Medicare chief Dr. Mehmet Oz speaks at an event announcing the artificial intelligence website, America.gov in Washington, D.C., last month.
Jim Watson/AFP via Getty Images
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Jim Watson/AFP via Getty Images
A slew of Medicare Advantage plans are disappearing for next year, leaving seniors in many areas with fewer options. In 193 counties across the country, no plans are offered at all.
Medicare’s annual open enrollment period kicked off October 15 and runs until December 7, and seniors enrolled in those privatized Medicare plans that are closing in certain markets should carefully review their options.
Medicare Advantage means private insurers run Medicare for older Americans who choose it over traditional Medicare, where the federal government itself administers the program. More than half of the 70 million Americans in Medicare choose Medicare Advantage. It’s popular because it covers services like vision and dental, often with lower premiums than traditional Medicare. It also often folds in the “Part D” drug benefit, simplifying that decision.
But a downside of Medicare Advantage is that companies can pick and choose where they offer plans. If a certain community is not profitable, a company can leave that market. And that has been happening on an increasingly large scale the last three years, according to research published in JAMA.
Who is affected
Big swaths of rural America are losing Medicare Advantage choices and so are some major metro areas.
Last year, 2.9 million seniors were in Medicare Advantage plans that closed up shop, according to JAMA. This year, an analysis of insurance company announcements by An Arm and A Leg podcast, shows at least 2 million people will be affected. Other preliminary estimates range from 3.2 million to 5 million seniors. About 35 million people are enrolled in Medicare Advantage.
According to an analysis of federal data by the health policy research organization KFF, the 193 counties that will have zero Medicare Advantage plans are mostly rural. Last year that number was about 120 counties without a plan offered.
KFF’s numbers also show that there will be far fewer plans offered in some metro areas. Dallas, Minneapolis, Seattle, Houston and Portland all have between a quarter and a third fewer Medicare Advantage plans for seniors.
What happens next
If your plan is ending, and you don’t choose another, the insurance company will assign you to another Medicare Advantage plan or the government will enroll you in traditional Medicare — but without a supplemental or drug plan.
If you want to switch from Medicare Advantage to traditional Medicare and your plan is ending, you can enroll in a Medicare supplemental plan — also known as Medigap — without the same restrictions that you would normally have. If you have a pre-existing condition that has prevented you from enrolling in Medigap before, that could be good news.
Another wrinkle this year is that insurance companies can cap enrollments on some of the Medicare Advantage plans that they do offer.
Which means: If you wait to sign up, a plan you want might already be full.
The companies are supposed to enroll people on a first-come, first-serve basis — and not cherry-pick customers based on health conditions, age, or demographics.
Another reason not to delay is that with so many people on the hunt for new plans, it may take longer than usual to get help.
How and where to find help
Here are some tips for navigating Medicare open enrollment this year:
- Find out if your plan is still offered: First, check your mail. Medicare Advantage plans that are closing should have sent letters the first week in October. You can also log in to your account on Medicare.gov to check your plan’s status for next year.
- Try calling your SHIP: There’s a State Health Insurance Assistance Program — known as a “SHIP” — in every state to help seniors with Medicare. The name’s not easy to remember or particularly descriptive, but it’s free, mandated by the federal government, and the staff and volunteers are required to give you unbiased information on all available options. Find your state in the directory at shiphelp.org. Your county may have a specific number that you can find on your state’s SHIP website.
- Look for local Medicare counseling services: Friends, family, leaders at your place of worship, and the constituent services of your local elected officials may have the scoop on where you can get one-on-one help. The nonprofit Medicare Rights Center also has a national helplineand a well-organized library of online guides.
- Brokers can be helpful, but be savvy: You want a broker who’s going to talk with you about all your options — including switching to traditional Medicare and a supplemental plan. Ask if they sell plans from all available insurance carriers. And ask if they answer questions about your plan year-round, because insurance never stops being confusing.
- Double check what you see on Medicare.gov: Medicare’s Plan Finder allows you to search plans online. But lists of doctors and drugs that are covered can sometimes be wrong. To be safe, double check with your doctor’s office or a SHIP counselor, broker, or other Medicare assistor.
- Don’t share your personal information with services you find online: Be careful where you share your personal information like your phone number. Some online agencies will sell your information, leading to spam calls and potentially even scam artists.
- Be mindful of the deadlines: Open enrollment for Medicare runs October 15, 2026 through December 7, 2026. The coverage starts January 1, 2027. If your plan is ending, you qualify for a “special enrollment period” to give you a little more time — until February 28, 2027. (For coverage that starts January 1, 2027, enroll by December 31.)
Emily Pisacreta is the senior producer for An Arm and a Lega podcast about the cost of healthcare produced in partnership with KFF Health News and distributed by KUOWSeattle’s NPR member station.
Source: www.npr.org
