coverage starting the first day of the month after the new plan gets your request. A December request still starts January 1; a January request starts February 1, and a February request March 1. Any stretch without Part D or other creditable drug coverage counts toward the 63-day penalty threshold.
Your Medigap rights if you move to Original Medicare
If you choose Original Medicare, you may also want a Medicare Supplement (Medigap) policy to help with the costs Original Medicare leaves to you. Outside your one-time Medigap Open Enrollment Period, insurers can generally use medical underwriting. A plan leaving Medicare, or stopping care in your area, is one of the situations where federal law says they can’t.
According to Medicare’s Choosing a Medigap Policy guide, if your Advantage plan is leaving Medicare or stops giving care in your area (or in a few other situations, including a significant change to the plan’s network), you have the right to buy certain Medigap policies sold in your state. Which ones depends on when you first became eligible for Medicare — people new to Medicare on or after January 1, 2020 get different choices from those eligible before it — and North Carolina can add rights of its own, so confirm your choices with SHIIP or the insurer before you apply. Inside that right, the insurer must sell you the policy, must cover pre-existing conditions, and can’t charge more because of your health.
Three conditions come with it:
- It only applies if you go to Original Medicare, rather than joining another Advantage plan.
- It has a deadline. For an involuntary loss like this, you can apply as soon as you receive the termination notice, and no later than 63 days after your Advantage coverage ends. The Medigap policy can’t start until the Advantage coverage ends.
- Your state may add more. The guide notes you may have additional rights under state law. In North Carolina, the Department of Insurance is the place to check.
If you join another Advantage plan instead and later decide you want Medigap, the protection you had in this window generally doesn’t carry forward. In many situations there’s no guaranteed right to buy a Medigap policy at that point, and medical underwriting can apply. Medicare Advantage vs. Medigap walks through that choice itself.
Where to go from here
Picture someone who opens that letter in mid-October, sets it aside for the holidays, and comes back to it in late January. They still have options, but they may have gone weeks without drug coverage, and their Medigap window is already partly used up. Nothing about the situation was complicated. The dates just kept moving while the letter sat in a drawer.
If you’ve received a non-renewal letter, or you’re not sure whether the letter you got is one, I’m glad to walk through what it says and what your choices are. I work with multiple carriers, and you can see more about how I help with Medicare or book a time to talk whenever it suits you.
