What's New in Medicare

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Plans Not Renewing Coverage in 2027

Every year, Medicare Part D and Medicare Advantage plans make changes to plan benefits and decide whether plans will still be offered the following year. Some plans completely cancel coverage for everyone in the plan, while other plans might do a Service Area Reduction and stop coverage for members in specific counties. Plans send notices about coverage changes in the mail, so it is important to open all your mail to be aware what is happening to your coverage and what your options are if your plan is not renewing next year.

Iowa Medicare Advantage & Cost Plans Cancelled in 2027:

If you are enrolled in one of these plans, you need to select new coverage by December 31st, 2026, so you do not have any gaps in coverage. You can enroll in a different Medicare Advantage plan, or you can choose to switch to Original Medicare with a “guaranteed issue” for a Medicare Supplement, which means you cannot be denied a policy or charged a higher premium due to your health conditions. Keep your plan non-renewal notice as proof of your options.

  • AARP Medicare Advantage from UHC IA-1 HMO-POS H5253-209
  • Humana Full Access PPO H5216-411
  • Medica Advantage Preferred PPO H8889-011
  • Medica Advantage Select PPO H8889-015
  • Medica Advantage Solution PPO H8889-009
  • Medica Advantage Value PPO H8889-010
  • (Wellmark) Blue Medicare Advantage PPO H5900-001
  • (Wellmark) Blue Medicare Advantage Valor PPO H5900-006

Iowa Medicare Advantage & Cost Plans with Service Area Reductions in 2027:

If you are currently enrolled in one of these plans and the plan is leaving your county next year, you will need to select new coverage by December 31st, 2026, so you do not have any gaps in coverage. You can enroll in a different Medicare Advantage plan, or you can choose to switch to Original Medicare with a “guaranteed issue” for a Medicare Supplement, which means you cannot be denied a policy or charged a higher premium due to your health conditions. Keep your plan non-renewal notice as proof of your options.

  • AARP Medicare Advantage Essentials from UHC NE-3 HMO-POS H2802-001 (Cass, Fremont, Harrison, Mills, Montgomery, Page & Shelby counties)
  • AARP Medicare Advantage Extras from UHC NE-5 HMO-POS H2802-074 (Cass, Fremont, Harrison, Mills, Montgomery, Page & Shelby counties)
  • Aetna Medicare Signature HMO-POS H1609-001 (Adams, Audubon, Butler, Chickasaw, Clayton, Davis, Des Moines, Greene, Howard, Lee, Louisa, Lyon, Mitchell, Pocahontas, Sac, Story, Taylor & Van Buren counties)
  • Aetna Medicare Signature Extra HMO-POS H1609-069 (Adams, Audubon, Butler, Chickasaw, Clayton, Davis, Des Moines, Greene, Howard, Lee, Louisa, Lyon, Mitchell, Pocahontas, Sac, Story, Taylor & Van Buren counties)
  • Aetna Medicare Signature PPO H1608-001 (Adams, Audubon, Butler, Chickasaw, Clayton, Davis, Des Moines, Greene, Howard, Lee, Louisa, Lyon, Mitchell, Pocahontas, Sac, Story, Taylor & Van Buren counties)
  • Aetna Medicare Elite PPO H1608-037 (Adams, Audubon, Butler, Chickasaw, Clayton, Davis, Des Moines, Greene, Howard, Lee, Louisa, Lyon, Mitchell, Pocahontas, Sac, Story, Taylor & Van Buren counties)
  • Aetna Medicare Eagle HMO-POS H1609-058 (Audubon, Chickasaw, Clayton, Davis, Des Moines, Howard, Lee, Mitchell, Story, Taylor & Van Buren counties)
  • Aetna Medicare Value Care HMO-POS H1609-068 (Audubon, Chickasaw, Clayton, Davis, Des Moines, Howard, Lee, Mitchell, Story, Taylor & Van Buren counties)
  • Aetna Medicare Enhanced Extra PPO H1608-117 (Audubon, Chickasaw, Clayton, Davis, Des Moines, Howard, Lee, Mitchell, Story, Taylor & Van Buren counties)
  • Aetna Medicare Dual Care HMO D-SNP H5593-001 (Story county)
  • Humana Gold Plus HMO H0028-053 (Lyon, Story, Woodbury counties)
  • HumanaChoice PPO H5216-014 (Page county)
  • HumanaChoice Giveback PPO H5216-340 (Jefferson, Marion counties)
  • HumanaChoice SNP-DE PPO D-SNP H5216-268 (Dallas, Delaware, Jefferson, Mahaska, Marion, Washington counties)
  • Humana Together in Health PPO I-SNP H7617-118 (Dickinson, Emmet, Howard, Lyon, O’Brien, Osceola, Page, Palo Alto, Story, Winneshiek, Woodbury counties)
  • Medical Associates North Iowa Senior Plan Cost Plan H1651-015 (Franklin, Mitchell & Winnebago counties)
  • Medical Associates Quad Cities Senior Plan Cost Plan H1651-013 (Cedar & Muscatine counties)
  • Wellcare Simple HMO H1862-005 (Bremer, Cherokee, Fayette, Ida, Scott & Woodbury counties)
  • Wellcare Dual Access HMO-POS D-SNP H1862-004 (Bremer, Cherokee, Fayette, Ida, Scott & Woodbury counties)
  • Wellcare Dual Liberty Sync HMO-POS D-SNP H1862-003 (Bremer, Cherokee, Fayette, Ida, Scott & Woodbury counties)
  • Wellcare Dual Reserve HMO-POS D-SNP H1862-006 (Bremer, Cherokee, Fayette, Ida, Scott & Woodbury counties)

