Angela Myers doesn’t know what she’s going to do.
The 54-year-old from Chittenden County lives with a disability. When she needed better health insurance, she said her doctors recommended Vermont Blue Advantage, a type of Medicare provided by Blue Cross Blue Shield that could offer her extra benefits and reduced costs.
She’s been on the plan for five years, she said, and it covers all her frequent doctor visits and monthly prescriptions.
But she’s going to lose that insurance soon.
Blue Cross Blue Shield of Vermont announced Oct. 1 that it would drop Medicare Advantage coverage in 2026, leaving the thousands of Vermonters like Meyers scrambling to secure new plans before the turn of the year. Vermont Blue Advantage covers over 26,000 people in Vermont, the company told the Burlington Free Press, and has more complete coverage than traditional Medicare, including dental work and prescriptions.
The company, which is paid by the government to run the program, says it costs too much. The “Vermont Medicare Advantage market is unsustainable for Vermont Blue Advantage to be able to offer reasonably priced and affordable products to serve as an alternative to traditional Medicare coverage,” Blue Cross Blue Shield of Vermont said when announcing the plan.
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That’s been the national trend, with Medicare Advantage plans whittled down across many states. But for a low-population place like Vermont, the disruption for people is magnified.
A big problem with choosing a new Medicare Advantage plan is that there just aren’t many offered in Vermont. The same day Vermont Blue Advantage announced its cut, UnitedHealthcare did the same. United, itself one of the largest purveyors of Medicare Advantage plans across the country, serves almost 8,000 Vermonters, the company told the Free Press.
Medicare Advantage plans in Vermont
As of September, over 51,600 Vermonters were insured by a Medicare Advantage plan, and over 168,000 people were eligible, government data shows.
Advantage plans are run by private companies but funded by the federal government. They are for people 65 and older or who have a disability. More than half of U.S. residents eligible for Medicare Advantage are insured under it, according to KFF, a national health care reporting and research outfit.
Vermonters skew under that trend at 34% for 2024, KFF reported. But the number has been rising. A decade prior, only 7% of eligible Vermonters used an Advantage plan.
Even so, the options are slimming. Insurance plans shuttering has become almost an annual tradition in Vermont. Two Advantage plans — operated by MVP and WellCare — folded this past January.
Come next year, the only option for those seeking an individual Medicare Advantage plan is Humana, which serves Bennington, Caledonia, Essex, Orange, Windam and Windsor counties, or less than half the counties in Vermont.
People losing health insurance feel ‘abandoned’
Larry Mindell of Williston said he and his wife signed up with Vermont Blue Advantage after MVP cancelled its coverage. He said they feel “abandoned” by the companies and worry this may only be the beginning of a sharper downturn.
“I say ‘abandon’ because that’s what it feels like, and it’s happening to us for the second year in a row,” Mindell said.
Mindell has been working with an insurance broker to find a new plan, but that’s not an option everyone has.
Some were able to be proactive in changing their plans. The Vermont Treasurer’s Office announced Sept. 11 that starting next year, retired teachers receiving health insurance from Vermont Blue Advantage will be covered by equivalent plans from HealthSpring.
The change will impact over 7,000 retirees and beneficiaries in Vermont, says the Treasurer’s Office. The decision came after Vermont Blue Advantage proposed a 50% premium increase in July, and it proved to be a good one as Blue Cross Blue Shield pulled the plan altogether just a few months later.
Other people were not prepared to lose their insurance.
Frankin County resident Barb Fichter has been living in Vermont since 2022 and said it took her a few years to find an Advantage plan she was happy with before choosing Blue Cross Blue Shield’s offering in January 2024.
Now, she’s back to where she started.
“It’s so disconcerting to wade through alternatives, and I fear I may just be on regular Medicare with no prescription drug coverage or dental coverage,” Fichter said. “I’m going to have to weigh out which things I’m going to have to give up because I can’t afford the costs or co-pays.”
When is Medicare open enrollment? Special enrollment if you’re losing coverage?
The annual open enrollment period for choosing new Medicare plans runs from Oct. 15 through Dec. 7. There is a special enrollment period for those who will be losing coverage, allowing them until March 4 to find a new plan.
But as the current plans end by Jan. 1, 2026, people will have a gap in coverage if they wait to sign up for a new one.
Sydney P. Hakes is the Burlington city reporter. Contact her at SHakes@gannett.com.
