Medicare Advantage Plans Vanish in 2027, Leaving 193 Counties Without Any Option
At least 2 million seniors, and by some estimates up to 5 million, face plan closures as open enrollment runs through Dec. 7.
A slew of Medicare Advantage plans are disappearing for next year, leaving seniors in many parts of the country with fewer choices. In 193 counties, no Medicare Advantage plan will be offered at all, according to an analysis of federal data by the health policy research group KFF. Last year that number was about 120 counties. Most of the counties with no plans are rural.
Medicare's annual open enrollment period began Oct. 15 and runs until Dec. 7. More than half of the 70 million Americans in Medicare are in Medicare Advantage, in which private insurers run the program, rather than the traditional version administered by the federal government. About 35 million people are enrolled. The plans are popular because they often cover vision and dental care, usually carry lower premiums than traditional Medicare and often fold in the Part D drug benefit.
The catch is that insurers can choose where to sell. If a community is not profitable, a company can leave, and research published in JAMA shows that has been happening on an increasingly large scale over the last three years. Last year, 2.9 million seniors were in plans that closed. This year, an analysis of insurer announcements by the podcast An Arm and A Leg found at least 2 million people will be affected, while other preliminary estimates range from 3.2 million to 5 million.
The losses are not limited to rural areas. KFF found that Dallas, Minneapolis, Seattle, Houston and Portland will each have between a quarter and a third fewer Medicare Advantage plans than before.
People whose plan is ending have choices, and doing nothing carries risk. If they don't pick a new plan, the insurer will assign them to another Medicare Advantage plan, or the government will enroll them in traditional Medicare, without a supplemental or drug plan. Seniors leaving a closing plan can buy a Medigap supplemental policy without the usual restrictions, which can matter for people whose pre-existing conditions previously kept them from qualifying.
There is a new wrinkle this year. Insurers can cap enrollment on some of the Medicare Advantage plans they still offer, which means a plan can fill up. Companies are supposed to take people on a first-come, first-served basis and not cherry-pick customers by health, age or demographics. With so many people searching for new coverage, getting help may also take longer than usual.
NPR's guidance for enrollees starts with checking the mail, since closing plans were supposed to send letters in the first week of October, and logging into a Medicare.gov account to see a plan's status for next year. Every state has a State Health Insurance Assistance Program, known as a SHIP, which offers free and unbiased counseling and is listed at shiphelp.org. The nonprofit Medicare Rights Center runs a national helpline. Brokers can help, but seniors should look for one who discusses all options, including traditional Medicare with a supplemental plan, and who sells plans from every available carrier.