Medicare Part D Plans No Longer Offered in 2027:

  • Aetna SilverScript Choice (S5601-050) – Plan is terminating December 31st, 2026. If you are enrolled in this plan, you need to select new Medicare drug coverage by the end of the year or you will not have drug coverage at the start of 2027.
  • HealthSpring Extra Rx (S5617-375) – This plan is crosswalking (automatically moving) its members to HealthSpring Assurance Rx, which will be a premium increase to $117.10 next year. Anyone currently enrolled in HealthSpring Extra Rx can either enroll in a new drug plan or do nothing and move to HealthSpring Assurance Rx. It is important to check whether HealthSpring Assurance Rx would be your best option for prescription coverage next year.

If you need to compare plans or choose new coverage next year, see our Medicare Open Enrollment Period page for how you can review plans yourself through Medicare.gov.

New Program: GLP-1 Bridge

Starting July 2026, there is limited coverage for Foundayo (tablet), Wegovy (injection or tablet), or Zepbound (KwikPen only) through the Medicare GLP-1 Bridge program that is running through the end of 2027. If you qualify for the program, then your GLP-1 prescription cost could be $50/month.

To qualify:

  • You must be enrolled in Medicare drug coverage (through a Part D plan or a Medicare Advantage plan with drug coverage) and your Medicare plan is not currently covering your Foundayo, Wegovy, or Zepbound prescription
  • You must not have Type 1 diabetes, moderate-to-severe sleep apnea, or fatty liver disease
  • You must meet prior authorization criteria based on your BMI (body mass index):
    • BMI 35+; or
    • BMI 30-34 with heart failure, hypertension, or chronic kidney disease; or
    • BMI 27-29 with prediabetes, previous heart attack or stroke, or blocked arteries in legs or arms

If you think you qualify, the first step is to talk with your doctor to start the approval process.

More Prescriptions Added to Drug Negotiation Program

Last year, the first round of the Medicare Drug Negotiation Program went into effect, which lowered prices on Eliquis, Enbrel, Entresto, Farxiga, Imbruvica, Januvia, Jardiance, NovoLog/Fiasp, Stelara, Xarelto. In 2027, the program will expand to include reduced costs on the following prescriptions:

Diabetes & Weight Management

  • Ozempic / Rybelsus / Wegovy
  • Janumet / Janumet XR
  • Tradjenta

Asthma & Chronic Obstructive Pulmonary Disease (COPD)

  • Trelegy Ellipta
  • Breo Ellipta

Cancer Treatments

  • Xtandi
  • Pomalyst
  • Ibrance
  • Calquence

Neurological & Mental Health Disorders

  • Austedo / Austedo XR
  • Vraylar

Other Chronic Conditions

  • Linzess
  • Xifaxan
  • Ofev
  • Otezla

You do not have to do anything to receive the lower cost benefits through the Drug Negotiation Program. Reduced costs on these prescriptions will be automatically built into Medicare drug coverage for all Medicare plans next year. During Open Enrollment, you should always check your Part D or Medicare Advantage plan to see whether the plan you are enrolled in will still offer the best coverage for you next year.

New Medicare Advantage Enrollment Restrictions for People with Medicare and Medicaid (or QMB)

Many people who have Medicare are considered “dual eligible,” meaning they are eligible for both Medicare and Medicaid or QMB (Qualified Medicare Beneficiary) benefits. When someone is dual eligible, they can choose to receive their Medicare benefits through Original Medicare or a Medicare Advantage plan. Some Medicare Advantage plans are Dual-eligible Special Needs Plans (called D-SNPs), meaning they are only available for someone who has Medicare and Medicaid or QMB.

Starting this Open Enrollment Period, there are some additional restrictions about who can enroll in a D-SNP. Now, anyone who has Medicaid benefits and is switching or enrolling into a Medicare Advantage D-SNP will only be able to join the D-SNP that matches their MCO (Managed Care Organization – Iowa Total Care, Molina, or Wellpoint). This is a new requirement from CMS (Centers for Medicare and Medicaid Services) to provide better alignment for your healthcare services and providers. Anyone currently enrolled in a D-SNP that doesn’t align with their MCO is allowed to remain in the same plan next year, if that is still the best plan for them. Moving forward, the Iowa Total Care (Wellcare), Molina, and Wellpoint D-SNPs will only be able to accept new members who are already enrolled in their matching MCO.

Updated “flex card” Requirements

Some Medicare Advantage plans, especially D-SNPs, offer “flex cards” that allow the member to use a pre-paid amount toward expenses like OTC (over-the-counter) products, rent/utilities, or healthy food purchases, etc. In 2027, there will be additional restrictions on how these flex cards can be used.

Starting next year, if you are enrolled in a Medicare Advantage plan that offers a flex card, you will only be able to use that card toward OTC products – unless you can prove you have a chronic condition that is life-threatening or limits your overall health & function, you have a high risk of hospitalization or adverse health outcomes, and you require intensive care coordination. If you meet those qualifying conditions, then you could spend the flex card allowance on other expenses that are not over-the-counter (OTC) products. Not all plans offer this benefit. For more details, you would need to reach out to the plan.