The version of this I run into most often costs a family somewhere between a couple hundred and a couple thousand dollars a year, and nobody in the family ever finds out it happened.
Here is the shape of it. Your mother is on a Medicare Advantage plan. Somewhere in that plan there is a dental allowance, an over-the-counter card for things like batteries and blood pressure cuffs, maybe a ride benefit to get her to appointments, maybe a grocery card if she has a qualifying chronic condition. She has never used a dollar of it. Not because she did not need it. Because she does not know it is there, and the twelve pounds of plan mail she got in October went into the drawer under the phone book.
On December 31, that money is gone. It does not roll over. In January the plan starts a fresh allowance and she does not know about that one either.
I spent eight years buying houses from families in transition, which means I spent eight years sitting at kitchen tables looking at what was left after a long illness. I am not on that side of the table anymore. But it taught me something that shows up over and over: the money families lose is rarely lost in one dramatic decision. It leaks, quietly, through paperwork nobody read.
Here is why this fall is different from last fall. There was supposed to be a letter. Starting in 2026, your parent's Medicare Advantage plan was going to be required to mail a notice every summer listing the supplemental benefits she had not touched in the first six months of the year. It was a small, sane, genuinely useful piece of consumer protection. It is gone. CMS removed the requirement on June 1, about four weeks before the first notices were due to go out, so almost certainly no one in your family ever saw one.
Which means the job of noticing just moved. It is yours now.
What CMS actually did
On April 6, 2026, CMS published the Contract Year 2027 final rule for Medicare Advantage and Part D in the Federal Register. Buried in it is a section titled "Rescind Mid-Year Supplemental Benefits Notice."
Here is the history, because it matters. In an April 2024 final rule, CMS created a new requirement, effective January 1, 2026, that Medicare Advantage organizations notify enrollees mid-year of any unused supplemental benefits available to them. Per that rule, the notice was supposed to list every supplemental benefit the enrollee had not used during the first six months of the plan year, and plans had to compile and mail it, on paper, between June 30 and July 31.
CMS has now taken it back. In the 2027 rule, the agency wrote that after careful consideration of the comments received, it would move forward with the proposal, without modification, and rescind the Mid-Year Notice of Supplemental Benefits. The regulation that carried the requirement, 42 CFR 422.111(l), now reads simply "[Reserved]." The rule took effect June 1, 2026 and applies to coverage beginning January 1, 2027.
CMS gave its reasons plainly. The agency said the notice duplicated information already in the Evidence of Coverage document plans send every year, that it imposed administrative and financial burden, especially on smaller plans, and that newer data suggested people were using their benefits more than CMS had assumed. The agency cited a survey of 1,846 Medicare Advantage enrollees in which 70 percent reported using at least one supplemental benefit in the past year, and 19 percent said they had not used theirs because they did not need them.
Read that survey number the other direction and you get the part that should interest you. Roughly three in ten of the people surveyed used no supplemental benefit at all, in a year they paid for one.
Two other verified numbers from that same CMS rule are worth holding onto. When CMS wrote the proposal, there were over 68 million Medicare beneficiaries, and 51.1 percent were enrolled in Medicare Advantage or other health plans, roughly 34 million people. And by CMS's own accounting, each year only three out of every ten beneficiaries compare plans during Medicare's Annual Election Period.
Seven out of ten do not look. That is the actual gap.
What this means at your parent's kitchen table
The money has a hard expiration date
If your parent's plan gives her benefits on a card, and a great many do now, that card is governed by a rule CMS finalized in the same 2027 package. Under 42 CFR 422.102(g)(2)(iv), plans must ensure debit cards are limited to the specific plan year. CMS spelled out what that means: a plan may let your mother keep using the same physical card next year, but the dollar amounts or benefit allocations associated with the card cannot carry over from one plan year to the next.
So it is not a savings account. It is closer to a use-it-or-lose-it bucket that empties every December 31, quietly, with no notice and no receipt. If she has $75 a quarter on an over-the-counter card and she has used none of it, that is $300 that will simply stop existing while she is watching the news on New Year's Eve.
The remaining paper trail is thinner than you think
CMS's defense of the rescission is that the Evidence of Coverage already tells your parent everything. That is true in the narrow sense. The Evidence of Coverage does list supplemental benefits, with descriptions, copays, coinsurance, and eligibility criteria where those apply, and plans have to send it annually.
