Disappearing Medicare Advantage Plans Leave Seniors With Fewer Choices

A significant number of Medicare Advantage plans are set to vanish next year, resulting in limited options for seniors in various regions. Alarmingly, in 193 counties nationwide, no plans will be available at all.

The open enrollment period for Medicare, which kicked off on October 15 and continues until December 7, is a crucial time for seniors enrolled in privatized Medicare plans that are shutting down in certain markets. It’s essential for them to review their alternatives carefully.

Medicare Advantage allows private insurers to manage Medicare for those older Americans who opt for it instead of traditional Medicare, which is administered directly by the federal government. Over half of the 70 million people on Medicare select Medicare Advantage, likely due to its additional services like vision and dental care, often featuring lower premiums compared to traditional Medicare. Furthermore, it usually combines the “Part D” drug benefit, which simplifies things for users.

However, a drawback of Medicare Advantage is that insurers can determine where to provide plans. If a particular community doesn’t prove profitable, an insurer may exit that market. This situation has reportedly worsened over the past three years, according to recent research published in JAMA.

Who is Affected

Many rural areas are losing access to Medicare Advantage options, alongside some large metropolitan locations.

Last year, approximately 2.9 million seniors were in Medicare Advantage plans that were discontinued, as per JAMA data. This year, reports indicate that at least 2 million will be impacted, with other early estimates suggesting numbers could range from 3.2 million to 5 million. Currently, about 35 million individuals are enrolled in Medicare Advantage.

Based on an analysis of federal data from KFF, the 193 counties without any Medicare Advantage plans are primarily rural. This figure has risen from around 120 counties lacking a plan last year.

KFF’s report also indicates a notable decrease in available plans within certain metro regions. Cities like Dallas, Minneapolis, Seattle, Houston, and Portland are witnessing reductions between 25% and 33% in Medicare Advantage plans for seniors.

What Comes Next

If your plan is ending and you don’t select another, the insurance company will either assign you to a different Medicare Advantage plan or transition you to traditional Medicare, though this option won’t include a supplemental or drug plan.

If you’re considering shifting from Medicare Advantage to traditional Medicare due to your plan ending, you have the chance to enroll in a Medicare supplemental plan, or Medigap, without facing the usual restrictions. This could be particularly beneficial if you have a pre-existing condition that prevented you from enrolling earlier.

This year brings an additional concern, as insurance companies may limit enrollments on some Medicare Advantage plans they still offer.

What this means is, if you wait to register, the plan you might want could already be at capacity.

Companies are required to enroll individuals on a first-come, first-served basis, without discriminating based on health conditions, age, or demographics.

With many people seeking new plans, it could also take longer than usual to receive assistance.

Navigating Open Enrollment

Here are some suggestions for making the most of this year’s Medicare open enrollment:

• Check if your plan is still available: Look out for any letters sent by your Medicare Advantage plan regarding closures, usually dispatched during the first week of October. You can also log in to Medicare.gov to see your plan’s status for the upcoming year.
• Contact your SHIP: Each state has a State Health Insurance Assistance Program (SHIP) to assist seniors with Medicare. Although the name isn’t particularly catchy, it’s a free resource, federally mandated, where staff and volunteers provide unbiased information about options. You can find your state’s SHIP through their directory.
• Seek local Medicare counseling services: Sometimes, friends, family, leaders from your community, and local elected officials can guide you to support services. The nonprofit Medicare Rights Center also has a national helpline and a detailed library of guides online.
• Be cautious with brokers: Look for brokers who are willing to discuss all your options, including switching to traditional Medicare along with a supplemental plan. It’s also wise to check if they provide information about all available plans year-round.
• Verify information from Medicare.gov: The Medicare Plan Finder allows you to search plans, but the information about covered doctors and medications can sometimes be inaccurate. Always double-check with your doctor or a SHIP counselor for peace of mind.
• Be careful with personal information online: Be judicious about sharing your personal details, like phone numbers, as some online services may sell your data, which can lead to spam calls or scams.
• Mind deadlines: Medicare’s open enrollment runs from October 15, 2026, to December 7, 2026, with coverage beginning January 1, 2027. If your plan is ending, you can qualify for a special enrollment period, extending your decision deadline to February 28, 2027, but be sure to enroll by December 31 for coverage that starts on January 1.