Vermont

Medicare Advantage plans are leaving Vermont. Now what? – VTDigger

Published

3 months ago

November 27, 2025

Medicare Advantage plans are leaving Vermont. Now what? – VTDigger

Bouncing from plan to plan for Medicare coverage has become an inadvertent, annual tradition for Becky Beerwald.

When she moved to Essex Junction from the Connecticut coast in 2023, she selected a Medicare Advantage plan before it was discontinued for the following year. Then she enrolled in a Vermont Blue Advantage plan, only for the insurer to announce in October that it would not offer the plans in 2026. This fall, she went back to the drawing board but in an insurance landscape almost entirely stripped of the Medicare Advantage plans that nearly 51,000 people in the state had relied on.

Beerwald is just one of the thousands of Vermonters trying to make sense of the coverage that remains available now that Medicare Advantage has essentially left the state.

by Olivia Gieger
October 1, 2025, 1:01 pmOctober 2, 2025, 11:18 am

This year’s open enrollment period for Medicare, which runs through Dec. 7, has been a “challenging one,” said Sam Carleton, who directs the State Health Insurance Program, a state entity that provides guidance for Medicare beneficiaries. The small office has been flooded with inquiries since the start of October, when BlueCross Blue Shield and United Healthcare’s departures from the Advantage market became public. Agewell, the elderly support agency Carleton leads in Northwestern Vermont has also seen a surge in interest for the webinars they offer to explain how Medicare works and how people can get the coverage they need under it.

Medicare is the federal health insurance program for people 65 and older and those with certain disabilities.

Medicare has four parts: Part A covers inpatient care while Part B broadly covers outpatient care, medical devices and preventative care, among other things. Together, these two are regarded as original Medicare. It generally covers 80% of the cost of services, meaning many people who opt for traditional Medicare coverage also opt for something known as a Medigap plan, or supplemental insurance, sold by a private insurer that can help cover the remaining 20% of costs.

Medicare Part D offers prescription drug coverage, which is also provided by a private insurer.

Part C plans bundle all of that — and often include additional benefits like dental, or vision. These plans, known as Medicare Advantage plans, are offered by private insurers.

While many people like their Advantage plans, others can feel trapped in them because they require approval before covering some drugs and services and often require people to see in-network providers.

When the insurers providing Medicare Advantage plans in Vermont announced the end to their coverage, it gave some people a welcomed exit ramp from plans that are otherwise difficult to leave, explained Kaj Samsom, the commissioner of the Department of Financial Regulation, the state office that regulates insurers.

“This event, as really truly unfortunate as it is for folks who are no longer in Medicare Advantage and no longer have other options, there are some people who are probably happy,” Samsom said.

When an insurer withdraws a plan, it triggers something called a special enrollment period, which comes with different privileges than the regular open enrollment period.

In particular, it means people searching for new plans get something called “Guaranteed Issue Rights.” These rights mean that insurance companies cannot charge someone more for their insurance based on pre-existing health conditions — things like diabetes or cancer — that would make care more expensive for the insurer to pay out.

When someone is new to Medicare and enrolling for the first time, they are also protected from this type of underwriting. But after that initial enrollment, Medigap plans can reject or charge sicker patients more based on their health history. Samsom referred to this as the “one way street” of Medicare Advantage, where individuals can’t switch to traditional Medicare without the massive cost of a Medigap supplement plan looming over them.

Now, nearly all Vermonters who bought Medicare Advantage plans will need to opt into original Medicare, with the option to buy the supplemental Medigap plans — protected from underwriting during this special enrollment.

The issue of underwriting became particularly concerning to Beerwald. As she scoured the best Medigap plan, she said some insurers asked for her health history, despite her guaranteed issue rights.

When open enrollment began, Beerwald said she started calling the insurers offering the least expensive Medigap plans for 2026: Medco, State Farm and Aflac.

Each insurer offers a selection of Medigap plans: A, B, C, D, F, G. These letter plans are standardized, so that plans with the same letter include the same benefits, no matter which insurer sells them. Price should be the only difference.

Beerwald said she wants a G plan because it offers the best coverage with the most diverse beneficiary pool — because of a 2015 law, people who became eligible for Medicare after 2020 can’t buy Medigap plans C or F. That restriction effectively leaves plans’ pool older. Plans D and G now offer similar coverage, without the age restriction.

“My mother lived until almost 102 my dad was 87, so I’ve got a long life ahead of me,” Beerwald said. “I don’t want to be in the older pool, I want to be in the younger pool.”

She said she worries that as the pools under plans C and F grow older and smaller over time, their premiums will soar or the plans could disappear altogether.

“I don’t want to be in the lurch again. I want to be in the popular plan with the popular kids,” she said.

Insurers she found that honored the guaranteed issue rights for plan G charged higher premiums. She did notice, however, that insurers would honor these rights for C and F plans.

Eventually, she bought a TVHP Medigap Blue Plan G from BlueCross BlueShield of VT, for about $258 per month, she said.

Still, the fact that she encountered some insurers who would not honor the guaranteed issue for every letter plan conflicted with her understanding of how the law should protect that right.

