Do Medicare Plans Automatically Renew?

Medicare, a federal health insurance program, provides coverage for millions of individuals across the United States. Many beneficiaries wonder if their Medicare plans automatically renew each year. Understanding the renewal process is important for maintaining continuous coverage and making informed decisions about healthcare options. This helps beneficiaries anticipate necessary actions and avoid unexpected gaps.

Automatic Renewal for Original Medicare

Original Medicare, which includes Part A (Hospital Insurance) and Part B (Medical Insurance), renews automatically each year. Beneficiaries do not need to take action to continue coverage if they remain eligible. Eligibility depends on being age 65 or older, or under 65 with a qualifying disability, and being a U.S. citizen or legal resident for at least five continuous years.

For most individuals, Part A is premium-free if they or their spouse worked and paid Medicare taxes for a sufficient period. Part B requires a monthly premium, which can be automatically deducted from Social Security benefits. As long as eligibility requirements are met and premiums are paid, Original Medicare continues.

Automatic Renewal for Medicare Advantage and Part D Plans

Medicare Advantage (Part C) plans and Medicare Prescription Drug (Part D) plans are offered by private insurance companies approved by Medicare. These plans renew automatically each year, provided the plan remains available in the beneficiary’s service area and they continue to meet eligibility criteria.

Each September, beneficiaries enrolled in these private plans receive an Annual Notice of Change (ANOC) from their plan provider. This document details any changes to the plan’s costs, benefits, formulary (drug list), and provider network for the upcoming year. Reviewing the ANOC is important, even with automatic renewal, to understand how the plan might differ in the new year.

Factors That Can Stop Automatic Renewal

While many Medicare plans renew automatically, several factors can prevent this, requiring beneficiaries to take action. A Medicare Advantage or Part D plan may not renew if the private insurance company decides to discontinue the plan or if Medicare terminates its contract with the plan provider. In such cases, the plan must send a non-renewal notice to inform affected individuals.

Moving out of a plan’s service area is another common reason for automatic renewal to cease. Medicare Advantage and Part D plans have defined geographic service areas. If a beneficiary relocates outside this area, their current plan will no longer cover them. Non-payment of premiums will also lead to the termination of coverage, stopping automatic renewal.

Loss of Medicare eligibility would also prevent renewal. Actively enrolling in a new Medicare plan during an enrollment period will automatically disenroll a beneficiary from their previous plan.

Your Annual Review and Action Steps

Even though many Medicare plans renew automatically, it is important for beneficiaries to conduct an annual review of their coverage. The Annual Notice of Change (ANOC), received by September 30, highlights changes in premiums, deductibles, copayments, and covered services for the upcoming year.

Beneficiaries should also review their Evidence of Coverage (EOC), which details the plan’s benefits, costs, and rules. Understanding these documents before the Annual Enrollment Period (AEP) begins is important.

The Medicare Annual Enrollment Period, which runs from October 15 to December 7 each year, is the primary time to make changes to Medicare Advantage and Part D plans. During this period, individuals can compare available plans, switch plans, or return to Original Medicare. Any changes made during AEP become effective on January 1 of the following year. Special Enrollment Periods (SEPs) allow for changes outside of AEP under specific qualifying life events, such as moving or losing other coverage.