2.6 Million Medicare Retirees Have Less Than 1 Week to Protect Their Prescription Drug Coverage

Health insurance coverage is critical for seniors. Some people get their coverage through traditional Medicare, but others opt for a Medicare Advantage plan instead. Although preapproval may be required, and patients may need to see in-network providers, Advantage plans often provide broader coverage for more services than traditional Medicare.

Seniors who choose a Medicare Advantage prescription drug plan (MAPD plan), for example, can get their medical care and prescription drug coverage through that plan. This can be a convenient option. However, it can also be a problem when the MAPD plan that a retiree is enrolled in ends up being discontinued.

Unfortunately, this is happening to around 2.6 million people in 2026, according to a report from the Kaiser Family Foundation. Those 2.6 million retirees could face a big problem if they don’t act quickly to protect their Medicare coverage.

Image source: Getty Images.

Medicare retirees have limited time to act

When your Medicare Advantage plan is discontinued, you should get a notice from the plan provider. At that point, you can pick another Medicare Advantage plan and, if you don’t do that, you’ll be enrolled automatically in traditional Medicare.

Unfortunately, if you’re enrolled in traditional Medicare by default (or because you decide to switch), you still have a choice you have to make: You need to pick and sign up for a Medicare Part D prescription drug plan. If you don’t do that, you’ll be left without prescription drug coverage since Medicare Parts A and D don’t cover drugs. And if you go more than 63 days without qualifying drug coverage, you’ll face permanent penalties in the form of higher Part D premiums if you sign up later.

The problem is, your time is running out to take action. The Medicare open enrollment period for the year is over, but if you received a notification saying your current Advantage Plan ended, you can qualify for a special enrollment period – but only through Feb. 28.

If you end up back on Medicare because of your Medicare Advantage plan being discontinued, you’ll also want to look into a Medigap policy, as these policies can help you cover out-of-pocket costs that Medicare doesn’t cover, including coinsurance costs. You’ll typically need to sign up for this within 63 days of your Advantage Plan being discontinued to avoid having to go through medical underwriting and potentially pay higher premiums.

If your plan is ending, you need to be aware of the strict timelines and deadlines and act quickly to explore your options before time runs out. Since you don’t want to end up spending money out of your retirement plans just to pay for medication because you didn’t make the right moves when your Advantage coverage ended, it’s worth looking into your Medicare coverage choices ASAP before your options disappear.