I'll be honest about which piece of Medicare mail worries me most this fall, and it's not the one about premiums. It's the short one. The one that says the plan your mother has been on for years won't exist on January 1. There's no copay to compare and no new deductible to grumble about. The plan is leaving her county, the letter hands her a phone number, and the rest is up to her. Which, if she's 81 and you live two hours away, means the rest is up to you.
Here's the part that bothers me. If nobody does anything, Medicare doesn't leave her uninsured. It quietly moves her to Original Medicare, and Original Medicare on its own has no drug coverage and no yearly limit on what she pays out of pocket. She won't get a warning call. She'll find out at the pharmacy counter in January, or when the first bill from the cardiologist shows up with a number on it she's never seen before.
I spent eight years on the other side of the table, buying houses from families in the middle of a transition. The expensive mistakes almost never happened because somebody chose badly. They happened because a letter sat under the grocery flyers until the deadline passed. The Medicare letter and the house are the same problem in different clothes. Both get decided by whoever opens the mail.
So this post is about that one letter: what it's called, why so many families are getting it this year, what happens if you let it ride, and the one right it gives your parent that the letter itself doesn't bother to explain. You've got until December 7 for the main decision. You've got a little longer for the one most people miss.
Why So Many Families Are Getting This Letter for 2027
Medicare.gov calls it the Plan Non-Renewal Notice. Your parent's plan sends it in October, and Medicare.gov describes it plainly: "You'll get this notice if your plan is leaving the Medicare program in the coming year. You must look for a new plan for coverage next year." That's the whole instruction. Look for a new plan.
The reason more of these letters went out this fall comes from the plan data the Centers for Medicare and Medicaid Services publishes every year before open enrollment. KFF, the health policy research group, published its county-by-county read of that CMS data on October 9, 2026. Its findings for 2027:
- In 193 counties, home to about 638,000 people on Medicare, there's no Medicare Advantage plan with drug coverage open to the general public at all. In 2026 that was 123 counties and about 399,000 people.
- The share of beneficiaries with more than 40 Medicare Advantage drug plans to choose from fell to 20 percent, down from 27 percent in 2026.
- The biggest pullbacks by county count, per KFF: Health Care Service Corporation left 498 counties and entered none; Centene left 359; UnitedHealth Group left 228; CVS Health left 186; Blue Cross Blue Shield of Michigan left 177; Elevance left 66; Humana left 62. Two companies, Group 1001 (Clear Spring Health) and Molina, left the general Medicare Advantage drug plan market entirely, though KFF notes Molina still offers Special Needs Plans in many counties.
CMS, for its part, says the program is stable. Its September 28, 2026 release counts about 5,532 Medicare Advantage plans nationally for 2027, down from 5,553, with more than 99 percent of beneficiaries able to get at least one plan and about eight in ten able to stay in their current plan at the same or a lower premium. CMS also projects the average Medicare Advantage premium falling from $14.37 to $12.00 a month.
Both things are true. The national picture is fine. The picture in a specific county, for a specific 81-year-old, can be a letter that says her plan is gone. Averages don't get mailed to anybody.
North Carolina's Insurance Commissioner, Mike Causey, put it this way in his department's October 14, 2026 release: "Many plans have indicated that they intend to have increases, some significantly," and "This is not the year to simply say, 'I'm happy with what I have,' without exploring your options."
What Happens If Your Parent Does Nothing
This is the section I'd read twice if I were you, because the letter doesn't cover it.
Medicare.gov's special enrollment page spells out the fallback in one sentence: "You'll be enrolled in Original Medicare if you don't join another Medicare Advantage Plan before your current plan ends." Original Medicare is Part A and Part B, hospital and doctor coverage. It isn't nothing. But look at what rides along with it, per Medicare.gov's cost page:
- Part B pays its share and your parent pays "usually 20% of the cost for each Medicare-covered service or item" after the deductible, which is $283 in 2026.
- "There's no yearly limit on what you pay out-of-pocket, unless you have supplemental coverage." A Medicare Advantage plan has a yearly cap; Original Medicare alone doesn't.
- Drug coverage doesn't come with it. If your parent's old plan bundled Part D, and most do, landing in Original Medicare by default means no drug plan on January 1.
That last one carries a penalty with a long tail. Medicare.gov says if your parent goes "63 days or more without creditable drug coverage," a late enrollment penalty gets added to the premium of whatever drug plan they join later. The penalty is one percent of the national base beneficiary premium ($38.99 in 2026) for every month without coverage, and Medicare.gov says it "is added for as long as you have Medicare drug coverage, even if you switch plans." A spring of not getting around to it becomes a surcharge for the rest of her life.