But an Evidence of Coverage is a phone book. It arrives in the fall, in the same envelope wave as everything else, and it describes what is theoretically available rather than what your mother personally has left. The mid-year notice was the one document that would have been individualized to her, and it was the one that would have arrived in July when nothing else was competing for her attention. That is the piece that is gone.
The 48-hour pause before a sales appointment is gone too
This one belongs in the same conversation, because the same rule did it and because your parent's phone is about to start ringing.
Since 2023, an agent or broker who collected a Scope of Appointment form from a Medicare beneficiary had to wait at least 48 hours before the actual sales appointment. In the 2027 rule, CMS finalized the elimination of that 48-hour waiting period, along with both of its exceptions, and also went back to permitting agents and brokers to collect Scope of Appointment forms at educational events.
I want to be fair about this. CMS's stated reasoning is that the waiting period kept people from getting information on their own schedule, which is a real problem for someone rural or without a ride. But it is worth knowing what CMS itself said the pause was for back in 2023: the agency acknowledged the burden was outweighed by the benefit of giving beneficiaries, especially vulnerable beneficiaries, time to speak with caregivers and others they rely on for help or advice.
That was the protection. Same day signing is now allowed. If you are the caregiver in that sentence, you should assume you will not be looped in unless you ask to be.
What to do, in order
You do not need to become a Medicare expert. You need to do four specific things between now and December 7.
1. Find the Evidence of Coverage and read only the supplemental benefits section
Skip the rest of it. Go to the section that lists extra benefits, the ones Original Medicare does not cover: dental, vision, hearing, over-the-counter, transportation, meals, fitness. Write down each one, the dollar amount, and any eligibility condition attached to it. Some benefits, the ones for chronically ill enrollees, require a qualifying condition, and plans now have to publicly post the eligibility criteria they developed for those.
2. Call the number on the back of the card and ask one question
Ask what the remaining balance is on every benefit for this plan year, and when each one expires. Not what the benefits are. What is left. Have your parent put you on the call, or get authorized to speak for her, before you need it in an emergency.
3. Open the September letter
By law, plans have to tell enrollees about changes taking effect January 1 at least 15 days before Open Enrollment starts, which puts that notice in the mailbox by September 30. Medicare.gov calls it the Plan Annual Notice of Change. It is the document that says whether her drug is still covered, whether her doctor is still in network, and what the plan will cost in January.
One number to look for while you have it open. In the CY 2027 Rate Announcement, CMS set the standard Part D deductible at $700 for 2027, up from $615, and the annual out-of-pocket threshold at $2,400, up from $2,100.
4. Compare, even if you are sure nothing changed
Open Enrollment runs October 15 through December 7, and Medicare.gov is explicit that the plan has to receive the enrollment request by December 7 for coverage starting January 1. Remember that only three in ten people do this. Being in the three costs an hour.
And if a doctor is the reason you are considering a switch, know that plans owe notice on that separately: under 42 CFR 422.111(e), for a primary care or behavioral health provider leaving the network, the plan must provide written notice and make one attempt at telephone notice at least 45 calendar days before the termination date.
5. Spend the balance before December 31
Whatever is left, spend it on something she actually needs. It does not carry over.
Frequently Asked Questions
Do Medicare Advantage flex card benefits roll over to the next year?
No. Under 42 CFR 422.102(g)(2)(iv), finalized in the Contract Year 2027 Medicare Advantage and Part D rule, plans must ensure debit cards are limited to the specific plan year. CMS clarified that a plan may allow an enrollee to keep using the same physical card in later years, but the dollar amounts or benefit allocations associated with the card cannot carry over from one plan year to the next. Unused balances end with the plan year.
Will my parent get a letter listing the Medicare benefits they have not used?
No, not anymore. An April 2024 CMS rule would have required Medicare Advantage plans to mail that notice every summer beginning in 2026, listing supplemental benefits unused in the first six months. In the Contract Year 2027 final rule published April 6, 2026, CMS rescinded the requirement at 42 CFR 422.111(l), effective June 1, 2026, which was before the first mailing window of June 30 to July 31 opened.
When is Medicare Open Enrollment and what can be changed?
Medicare.gov states that Open Enrollment runs October 15 through December 7 each year, and that changes made during it take effect January 1 of the following year, with the plan required to receive the enrollment request by December 7. During that window a person can join, drop, or switch a Medicare Advantage plan, join, drop, or switch a Medicare drug plan, or move between Original Medicare and Medicare Advantage.
