3 Costly Medicare Advantage Renewal Mistakes to Avoid

If you’re on a Medicare Advantage plan, the worst mistake you can make is letting it auto-renew without a thorough review. I’ve seen countless clients get blindsided by changes that cost them thousands of dollars—changes they could have avoided with just a little preparation. Medicare Advantage plans change every single year, and what worked for you in 2026 might be a financial disaster in 2026.

Mistake #1: Not Checking Your Provider Network

This is the biggest shock I see every year. Medicare Advantage plans renegotiate their doctor and hospital networks annually, and your trusted physician who was in-network this year could be completely out-of-network come January 1st, 2026.

Here’s what happens when you don’t check: You show up to your doctor’s appointment in January, only to discover they’re no longer in your plan’s network. Now you’re facing hundreds or even thousands of dollars in out-of-pocket expenses, or worse—you’re left scrambling to find a new doctor who may not know your medical history.

The solution is simple but critical. First, check your 2026 provider directory through your plan’s website or on medicare.gov. But don’t stop there—actually call your doctor’s office and confirm they’re participating in your specific plan for 2026. Insurance directories aren’t always updated in real-time, and I’ve seen patients get caught because the online directory was wrong.

Agent Tip

I tell my clients to call their doctor’s billing department directly and ask: “Are you in-network with [Plan Name] for 2026?” Get the answer in writing if possible. Online directories can be months out of date.

If your doctors aren’t going to be in-network, this might be the perfect time to consider switching to a Medicare supplement plan, which gives you access to any doctor who accepts Medicare—nationwide.

Mistake #2: Ignoring Prescription Drug Coverage Changes

Formularies change every year, and so do co-pays. Even with the recent improvements to Part D—the donut hole being eliminated and the annual out-of-pocket maximum capped at $2,100—you still need to verify that your specific medications are covered under your plan’s 2026 formulary.

This year, I’m seeing something particularly concerning: big-name branded medications being removed from formularies entirely. If your plan drops coverage for a medication you’ve been taking, you could go from paying a small co-pay to paying the full retail price—which could be hundreds or thousands of dollars per month.

Don’t assume your medications will be covered just because they were this year. Check your coverage on medicare.gov’s Plan Finder tool, or contact your insurance carrier directly. Pay special attention if you take any branded or expensive medications, as these are often the first to be dropped or moved to higher cost-sharing tiers.

Mistake #3: Not Reviewing Your Out-of-Pocket Maximum

Here’s what most people don’t realize: your plan’s maximum out-of-pocket limit can increase significantly from year to year. You might have a plan with a $0 premium that looks attractive on the surface, but if your maximum out-of-pocket limit jumps from $6,000 to $9,000, that “free” plan just became much more expensive if you need medical care.

In 2026, I’m seeing many Medicare Advantage plans with maximum out-of-pocket limits at or near $9,000. That means if you have a serious health issue, you could be responsible for up to $9,000 in medical expenses before your plan pays 100%.

Your Annual Notice of Change letter will show these differences, but you need to look beyond just the premium. Compare:

• Primary care doctor co-pays
• Specialist co-pays
• Emergency room visits
• Inpatient hospital stays
• Skilled nursing facility costs
• The overall maximum out-of-pocket limit

Agent Tip

Small co-pay increases might seem minor—$10 to $15 for a doctor visit—but if you see specialists regularly, that $5 increase times 20 visits equals $100 more per year. These small changes compound quickly.

Understanding Medicare costs and how Advantage compares to supplements can help you make a more informed decision about whether to stick with your current plan or explore other options.

Bonus Check: Plan Terminations

Here’s something that’s becoming increasingly common: entire Medicare Advantage plans being canceled for the following year. Many insurance carriers are terminating plans for 2026, especially PPO plans that offered more provider flexibility.

If your plan is being terminated, you should receive a letter from your insurance company, but these notices can easily get lost in the flood of enrollment season mail. Don’t wait for a letter that might never come—manually verify that your plan is renewing by checking medicare.gov or calling your insurance carrier directly.

If your plan is being canceled, you’ll have a Special Enrollment Period that allows you to choose a new plan or switch to a Medicare supplement without the usual restrictions.

What This Means for Your Bottom Line

These might seem like small details, but they add up to significant money. I’ve had clients discover in January that their new out-of-pocket maximum, combined with their doctor being out-of-network and their prescription no longer being covered, would cost them an additional $8,000 compared to the previous year.

The solution? Take action during the Medicare Annual Open Enrollment period (October 15 – December 7) to review your options and make changes if needed.

Review Area	What to Check	Potential Cost Impact
Provider Network	Doctor and hospital participation	$5,000+ if out-of-network
Prescription Coverage	Formulary changes and co-pays	$2,000+ annually
Out-of-Pocket Maximum	Annual limit increases	$3,000+ difference in limits
Plan Continuation	Plan termination notices	Forced into suboptimal plan

When to Consider Switching

If you discover significant changes to your Medicare Advantage plan, it might be time to explore your alternatives. Comparing Medicare Advantage to supplement plans can help you understand whether a different approach might save you money and provide better coverage.

For many of my clients, discovering these changes leads them to consider switching to a Medicare supplement plan, which offers more predictable costs and broader provider access. The trade-off is typically a monthly premium, but for people who value choice and predictability, it’s often worth it.

Frequently Asked Questions

When should I review my Medicare Advantage plan for next year?

You should review your plan as soon as you receive your Annual Notice of Change, typically in late September or early October. This gives you the full Open Enrollment Period (October 15 – December 7) to make changes if needed.

What happens if I don’t make any changes during Open Enrollment?

Your current Medicare Advantage plan will automatically renew for the following year, even if there are significant changes to benefits, costs, or provider networks. You’ll be locked into whatever changes the plan made until the next Open Enrollment Period.

Can I switch from Medicare Advantage to a Medicare supplement plan?

Yes, but you may face medical underwriting unless you qualify for a Special Enrollment Period or guaranteed issue rights. It’s important to understand the implications before making this switch.

How do I find out if my doctors will be in-network next year?

Check your plan’s 2026 provider directory on their website or medicare.gov, then call your doctor’s office directly to confirm their participation. Don’t rely solely on online directories as they may not be current.

What should I do if my plan is being terminated?

If your Medicare Advantage plan is being canceled, you have a Special Enrollment Period to choose a new plan. You can select another Medicare Advantage plan or switch to Original Medicare with a supplement plan, depending on your needs and eligibility.