Overview
• Several organizations are discontinuing Medicare Advantage plans in parts of the Driftless area.
• Many residents in Wisconsin and Minnesota will need to seek new insurance options during open enrollment.
• These changes are attributed to limits on prescription drug costs and decreased payments from Medicare to insurance companies.
VIROQUA, Wis. — A significant number of Medicare beneficiaries in the Driftless region are facing a need to find new health insurance as a major insurer has announced it will stop providing Medicare Advantage plans in certain counties.
Quartz has confirmed to local news that it will cease offering these plans south of La Crosse starting in 2026.
In a statement, Quartz officials noted:
“Each year, Quartz thoroughly assesses our product offerings to ensure we meet the value and quality expectations of our members. After careful consideration, we’ve made the tough choice to discontinue our Medicare Advantage products…because we believe we can’t maintain a competitive offering.”
Anthem Blue Cross Blue Shield is also reportedly making adjustments, according to insurance agent Marshall Pearce from Hoogom Insurance Agency in Onalaska.
In his statement, he mentioned that Anthem will limit its Medicare Advantage plans in 2026 to those enrolled in both Medicare and Medicaid in their area.
“Each county has its own circumstances, but many plans are impacted. Overall, I believe around two million people could lose coverage nationwide,” said Rick Teska, owner and CEO of Strive Medicare in La Crosse.
Teska highlighted specific counties like Vernon, Jackson, Crawford, Juneau, and Richland in Wisconsin, along with Winona and Houston counties in Minnesota, that will experience a loss of coverage.
“In my 41 years in the field, this is the most significant change I’ve ever witnessed,” Teska shared.
The Vernon County Aging and Disability Resource Center held a meeting about these developments, attracting a large crowd, although many were unfortunately turned away due to capacity limits.
“People are really anxious,” said one participant. “Health care is crucial and costs are high. It’s vital to take action on this.”
Reasons for Coverage Changes
Teska outlined two primary reasons why insurers are exiting the market.
The first involves limits on prescription drug costs, which essentially transfer financial responsibility to the insurers.
“If you set an out-of-pocket cap at $2,000, someone has to cover that expense. This means the financial burden falls on the insurance company,” Teska explained.
The second reason relates to changes within Medicare that have reduced payments to the insurers.
“All Medicare Advantage plans negotiate with Medicare on pricing, and many of these contracts have seen reductions,” Teska noted.
Options for Affected Residents
Despite the confusion, Teska emphasized that there are alternatives available. He advised those losing coverage to reach out to local independent insurance agents for guidance.
“Often, you can modify your plan to keep your doctor and pharmacy,” he said.
Pearce also recommended taking prompt action.
“If we don’t act, we might end up limited to Original Medicare, which could lead to higher out-of-pocket expenses,” he cautioned.
During the meeting, residents expressed frustration towards local representatives.
“I hope I remember these issues when it’s time to vote again. But what am I supposed to do until then? It’ll be tough,” commented one attendee.
The open enrollment period for Medicare starts Wednesday, October 15, and runs until Sunday, December 7.
Pearce stated there will be a special enrollment period for those losing coverage, from December 8 to February 28, 2026.
