Overview
• Several organizations are ceasing Medicare Advantage coverage in various counties within the Driftless region.
• Thousands of residents in Wisconsin and Minnesota will need to find new insurance plans during the open enrollment period.
• These changes stem from limitations on prescription drug costs and reductions in Medicare contract payments to insurers.
VIROQUA, Wis. — A significant number of Medicare beneficiaries in the Driftless area will need to secure new health insurance as a prominent health insurance provider has decided to discontinue its Medicare Advantage plans in certain parts of the region.
Quartz has confirmed it will stop offering these plans in counties south of La Crosse starting in 2026.
Quartz officials stated:
“Every year, we closely evaluate our product offerings to ensure we provide the value and quality our members expect. After significant review, we have made the tough choice to withdraw our Medicare Advantage products…because we believe we cannot maintain a competitive product.”
Anthem Blue Cross Blue Shield is also reportedly modifying its offerings, according to insurance agent Marshall Pearce of Hoogom Insurance Agency in Onalaska.
Pearce mentioned to News 8 that Anthem “will only provide Medicare Advantage plans in 2026 to individuals who are enrolled in both Medicare and Medicaid in their local areas.”
“Every county’s circumstances are unique, but many plans are impacted. Statistically, about 2 million people are being dropped from plans nationwide,” noted Rick Teska, owner and CEO of Strive Medicare in La Crosse.
Specifically, Teska pointed out that counties like Vernon, Jackson, Crawford, Juneau, and Richland in Wisconsin are likely to experience reductions in coverage. Similarly, Winona and Houston counties in Minnesota will also see some effects.
“I’ve been involved in this for 41 years…and I can honestly say, this is the most significant change I’ve ever witnessed,” Teska shared.
The Vernon County Aging and Disability Resource Center organized a meeting about these changes on Wednesday afternoon.
Numerous individuals filled the Bethel Home Fellowship Hall in Viroqua, but many were turned away due to space limitations.
“Everyone is anxious,” remarked an attendee. “Healthcare is crucial and very costly; people really need to understand this and take action.”
Reasons for Coverage Termination
Teska identified two primary factors contributing to the insurers’ exit from the market.
The first issue relates to limits on prescription drug costs that shift financial responsibility onto insurance providers.
“If you set an out-of-pocket cap at $2,000, someone has to cover that. Essentially, the insurance company bears that extra cost,” Teska elaborated.
The second factor involves changes in Medicare itself that result in lowered payments to insurance companies.
“All Medicare Advantage plans negotiate with Medicare for service pricing, and many of the agreements reached have seen reductions,” Teska explained.
Options for Affected Residents
Despite the uncertainty, Teska emphasized that alternatives are available for those who have lost coverage. He encourages affected individuals to reach out to local independent insurance agents to investigate their options.
“In many cases, you can tweak your plan so that you don’t need to change doctors. You can continue seeing the same provider and using the same pharmacy,” Teska advised.
Pearce also recommends taking early action.
“If we remain passive, we could end up back with just Original Medicare, which may lead to higher out-of-pocket expenses,” he cautioned.
During the meeting, residents expressed frustration with their elected officials.
“I hope when I go to vote next time, I will remember these issues. But how will I manage until then? It’s going to be quite tough,” one attendee lamented.
Open enrollment for Medicare starts on Wednesday, October 15th, and continues through Sunday, December 7th.
Pearce indicated that there will be a special enrollment period for those who have lost coverage, running from Monday, December 8th to Saturday, February 28th, 2026.