The one thing no plan covers
While you're comparing plans, keep one sentence from Medicare.gov in front of you: "Medicare doesn't pay for long-term care." Not Original Medicare, not any Medicare Advantage plan, not a Medigap policy. If the real question in your family is who pays for assisted living or a daily aide, the plan decision doesn't answer it. The house, the savings, and the Social Security check do. The plan decision just keeps the medical bills from eating those three faster.
The 63-Day Right the Letter Doesn't Explain
Here's what I wish every non-renewal letter printed in bold on the first page.
Normally, a Medigap policy (Medicare Supplement insurance, the kind that covers the 20 percent and the gaps in Original Medicare) is only guaranteed during the six months after your parent first gets Part B at 65. After that, Medicare.gov says you "may be denied a Medigap policy or charged more for a Medigap policy due to past or present health problems." An 81-year-old with a heart condition and a cane doesn't usually get a friendly quote.
But a Medicare Advantage plan leaving Medicare, or no longer covering where your parent lives, is one of the specific situations where Medicare.gov says a guaranteed issue right kicks in. In those situations, an insurance company "must sell you a Medigap policy," "must cover all your pre-existing health conditions," and "can't charge you more for a Medigap policy because of past or present health problems." Medicare.gov lists the policies covered by this right as Medigap Plan A, B, C, D, F, G, K, or L sold by an insurer in your state.
The window, per Medicare.gov: you can apply as early as 60 days before the Medicare Advantage coverage ends, and no later than 63 days after it ends. For a plan ending December 31, that means you can start in early November and you're still inside the window into early March.
Three conditions matter:
- The right only applies "if you switch to Original Medicare (rather than joining another Medicare Advantage Plan)." Pick another Advantage plan and this door closes.
- "Medigap coverage can't start until your Medicare Advantage Plan coverage ends." So the policy begins January 1 at the earliest, not the day you apply.
- You'll need proof. Medicare.gov says to "keep any letters, notices, emails or claim denials from your Medicare Advantage Plan" because "you may need to include copies of these documents with your Medigap application." That non-renewal letter is the proof. Don't let it get thrown out with the flyers.
This is the fork in the road, and it's a real one. Original Medicare plus a Medigap policy plus a stand-alone drug plan means three premiums instead of one, and none of the extras some Advantage plans advertise. In exchange, Medicare.gov says your parent "can use any doctor or hospital that takes Medicare, anywhere in the U.S.," in most cases with no referral, and the Medigap policy covers the exposure that Original Medicare alone leaves open. For a parent who may move closer to you next year, that portability is worth a hard look. For a parent who's settled and happy with the local network, another Advantage plan may fit better. Neither answer is wrong. Letting the deadline answer for you is.
The 2027 Drug Numbers You'll See While Comparing
Two figures changed for 2027, both confirmed on Medicare.gov's Part D cost page:
- The most a drug plan can charge as a deductible rises to $700 in 2027, from $615 in 2026. Some plans have no deductible at all.
- The yearly out-of-pocket cap on covered drugs rises to $2,400 in 2027, from $2,100 in 2026. After that, the plan pays.
CMS says the average stand-alone drug plan premium moves from $35.09 to about $36 a month, a change of less than a dollar. CMS also confirmed in its September release that the temporary program that had been cushioning Part D premiums is "planned to be discontinued in 2027," which is one reason to look at the premium on the specific plan rather than the average.
And if your parent's income is modest, check Extra Help. Medicare.gov's 2026 limits are $23,940 in income and $18,090 in resources for a single person, $32,460 and $36,100 for a married couple. Under Extra Help in 2027, Medicare.gov lists the plan premium at $0, the deductible at $0, and no more than $5.80 per generic and $14.40 per brand-name drug. Extra Help also wipes out that late enrollment penalty.
Six Things to Do Before December 7
1. Find the letter and read the first paragraph out loud
Ask your parent for every envelope from the plan since mid-September. You're looking for two documents: the Annual Notice of Change, which every plan sends and which lists what's changing, and the Plan Non-Renewal Notice, which only comes if the plan is going away. If the words "non-renewal" or "will not be offered" are in it, you're in this post's situation, not the ordinary open enrollment one.
2. Write down the three numbers that actually matter
Before you open a comparison tool, get your parent's list of medications with doses, the names of the doctors they won't give up, and the pharmacy they use. Every plan comparison lives or dies on those three things. A plan with a $0 premium that doesn't cover the heart medication is not a $0 plan.
3. Call SHIIP before you call anyone who sells plans
North Carolina's Seniors' Health Insurance Information Program, run by the Department of Insurance, gives free, unbiased counseling to people on Medicare and their caregivers. The number is 1-855-408-1212, weekdays 8 a.m. to 5 p.m. Every state has a version of this program, called SHIP in most places. These counselors don't sell anything. Start there, with the medication list in hand, and ask them to run the comparison with you. Then, if you want, talk to an agent.
