Annual Enrollment Period (AEP) 2026: The Shift Away From PPO Networks?
Plan year 2025 marked the end of the long standing “donut hole” or coverage gap that affected many Medicare beneficiaries for years. The Inflation Reduction Act established a $2,000 out of pocket maximum (soon to increase to $2,100) for all Stand Alone Part D Prescription Drug Plans (PDPs) and Medicare Advantage Prescription Drug Plans (MAPDs), prompting insurers to respond in different ways. As we move into 2026, even more changes are coming with several carriers discontinuing additional plans. Many beneficiaries may find themselves without coverage on January 1, either reverting to Original Medicare or being automatically mapped into a similar plan.
To our current clients or those who would like to work with us, please E-Mail us at [email protected], your updated prescription (name, dosage, and frequency) and doctor lists (if you haven’t done so already) to help us assess whether your current plan(s) are still the best fit for your needs. We appreciate your patience, as many Medicare Advantage and Prescription Drug Plans are being discontinued, leading to high call volume. Rest assured, we will get back to you as soon as possible!
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Medicare Compliance requires brokers and agents to include this disclaimer: “We do not offer every plan available in your area. Currently we represent 14 organizations which offer 108 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.”
*As mandated by Medicare, we must provide this statement. However, fulfilling this requirement can be challenging due to our operations across multiple states. For illustrative purposes, we will utilize Montgomery County, Pennsylvania, where our headquarters are located.
Do It For Me Insurance makes Medicare simple by helping you compare and enroll in Medicare Supplements, Medicare Advantage Plans, and Part D Prescription Drug Plans. With our deep industry expertise and trusted partnerships across Pennsylvania, New Jersey, Delaware, and beyond, we provide personalized guidance and a truly fee-free experience. As your independent broker, Joe Covell is here to help you confidently navigate the 2026 Medicare Annual Enrollment Period and find coverage that fits your needs and budget.
Some of the noteworthy changes for 2026
- Independence Blue Cross is discontinuing most PPO options, affecting roughly 50,000 members.
- Highmark Blue Shield and BCBS in certain regions are making major changes in PA, DE, WV, and parts of NY, affecting about 150,000 members.
- UnitedHealthcare estimates nearly 600,000 members nationwide will lose current plans.
- Other national companies are also eliminating or altering plans.
Why this matters
Many plans are becoming non-commissionable to brokers. Once a plan is filed with CMS for the upcoming year, it cannot be removed until the following year. Carriers may stop paying brokers as a way to slow new enrollments. They cannot deny you a plan if you request it, but their call centers may try to persuade you not to enroll.From experience, whenever a plan becomes non-commissionable it often disappears the next year, leaving consumers back at square one searching for coverage again. Most people do not want to go through that every single year.
Two major factors are driving these changes:
- Increased utilization as people who delayed care during the pandemic are now catching up on services.
- The $2,100 annual out-of-pocket maximum for prescription drugs is leading to higher use of brand-name medications, driving up insurer costs and resulting in less generous benefits.
We will be producing and releasing our 2026 Medicare 101 Video once CMS has released all final 2026 figures so that we can provide accurate information based on official data rather than projections.
Discover the Best Medicare Plans for You!
Thank you for taking the time to read our newsletter. We hope this message finds you well. As trusted partners with leading insurance carriers across PA, NJ, MD, DE, and beyond, we are here to guide you through your Medicare plan options. Our Open Enrollment Resource Page for Plan Year 2026 has been updated to answer common questions and provide helpful information. Whether you are a current client, were referred by a carrier, or met us at a community event, our goal remains the same. We make Medicare simple. We offer complimentary plan reviews to help you compare coverage and find the plan that best fits your needs.
Why choose Do It For Me Insurance for your Medicare needs?
1. Trusted Expertise: With years of experience and extensive knowledge of the insurance industry, we are well-equipped to guide you through the process of selecting the right Medicare Plan.
2. Comprehensive Coverage: Our partnerships with reputable carriers enable us to offer a wide range of Medicare Plans, ensuring that you have access to the best options available.
3. Personalized Service: We believe in building strong relationships with our clients. When you work with us, you can expect personalized attention and assistance tailored to your unique requirements.
Don’t miss this annual opportunity to review your current coverage and explore Medicare plans that may offer you better value. This year is especially important, as many plans are being discontinued and drug coverage changes are more significant than usual. It’s a great time to get an unbiased review, even if the best recommendation ends up being a plan we don’t offer. To get started, simply reply to this email or call or text us directly. Please be patient if response times are slightly longer this season. Our digital assistant, available across all our pages for the past three years, can help with general Medicare questions and guide you to secure online enrollment options if you prefer a self-service experience. You can unsubscribe at any time, though we typically send only one annual newsletter and a few brief reminders before the December 7 deadline. Thank you for considering Do It For Me Insurance. We look forward to helping you with your Medicare plan needs.
Please be advised that Joe Covell is no longer on payroll with Custom Benefit Plans, Inc. and is now fully focused on serving our clients through Do It For Me Insurance. Joe is available at our Willow Grove office (616 Easton Rd., Willow Grove, PA 19090) on Mondays and by appointment upon request. While he is no longer a broker manager, his priority remains helping clients find the right coverage. We offer limited in-person appointments, as well as phone consultations and Zoom/video meetings, to make scheduling as convenient as possible.
Every October, we send a letter to our valued clients – a gentle reminder to review options for the upcoming year. If you’re not currently working with us but interested in exploring options, or if you know someone who could use our help, please know that we’re always here, ready to welcome new clients! You can also view the letter on our blog
If your address has changed or if you are not currently receiving our annual letter but would like to, please contact us so that we can include you in our mailing list. We would be delighted to keep you updated with the latest news and events. We make every effort to work with all the relevant insurance carriers, there are certain plans and carriers that independent brokers are not authorized to offer. These plans are often institution-specific. Nonetheless, We are ready to aid you in comparing all available options.
If you come across a solicitation with promises that seem “too good to be true” and you want to investigate further, or if you simply want to discuss and compare your current coverage and other options, we are always here to assist you. Your satisfaction and access to products that cater to your needs are of utmost importance, regardless of whether you are currently our client. The same applies to any family or friends you refer!
We specialize in comprehensive insurance solutions. If you’re seeking a second opinion or looking for a quote on any coverage, don’t hesitate to reach out! Attached below is a brochure we’ve been distributing at local community events.