What is the Medicare Part D deductible for 2027?
In the Announcement of Calendar Year 2027 Medicare Advantage Capitation Rates and Part C and Part D Payment Policies, CMS set the defined standard benefit deductible at $700 for 2027, up from $615 in 2026, and set the annual out-of-pocket threshold at $2,400, up from $2,100. Individual plans can differ from the defined standard benefit, so the plan's own notice is what governs what your parent actually pays.
Can a Medicare agent now meet with my parent the same day they sign a form?
Yes. In the Contract Year 2027 final rule, CMS eliminated the 48-hour waiting period that had been required between completing a Scope of Appointment form and holding a personal marketing appointment, along with its two exceptions, and again permits agents and brokers to collect those forms at educational events. When CMS created the 48-hour pause in 2023, the agency described its purpose as giving beneficiaries, especially vulnerable ones, time to speak with caregivers before deciding.
About Ryan Riggins
Ryan Riggins is a senior transition advisor and former house flipper. After 8+ years buying homes 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 SeniorSafe app.
Want to see the holes before they cost you? The free Medicare Gap Analyzer walks through what Medicare does not cover in about three minutes, no email required: rigginsstrategicsolutions.com/tools/medicare-gap-analyzer
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. SeniorSafeApp keeps daily check-ins, medications, and documents where the whole family can see them: seniorsafeapp.com
Sources
All sources checked August 21, 2026.
- CMS, Medicare Program; Contract Year 2027 and Certain Contract Year 2026 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, and Medicare Cost Plan Program, final rule, 91 FR 17384, published April 6, 2026. Effective June 1, 2026; applicable to coverage beginning January 1, 2027. Source for the rescission of the Mid-Year Supplemental Benefits Notice at 42 CFR 422.111(l) and 422.2267(e)(42), the April 2024 origin of the requirement and its June 30 to July 31 mailing window, CMS's stated rationale, the survey of 1,846 enrollees with 70 percent using at least one supplemental benefit and 19 percent citing no need, the debit card plan-year limit at 42 CFR 422.102(g)(2)(iv) and the no-carryover clarification, the elimination of the 48-hour Scope of Appointment waiting period and its two exceptions, the return of Scope of Appointment forms at educational events, CMS's 2023 rationale about giving vulnerable beneficiaries time to speak with caregivers, the figure of over 68 million Medicare beneficiaries with 51.1 percent in Medicare Advantage and other health plans, and the statement that only three out of every ten beneficiaries compare plans during the Annual Election Period. https://www.federalregister.gov/documents/2026/04/06/2026-06600/medicare-program-contract-year-2027-and-certain-contract-year-2026-policy-and-technical-changes-to
- CMS, Contract Year 2027 Medicare Advantage and Part D Final Rule fact sheet, April 2, 2026. Source for the summary of the rescinded mid-year notice, the supplemental benefit debit card requirements, and the requirement that plans publicly post plan-developed SSBCI eligibility criteria. https://www.cms.gov/newsroom/fact-sheets/contract-year-2027-medicare-advantage-part-d-final-rule
- eCFR, 42 CFR 422.111, current text. Source for paragraph (l) reading [Reserved], for the requirement at paragraph (d)(2) that enrollees be notified of January 1 changes at least 15 days before the Annual Coordinated Election Period, and for the provider termination notice requirements at paragraph (e), including written notice plus one telephone attempt at least 45 calendar days before the termination effective date for primary care and behavioral health providers. https://www.ecfr.gov/current/title-42/part-422/section-422.111
- CMS, Announcement of Calendar Year (CY) 2027 Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies, April 6, 2026, Attachment V, Table V-2. Source for the 2027 defined standard Part D deductible of $700 against $615 in 2026, and the 2027 annual out-of-pocket threshold of $2,400 against $2,100 in 2026. https://www.cms.gov/files/document/2027-announcement.pdf
- Medicare.gov, Open Enrollment. Source for the October 15 to December 7 window, the January 1 effective date, the December 7 receipt deadline, and the list of changes permitted during Open Enrollment. https://www.medicare.gov/health-drug-plans/open-enrollment
- Medicare.gov, Plan Annual Notice of Change (ANOC). Source for the ANOC arriving in September from the plan and covering changes in coverage and costs effective in January. https://www.medicare.gov/basics/forms-publications-mailings/mailings/costs-and-coverage/upcoming-plan-changes