4. Decide the fork: another Advantage plan, or Original Medicare plus Medigap
Use the section above. Ask the SHIIP counselor directly: "Her plan is non-renewing. Does she have a guaranteed issue right to a Medigap policy, and what does Plan G cost in her county at her age?" Get the monthly number for both paths on one sheet of paper. If she's likely to move in the next year or two, say so. That changes the answer.
5. Enroll by December 7, and keep every piece of paper
Medicare.gov says the plan "must get your request to join by December 7" for coverage to start January 1. If you choose the Medigap route, apply for the drug plan during open enrollment and the Medigap policy inside the 60-days-before, 63-days-after window, with the non-renewal letter attached. Copies of everything go in one folder. If the family already uses a shared place for documents, this is exactly what it's for.
6. Put a January 15 reminder on your own calendar
Not your parent's. Yours. Call and ask one question: did the first prescription fill go through on the new plan? That one call catches a missed enrollment while it can still be fixed. Medicare.gov gives people whose plan wasn't renewed a special enrollment window from December 8 through the last day of February to switch to another plan, and anyone already in a Medicare Advantage plan can make one change between January 1 and March 31. Those are safety nets, not a plan. The plan is December 7.
Frequently Asked Questions
What happens if my parent's Medicare Advantage plan isn't renewed and they don't pick a new one?
Medicare.gov says: "You'll be enrolled in Original Medicare if you don't join another Medicare Advantage Plan before your current plan ends." Original Medicare has no yearly out-of-pocket limit and no drug coverage on its own, so your parent would start January with no drug plan and the full 20 percent coinsurance on Part B services.
Does a plan leaving give my parent a guaranteed right to buy Medigap?
Yes. Medicare.gov lists a Medicare Advantage plan leaving Medicare, or no longer covering where you live, as a guaranteed issue situation. The insurer must sell the policy, must cover pre-existing conditions, and can't charge more for health problems. You can apply from 60 days before the Advantage coverage ends to 63 days after, and only if your parent switches to Original Medicare rather than another Advantage plan.
When is the deadline to pick a new Medicare plan for 2027?
Medicare Open Enrollment runs October 15 through December 7, 2026, and Medicare.gov says the plan must get the request to join by December 7 for coverage to start January 1, 2027. If a plan's contract wasn't renewed, Medicare.gov also allows a switch between December 8 and the last day of February.
Is there a penalty if my parent goes without drug coverage for a few months?
Yes. Medicare.gov says going 63 days or more without creditable drug coverage triggers a late enrollment penalty of one percent of the national base beneficiary premium ($38.99 in 2026) for each month without coverage, added to the premium for as long as your parent has Medicare drug coverage. People who qualify for Extra Help don't pay it.
What are the 2027 Medicare Part D deductible and out-of-pocket cap?
Per Medicare.gov, no drug plan can charge a deductible above $700 in 2027, up from $615 in 2026, and the yearly out-of-pocket cap on covered drugs rises to $2,400 in 2027, up from $2,100.
About Ryan Riggins
Ryan Riggins is a senior transition advisor and former house flipper. After 8 years buying and flipping homes, many of them from families in transition, he walked away from the cash-buyer side to help families avoid the $50K mistakes he used to profit from. Based in Greensboro, NC. NC Real Estate License #361546, eXp Realty. Founder of Riggins Strategic Solutions and the Hammock365 app.
Want a step-by-step guide? The Senior Transition Blueprint is free, all 20 modules and 69 tools: rigginsstrategicsolutions.com/the-blueprint
Not sure where your family stands? The free Family Readiness Score takes five minutes and shows the gaps across the home, the money, the legal documents, care, and family alignment: rigginsstrategicsolutions.com/tools/family-readiness-score
Need a personalized plan? The Senior Transition Roadmap is free, by application. It adds calls with Ryan and 90 days of email support: rigginsstrategicsolutions.com/the-roadmap
Selling a parent's home? Ryan finds and vets the right local agent for your situation and stays in your corner on the whole sale, at no added cost to your family: rigginsstrategicsolutions.com/in-your-corner
Coordinate the family in one place. Hammock365 keeps daily check-ins, medications, and documents where the whole family can see them: hammock365.com
Sources
All checked October 23, 2026.
