My Medicare Plan Is
Leaving Kit.
Notice decoder, deadlines, doctor and drug lists, and a four plan comparison
Got a letter that your Medicare Advantage plan is leaving? Put your notice, deadlines, doctors, medicines and plan choices in one place. Plain English, with official Medicare sources for every rule.
PDF, US Letter, 33 pages. Fill it in on a computer or tablet, or print it. Type your name and plan once on page 2 and they fill in throughout the kit. Letter pages print plain, ready to sign and mail.
Choosing and joining a Medicare plan is free through Medicare.gov, 1-800-MEDICARE, or your free local SHIP counselor. FormFriendlyKits is not affiliated with Medicare or any government agency. This kit is an organizer with general information, not legal, financial or medical advice.
33 pages.
Type it once.
Your name and plan fill in once and appear throughout the kit.
- Letter decoder and the 2026 to 2027 nonrenewal deadlines
- When new coverage starts for December, January and February enrollment
- Doctor, prescription and pharmacy worksheets
- A side by side four plan comparison
- Yearly cost worksheet, plus Original Medicare, Medigap and Part D worksheet
- Medigap rights, drug coverage and late penalty explained
- Extra Help, Medicare Savings Programs and free counseling contacts
- Call log, helper page, scam warning signs and an enrollment checklist
- Two optional request letters, each with a one page guide
See how it reads.
The cover, the contents, and the deadlines page from the kit.
Before you buy.
Short answers, plain English.
My Medicare Advantage plan is leaving. Do I have to do anything?
If you do nothing, you generally return to Original Medicare when the plan ends, and you may not have drug coverage. You can choose another plan instead. The kit walks you through both paths and the deadlines that apply to your notice.
How long do I have to pick a new plan?
If your plan is not renewed, Medicare lists a special window from December 8 through the last day of February. Open Enrollment runs October 15 to December 7. The kit shows when coverage starts for each month you enroll, with the official Medicare sources.
Is it free to change Medicare plans?
Yes. Joining a plan through Medicare.gov or 1-800-MEDICARE is free, and your local SHIP offers free, unbiased counseling. This kit is an organizer that keeps your notice, doctors, drugs, costs and calls in one place.
Does this kit work in my state?
Yes. It is built on federal Medicare rules that apply in every state. Some Medigap and savings program rules vary by state, and the kit shows you where to check.
Can I fill it in on a computer?
Yes. It is a fillable PDF. Type your name and plan once on page 2 and they appear throughout. You can also print it and write by hand.
How do I get the kit after I buy it?
Right after checkout you get a download link on screen, and the same link is emailed to you. It is a PDF you keep.
Is this advice from Medicare?
No. FormFriendlyKits is not affiliated with Medicare or any government agency. The kit is general information that helps you ask the right questions and keep track, with official sources listed for every rule.