non-renewal occurs when a plan or contract will no longer be offered for the following plan year.<\/span><\/p>\nThis is different from an Annual Notice of Change, or ANOC.<\/span><\/p>\nEn <\/span>ANOC<\/b> explains changes to a plan that will continue into the next year.<\/span><\/p>\nA <\/span>non-renewal notice<\/b> tells the beneficiary that the current plan will not continue.<\/span><\/p>\nFor a plan ending December 31, 2026, the beneficiary will need to make a coverage decision for 2027.<\/span><\/p>\nIf the beneficiary does not enroll in another Medicare Advantage plan before the current plan ends, Medicare generally returns the beneficiary to Original Medicare when the Medicare Advantage coverage terminates.<\/span><\/p>\nThat does not automatically provide separate prescription drug or Medigap coverage.<\/span><\/p>\nAgents should therefore read the official notice carefully before explaining the beneficiary’s options.<\/span><\/p>\nWhy Should Agents Separate ANOC and Non-Renewal Workflows?<\/b><\/h2>\n
The documents trigger different conversations.<\/span><\/p>\nAn ANOC review focuses on changes inside a continuing plan.<\/span><\/p>\nA non-renewal conversation focuses on what happens when a plan ends.<\/span><\/p>\nFor non-renewal clients, agents may need to address:<\/span><\/p>\n\n- \u00a0 \u00a0 \u00a0 <\/span>The date the current plan ends<\/span><\/li>\n
- \u00a0 \u00a0 \u00a0 <\/span>Replacement Medicare Advantage options<\/span><\/li>\n
- \u00a0 \u00a0 \u00a0 <\/span>Returning to Original Medicare<\/span><\/li>\n
- \u00a0 \u00a0 \u00a0 <\/span>Prescription drug coverage<\/span><\/li>\n
- \u00a0 \u00a0 \u00a0 <\/span>Potential Medigap Guaranteed-Issue rights<\/span><\/li>\n
- \u00a0 \u00a0 \u00a0 <\/span>Applicable Special Enrollment Periods<\/span><\/li>\n
- \u00a0 \u00a0 \u00a0 <\/span>Provider and prescription continuity<\/span><\/li>\n<\/ul>\n
Do not assume that every client receiving an ANOC is losing coverage.<\/span><\/p>\nLikewise, do not describe a plan as terminating unless the carrier’s official notice confirms it.<\/span><\/p>\nHow Should I Identify Affected Clients?<\/b><\/h2>\n
Start with official carrier information.<\/span><\/p>\nUse your CRM to separate:<\/span><\/p>\nWatchlist<\/b><\/h3>\n
Clients whose carrier, county, or plan may be affected but whose specific non-renewal has not yet been confirmed.<\/span><\/p>\nConfirmed Non-Renewal<\/b><\/h3>\n
Clients for whom you have official plan or carrier confirmation that coverage is ending.<\/span><\/p>\nDo not combine those categories.<\/span><\/p>\nA useful workflow includes:<\/span><\/p>\n\n- \u00a0 \u00a0 \u00a0 <\/span>Transportista<\/span><\/li>\n
- \u00a0 \u00a0 \u00a0 <\/span>Plan<\/span><\/li>\n
- \u00a0 \u00a0 \u00a0 <\/span>County<\/span><\/li>\n
- \u00a0 \u00a0 \u00a0 <\/span>Current coverage end date<\/span><\/li>\n
- \u00a0 \u00a0 \u00a0 <\/span>Official notice received<\/span><\/li>\n
- \u00a0 \u00a0 \u00a0 <\/span>Provider review needed<\/span><\/li>\n
- \u00a0 \u00a0 \u00a0 <\/span>Prescription review needed<\/span><\/li>\n
- \u00a0 \u00a0 \u00a0 <\/span>Medigap GI review needed<\/span><\/li>\n
- \u00a0 \u00a0 \u00a0 <\/span>AEP appointment requested<\/span><\/li>\n
- \u00a0 \u00a0 \u00a0 <\/span>Non-renewal SEP follow-up<\/span><\/li>\n
- \u00a0 \u00a0 \u00a0 <\/span>Final coverage selected<\/span><\/li>\n<\/ul>\n
OmniReach can be configured to help agents organize these categories and follow-up steps.<\/span><\/p>\nThe CRM helps organize the workflow. It does not determine whether a beneficiary legally qualifies for a particular enrollment or Guaranteed-Issue right.<\/span><\/p>\nHow Should I Run the Non-Renewal Conversation?<\/b><\/h2>\n
Start with the official notice.<\/span><\/p>\nConfirm:<\/span><\/p>\n\n- \u00a0 \u00a0 <\/span>The exact plan that is ending.<\/span><\/li>\n
- \u00a0 \u00a0 <\/span>The coverage termination date.<\/span><\/li>\n
- \u00a0 \u00a0 <\/span>Whether the beneficiary has received any additional carrier communications.<\/span><\/li>\n
- \u00a0 \u00a0 <\/span>The beneficiary’s doctors and specialists.<\/span><\/li>\n
- \u00a0 \u00a0 <\/span>Current prescriptions.<\/span><\/li>\n
- \u00a0 \u00a0 <\/span>Pharmacy preferences.<\/span><\/li>\n
- \u00a0 \u00a0 <\/span>Other health coverage.<\/span><\/li>\n<\/ol>\n
Then explain the available paths without ranking them before understanding the beneficiary’s needs.<\/span><\/p>\nDepending on eligibility and timing, a beneficiary may consider:<\/span><\/p>\n\n- \u00a0 \u00a0 \u00a0 <\/span>Enrolling in another Medicare Advantage plan<\/span><\/li>\n
- \u00a0 \u00a0 \u00a0 <\/span>Returning to Original Medicare<\/span><\/li>\n
- \u00a0 \u00a0 \u00a0 <\/span>Adding a stand-alone Part D plan when appropriate<\/span><\/li>\n
- \u00a0 \u00a0 \u00a0 <\/span>Applying for a Medigap policy if Guaranteed-Issue or other enrollment rights apply<\/span><\/li>\n<\/ul>\n