- Medicare.gov, "Plan Non-Renewal Notice": sent in October by the plan when it is leaving Medicare the coming year; "You must look for a new plan for coverage next year." https://www.medicare.gov/basics/forms-publications-mailings/mailings/costs-and-coverage/change-in-plan-availability
- Medicare.gov, "Special Enrollment Periods": contract not renewed, switch between December 8 and the last day in February; "You'll be enrolled in Original Medicare if you don't join another Medicare Advantage Plan before your current plan ends." https://www.medicare.gov/basics/get-started-with-medicare/get-more-coverage/joining-a-plan/special-enrollment-periods
- Medicare.gov, "When can I buy a Medigap policy?": the Medicare Advantage plan leaving Medicare or no longer covering where you live; 60 days before and 63 days after; Plans A, B, C, D, F, G, K, or L; only if switching to Original Medicare; keep letters and notices. https://www.medicare.gov/health-drug-plans/medigap/ready-to-buy/when
- Medicare.gov, "Get ready to buy" (Medigap): guaranteed issue rights, must sell, must cover pre-existing conditions, can't charge more; may be denied or charged more outside the open enrollment period. https://www.medicare.gov/health-drug-plans/medigap/ready-to-buy
- Medicare.gov, "Joining a plan": Open Enrollment October 15 to December 7, request by December 7, coverage January 1; Medicare Advantage Open Enrollment January 1 to March 31. https://www.medicare.gov/basics/get-started-with-medicare/get-more-coverage/joining-a-plan
- Medicare.gov, "Compare Original Medicare & Medicare Advantage": any doctor or hospital that takes Medicare, anywhere in the U.S.; in most cases no referral. https://www.medicare.gov/basics/get-started-with-medicare/get-more-coverage/your-coverage-options/compare-original-medicare-medicare-advantage
- Medicare.gov, "Medicare costs": Part B coinsurance usually 20 percent, 2026 Part B deductible $283, no yearly out-of-pocket limit without supplemental coverage. https://www.medicare.gov/basics/costs/medicare-costs
- Medicare.gov, "Avoid late enrollment penalties": 63 days or more without creditable drug coverage; national base beneficiary premium $38.99 in 2026; penalty added for as long as you have drug coverage; Extra Help exception. https://www.medicare.gov/basics/costs/medicare-costs/avoid-penalties
- Medicare.gov, "How much does Medicare drug coverage cost?": 2027 deductible limit $700 ($615 in 2026); out-of-pocket cap $2,400 in 2027 ($2,100 in 2026). https://www.medicare.gov/health-drug-plans/part-d/basics/costs
- Medicare.gov, "Help with drug costs": 2026 Extra Help income and resource limits; 2027 Extra Help copays. https://www.medicare.gov/basics/costs/help/drug-costs
- Medicare.gov, "Long-term care": "Medicare doesn't pay for long-term care." https://www.medicare.gov/coverage/long-term-care
- Centers for Medicare and Medicaid Services, press release, September 28, 2026, "Medicare Advantage and Medicare Prescription Drug Programs Expected to Remain Stable in 2027": plan counts, average premiums, access, eight in ten staying in their plan, Part D Premium Stabilization Demonstration planned to be discontinued in 2027. https://www.cms.gov/newsroom/press-releases/medicare-advantage-medicare-prescription-drug-programs-expected-remain-stable-2027
- CMS, "Announcement of Calendar Year (CY) 2027 Medicare Advantage Capitation Rates and Part C and Part D Payment Policies," April 6, 2026: method for updating the 2027 Part D deductible and out-of-pocket threshold from the 2026 amounts of $615 and $2,100. https://www.cms.gov/files/document/2027-announcement.pdf
- KFF, "Medicare Advantage Plan Availability Varies Widely by County for 2027," October 9, 2026, an analysis of CMS landscape files: 193 counties and about 638,000 beneficiaries with no general-enrollment MA-PD plan, up from 123 counties and 399,000; share with more than 40 options 20 percent, down from 27 percent; insurer county exits and entries. https://www.kff.org/medicare/medicare-advantage-plan-availability-varies-widely-by-county-for-2027/
- North Carolina Department of Insurance, press release, October 14, 2026, "Commissioner Causey urges Medicare recipients to check their 2027 options": the Causey quotes, SHIIP at 1-855-408-1212 weekdays 8 a.m. to 5 p.m. https://www.ncdoi.gov/news/press-releases/2026/10/14/commissioner-causey-urges-medicare-recipients-check-their-2027-options
- NC Department of Insurance, "Medicare and Seniors' Health Insurance Information Program (SHIIP)": free, unbiased counseling for Medicare beneficiaries and caregivers. https://www.ncdoi.gov/consumers/medicare-and-seniors-health-insurance-information-program-shiip
Not stated anywhere above and deliberately left out: how many North Carolina counties lost a plan for 2027 (neither KFF's summary nor the NCDOI release gives a state count), the 2027 Part B premium (not yet published by CMS), and the 2027 national base beneficiary premium for the Part D penalty.
