My name is John Salois and in my 10 years helping seniors with Medicare, I’ve never seen changes as dramatic as what’s coming in 2026. Part D premiums could increase up to $50/month, and millions are losing their Medicare Advantage PPO plans.
Several carriers are terminating or withdrawing from the Florida market. Many MA PPO plans, and prescription drug plans will be discontinued, requiring members to find new coverage. It is crucial for current MA enrollees to review their options for 2026.
Additionally, because of the work-to-pay ratio on Prescription Drug Plans, some agents are no longer assisting their clients with that portion of their needs. Others simply refer clients to Medicare.gov and instruct them to self-enroll there.
I help seniors by providing guidance regardless of the compensation I receive from insurance companies at no cost to you. I’m here to help you navigate these unprecedented changes and protect your healthcare freedom.
Agents like me are restricted from disclosing specific details about what will be happening in local markets with the major MA carriers until October 1st, but here are some generally known and widely reported changes here in Florida.
More MA PPOs will be terminated for 2026. One carrier that serves the Florida MA market exclusively will exit the Medicare MA market entirely in 2026 leaving thousands having to find plans with other carriers.
What You Can Do to Prepare for Medicare Changes in 2026
• Open enrollment, which lasts from October 15 through December 7 each year, is your opportunity to review your coverage and make changes for the coming year. (This year it’s critical to review your Medicare or Medicare Advantage plan and options heading into 2026.)
• When you get your Annual Notice of Change from your insurance company you need to read and understand the changes and how they will affect your coverage. You should receive your annual notice of change by September 30th
• Review Your Coverage: Start reviewing your current plan and look for alternatives before the October 15th period begins.
• Consider Medicare Supplement Plans: If your current MA plan is terminated, you may have a guaranteed issue right to a Medicare Supplement plan, which provides different coverage options.
• Stay Informed: Pay attention to communications from your current MA carrier for specific information regarding your plan and its potential termination.
• Seek Guidance: Consult with a local insurance agent to help you navigate the changes and find a suitable plan for your healthcare needs.
RED FLAGS THAT DEMAND
IMMEDIATE ACTION
• Premium increases over $20/month
• Your main medications moved to higher tiers
• Your primary doctor dropped from the network
• Your pharmacy is no longer preferred
• The plan is being discontinued
• Star rating below 3 stars
To get a free step-by-step guide on how to read your Annual Notice of Change letter, go to my website www.johnsalois.com
What Should to Do if You Get a Disenrollment Letter from Your Medicare Advantage Plan?
If you are among those that get a plan termination letter from your carrier there is a silver lining. Involuntary disenrollment from an MA plan gives you a guaranteed issue right to a Medicare Supplement plan.
Review your options for transitioning your Medicare coverage from Medicare Advantage to Original Medicare and a Supplement with a local insurance agent. If a Medicare Supplement is out of reach because of the monthly premium, your agent will find a suitable Medicare Advantage plan for you to move to.
To learn more about your options, call to schedule an appointment at my 24/7 live USA receptionist line (239) 507-0507 or visit: johnsalois.com.