If the beneficiary takes no action and the Medicare Advantage plan terminates, the beneficiary may be returned to Original Medicare.<\/span><\/p>\nThat does not mean the person automatically receives Medigap or stand-alone Part D coverage.<\/span><\/p>\nHow Do Medigap Guaranteed-Issue Rights Work After a Plan Non-Renewal?<\/b><\/h2>\n
A Medicare Advantage plan non-renewal may create a federal Medigap Guaranteed-Issue right when the beneficiary returns to Original Medicare.<\/span><\/p>\nThe timing is important.<\/span><\/p>\nFor qualifying situations, Medicare allows the beneficiary to apply for Medigap:<\/span><\/p>\n\n- \u00a0 \u00a0 \u00a0 <\/span>Beginning <\/span>60 days before<\/b> Medicare Advantage coverage ends<\/span><\/li>\n
- \u00a0 \u00a0 \u00a0 <\/span>Through <\/span>63 days after<\/b> the coverage ends<\/span><\/li>\n<\/ul>\n
For a Medicare Advantage plan ending December 31, 2026, the beneficiary may therefore be able to begin the Medigap application process before the end of the year.<\/span><\/p>\nThe beneficiary generally must switch to Original Medicare to use the applicable Medigap Guaranteed-Issue right.<\/span><\/p>\nMedigap coverage cannot begin while the beneficiary remains enrolled in Medicare Advantage.<\/span><\/p>\nKeep the non-renewal or termination notice because the Medigap carrier may require documentation showing that the prior coverage ended. Medicare confirms this 60-day-before \/ 63-day-after framework for qualifying Guaranteed-Issue situations.<\/span><\/p>\nWhich Medigap Plans May Be Available Under Guaranteed Issue?<\/b><\/h2>\n
Do not tell every client that every Medigap plan is available under GI.<\/span><\/p>\nThe applicable plans depend on Medicare eligibility date and state rules.<\/span><\/p>\nIn Texas, TDI explains that beneficiaries who first became eligible for Medicare before January 1, 2020 may have GI access to Plans A, B, C, F, K, or L, while those first eligible on or after January 1, 2020 may have GI access to Plans A, B, D, G, K, or L, subject to the applicable qualifying event.<\/span><\/p>\nAgents should verify:<\/span><\/p>\n\n- \u00a0 \u00a0 \u00a0 <\/span>The beneficiary’s original Medicare eligibility date<\/span><\/li>\n
- \u00a0 \u00a0 \u00a0 <\/span>The reason coverage is ending<\/span><\/li>\n
- \u00a0 \u00a0 \u00a0 <\/span>Current federal GI rules<\/span><\/li>\n
- \u00a0 \u00a0 \u00a0 <\/span>Texas requirements<\/span><\/li>\n
- \u00a0 \u00a0 \u00a0 <\/span>The Medigap carrier’s documentation requirements<\/span><\/li>\n<\/ul>\n
Do not promise issuance until eligibility has been confirmed.<\/span><\/p>\nWhat Is the Non-Renewal Special Enrollment Period?<\/b><\/h2>\n
CMS provides a Special Enrollment Period for individuals whose Medicare Advantage or Part D plan is non-renewed effective January 1.<\/span><\/p>\nFor a plan ending December 31, 2026, the non-renewal SEP runs:<\/span><\/p>\nDecember 8, 2026 through February 28, 2027.<\/b><\/p>\n
CMS’s 2027 enrollment guidance confirms that:<\/span><\/p>\n\n- \u00a0 \u00a0 \u00a0 <\/span>Elections made December 8\u201331 generally take effect January 1.<\/span><\/li>\n
- \u00a0 \u00a0 \u00a0 <\/span>Elections made in January generally take effect February 1.<\/span><\/li>\n
- \u00a0 \u00a0 \u00a0 <\/span>Elections made in February generally take effect March 1.<\/span><\/li>\n<\/ul>\n
This SEP gives affected beneficiaries additional time after AEP to select eligible Medicare Advantage or Part D coverage.<\/span><\/p>\nHow Does the Non-Renewal SEP Fit With AEP?<\/b><\/h2>\n
The two enrollment opportunities overlap operationally but serve different purposes.<\/span><\/p>\nOctober 15\u2013December 7: Medicare Open Enrollment<\/b><\/h3>\n
Affected beneficiaries can review available 2027 options and make an eligible election during AEP.<\/span><\/p>\nIf the beneficiary selects new coverage during AEP, that election generally begins January 1.<\/span><\/p>\nDecember 8\u2013February 28: Non-Renewal SEP<\/b><\/h3>\n
A beneficiary affected by a January 1 non-renewal who did not complete a replacement election during AEP has an additional enrollment opportunity.<\/span><\/p>\nMedicare.gov confirms that this SEP is available between December 8 and the last day of February following the plan year in which the non-renewal occurs.<\/span><\/p>\nDo not describe the SEP as an unlimited extension of AEP.<\/span><\/p>\nUse the SEP according to the specific non-renewal rules and document which enrollment period supports the election.<\/span><\/p>\nHow Should Agents Handle Clients Who Want Original Medicare and Medigap?<\/b><\/h2>\n
Treat the Medigap and Medicare enrollment pieces as related but separate.<\/span><\/p>\nConfirm:<\/span><\/p>\n\n- \u00a0 \u00a0 <\/span>The Medicare Advantage termination date.<\/span><\/li>\n