Medicare chief Dr. Mehmet Oz speaks at an event announcing the America.gov artificial intelligence website in Washington, DC, last month.
Jim Watson/AFP via Getty Images
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Jim Watson/AFP via Getty Images
Many Medicare Advantage plans will disappear next year, leaving seniors in many areas with fewer options. In 193 counties nationwide, no plan is proposed.
The annual Medicare open enrollment period began October 15 and will continue through December 7, and seniors enrolled in privatized Medicare plans that are closing in some markets should consider their options carefully.
Medicare Advantage means that private insurers manage 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 with Medicare choose Medicare Advantage. It is popular because it covers services such as vision and dental care, often with lower premiums than traditional Medicare. It is also often integrated into the benefit of “Part D” drugs, thereby simplifying this decision.
But the downside to Medicare Advantage is that companies can choose where they offer plans. If a certain community is not profitable, a company may exit that market. And it’s been happening on an increasingly larger scale over the past three years, according to a study published in JAMA.
Who is affected
Large swaths of rural America are losing Medicare Advantage choices, as are some large metropolitan areas.
Last year, 2.9 million seniors had Medicare Advantage plans that closed shop, according to JAMA. This year, an analysis of insurance company announcements by An arm and a leg podcast, shows that at least 2 million people will be affected. Other preliminary estimates range from 3.2 million to 5 million elderly people. About 35 million people are enrolled in Medicare Advantage.
The 193 counties that will have no Medicare Advantage plans are mostly rural, according to an analysis of federal data by health policy research organization KFF. Last year, that number was about 120 counties without a proposed plan.
The KFF figures also show that there will be significantly fewer plans offered in some metropolitan 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 ends and you don’t choose another plan, the insurance company will assign you to another Medicare Advantage plan or the government will enroll you in traditional Medicare, but without a supplement plan or drug plan.
If you want to switch from Medicare Advantage to traditional Medicare and your plan ends, you can enroll in a Medicare supplement plan – also known as Medigap – without the same restrictions you normally would have. If you have a pre-existing condition that has prevented you from enrolling in Medigap before, this could be good news.
Another issue this year is that insurance companies may cap enrollment in some of the Medicare Advantage plans they offer.
Which means: if you wait to sign up, a plan you want may already be full.
Companies are supposed to sign people up on a first-come, first-served basis – not select customers based on their health, age or demographics.
Another reason not to delay is that with so many people looking for new projects, 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 package is still offered: First, check your mail. Medicare Advantage plans that are in the process of being closed should have sent letters the first week of October. You can also log into your account on Medicare.gov to check the status of your plan for next year.
- Try calling your SHIP: There is a State Health Insurance Assistance Program – known as “SHIP” – in every state to help seniors with Medicare. The name isn’t easy to remember or particularly descriptive, but it’s free, federally mandated, and staff and volunteers are required to give you unbiased information about 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.
- Search for local Medicare counseling services: Friends, family, leaders in your place of worship, and your local elected officials’ constituent departments may have information on where you can get individual help. The Medicare Rights Center, a nonprofit organization, also has a national hotline and a well-curated library of online guides.
- Brokers can be helpful, but be careful: You want a broker who will discuss all of your options with you, including switching to traditional Medicare and a supplemental plan. Ask them if they sell plans from all the insurance companies available. And ask if they answer your questions about your plan all year round, because insurance never stops being confusing.
- Check what you see on it Medicare.gov: Medicare Plan Finder lets you search for plans online. But the lists of covered doctors and medications can sometimes be wrong. To be safe, check with your doctor’s office or a SHIP advisor, broker or other Medicare assistant.
- Don’t share your personal information with services you find online: Be careful when sharing your personal information like your phone number. Some online agencies will sell your information, leading to spam calls and potentially even scammers.
- Pay attention to deadlines: Medicare open enrollment runs from October 15, 2026, through December 7, 2026. Coverage begins January 1, 2027. If your plan ends, you are eligible for a “special enrollment period” to give you a little more time — until February 28, 2027. (For coverage that begins January 1, 2027, enroll by December 31.)
Emilie Pisacreta is the main producer of An arm and a lega podcast on the cost of healthcare produced in partnership with KFF Health News and distributed by KUOWSeattle’s NPR member station.
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