Inside Medicare | Do I have to change my insurance and if so, when?

Janell Sluga Medicare & Individual Health Insurance Account Executive View Bio

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Question:

When can I change my insurance? I think I looked at it this time last year. Do I have to change my insurance?

Answer:

Happy Insurance Season! I LOVE The Annual Open Enrollment Period, which is open from October 15^th until December 7^th. This period is the time of year you’re asking about: when you have your opportunity to evaluate your insurance options and switch to a plan that works better for you if you want to.

With AEP approaching, curiosity about the coming year’s plans and plan changes is at a peak right now! Unfortunately, you are a little early to get your Medicare plan information for 2026. The information is generally mailed to you by October 1^st, but there are carriers who send the information earlier in September. I LOVE getting a little bit of information early! So to all my clients out there who sent me and have told me about their plan changes, THANK YOU!

Because plan info gets sent out a few days before the actual AEP starts, you have some time to consider your options before changing, and insurance companies have time to send you anything you need in a new plan after AEP.

So what can you do during AEP? You can add prescription drug coverage, you may change the company you get your prescription drug coverage from, or the way you get your prescription drug coverage. If you aren’t currently in a prescription drug plan, this is the period where you can join for the first time. If you are already in a prescription drug plan, you can switch to an alternate plan. Whatever change you make during this year’s AEP, will take effect the first of the new year, January 1^st, 2026.

This is significant because most individuals MUST make a decision by the end of AEP, December 7^th, 2025. If you miss this deadline, you will NOT be able to change your insurance. You must research your decision and complete the enrollment prior to December 7^th.

Again, each of the companies will announce their insurance products beginning October 1^st. I’m sure you’ve already received some mail from insurance companies. The most important information to watch for is from your current insurance company, and it’s call the Annual Notice of Change. You should review this material and decide whether the changes to the plan still meet your needs. The other mailings you receive you can certainly review to see if they are of interest to you. If review this material regarding changes to your plans and you decide to stay with the plan you have, you don’t need to do anything – the plan you currently have will roll over into 2026.

If you are interested in switching insurance products, you can research the options as of October 1^st, and then you have to decide (enroll) between October 15^th and December 7^th, so the plan can begin on January 1^st, 2026.

In summary, this date for the Annual Enrollment Period gives us 54 days to make our changes. This will allow everyone to get their new insurance cards prior to the start date of the insurance. The plan changes are announced on October 1^st, so you have 14 days to do your research before the enrollment period begins, as well the remaining 54 days of AEP. Just don’t wait too long to make your enrollment decision.

There are some individuals who will be informed that their plan is no longer being offered. We saw this happen to a large number of individuals last year. When your plan is no longer being offered, you must make a NEW enrollment decision. In this situation you are given extra time to make that choice.

If your plan is no longer being offered, you actually have from October 15^th until February 28^th, 2026 to enroll into a new plan. Now, I do NOT recommend waiting until after January 1 to make that choice, as you will have a month without coverage. But you CAN use the remainder of December to enroll in a plan and still have it begin January 1^st – think of this as an extension to your normal AEP December 7 deadline, to help you with the loss of your plan for the new year. Again if your plan is NOT being discontinued, plan changes still need to be made by December 7^th.

To restate, if you find your plans HAS been discontinued, you have from October 15^th to December 31^st to enroll into a new plan and still have your coverage begin January 1^st. If you enroll into the new plan during January, your coverage will begin February 1^st, and if you enroll in February, your new coverage will begin March 1^st.

This is a good time to watch the mail, and to call to make your appointment with your insurance representative, if you have one. This is also a good time to take stock of your current coverage: were you happy? Did you use it to its greatest potential? Do you want the same type of coverage next year?