Beerwald’s quest to understand and rectify this issue offers a window onto the maelstrom that can arise when private insurers are tasked with delivering a government service. She said she reached out to the state office tasked with regulating insurers, their consumer protection line, U.S. Rep. Becca Balint’s office, SHIP and Carleton, in an attempt to make sense of it all.

“I certainly feel that frustration. I mean, you’re in a circumstance where you’ve lost your insurance, you received notice from the federal government that you are getting a special enrollment period, and you’re able to get another plan. You’ve done the legwork. … You’ve made a choice, and you then call this insurance company, those insurance companies say sure we’ll sell you a policy, but only if you send us all your medical records. That stinks,” Carleton said.

However, Carleton and the Department of Regulation told Beerwald — and confirmed to VTDigger — that it is legal for insurers to not apply guaranteed issue rights to every letter plan.

It comes down to one small matter of wording in the regulation that applies to Medigap plans: “It’s a ‘must’ for (plans) A, B, C, F,” Department of Regulation Deputy Commissioner Mary Block said. “It’s a ‘may’ for G, for people before that 2020 date.”

“So some insurance companies will offer it, some will not,” she added.

There’s nothing the state can do to rectify this frustration, according to Block, since federal law dictates Medigap plan regulations.

“In Vermont, we don’t have the discretion to say Plan G is always going to be available to everybody,” she said.

Block added that other consumers have run into confusion when dealing with insurance brokers, who may not be aware of which customers are receiving guaranteed issue rights and may mix up forms.

The best way to combat that, Samson said, is for people to advocate for themselves and make it very clear when they are on the phone that they need the guaranteed issue rights.

Beerwald remains unsatisfied with their explanation.

Now, the only remaining Medicare Advantage plans in the state are Humana plans in six counties — including Orange, Windham and Windsor, where many of the available care comes from providers in the Dartmouth Health network. However, Dartmouth Health has long been out of network for Humana. During a Nov. 19 town hall with the Vermont congressional delegation, Balint raised particular concern over this and cautioned beneficiaries in those counties to choose new plans.

Carleton assured that even in the counties where Humana remains, if people have lost their other Advantage plan, they should still receive guaranteed issue rights for Medigap plans if they chose to buy one and opt into original Medicare.

“What prompts the special enrollment period is your plan leaving, not necessarily the loss of all Medicare Advantage plans,” he said.

Carleton said he worries about the overall sticker shock that comes with Medigap plans, and fears some people will opt into original Medicare and forgo supplemental plans, leaving them vulnerable to the 20% of costs that original Medicare doesn’t cover.

Beerwald said she’s going to end up paying more than $7,500 for insurance this year. After her Medigap plan, she said she’s buying a drug plan, vision and hearing plans, as well as a dental plan, to cover the cost of extensive dental work she needs

She said she worries not just for herself but for other older adults who are not as savvy as navigating all the pitfalls of the insurance system. But for now, she is locked in to her BlueCross BlueShield’s plan for at least a year and whatever 2026 may have in store.

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Vermont

19 Vermont school budgets fail as education leaders debate need for reform

Published

10 hours ago

March 5, 2026

Press Room

19 Vermont school budgets fail as education leaders debate need for reform

MONTPELIER, Vt. (WCAX) – Most Vermont school budgets passed Tuesday, but 19 districts and supervisory unions saw their spending plans rejected — an uptick from the nine that failed in 2025, though well below the 29 that failed in 2024.

Some education leaders say the results show communities are largely supportive of their schools.

“We’re starting to kind of equalize out again towards the normal trend of passage of school budgets each year,” said Chelsea Meyers of the Vermont Superintendents Association.

Sue Ceglowski of the Vermont School Boards Association said the results send a clear message. “Vermont taxpayers support Vermont’s public schools,” she said.

Meyers said the results also raise questions about the scope of education reform being considered in Montpelier. “If we are going to reform the system, it might not require sweeping broad changes as are being considered right now, but a more concise approach to consider that inequity,” she said.

But in districts where budgets failed, officials say structural changes are still needed. In Barre, where the budget failed, Barre Unified Union School District Board Chair Michael Boutin said the Legislature must, at a minimum, create a new funding formula. “We have to have that in order to avoid the huge increases and decreases — the huge increases that we’ve seen in the last couple years,” Boutin said.

He said the rise in school budgets is separate from why property owners are seeing sharp tax increases. The average state increase in school budgets is 4%, but the average property tax increase is 10%, driven by cost factors including health care. “There’s a complete disconnect, and that’s a product of the terrible system that we have in Vermont with our funding formula,” Boutin said.

Ceglowski says the state should address health care costs before moving forward with rapid education policy changes. “Addressing the rapid rise in the cost of school employees’ health benefits by ensuring a fair and balanced statewide bargaining process for those benefits,” she said.

The 19 districts that did not pass their budgets will need to draft new spending plans to present to voters, which often requires cuts. Twelve school districts are scheduled to vote at a later date.

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Vermont

6 of the Quirkiest Towns in Vermont

Published

22 hours ago

March 4, 2026

Press Room

Vermont is, for many visitors, the postcard-perfect New England state. A part of the United States since 1791, the first to join the Union after the Thirteen Original Colonies, Vermont has many unique, and sometimes quirky, features. The place has attracted artists and other creative geniuses, some of them decidedly eccentric, from its earliest days. The natural parts of Vermont, like the famous Lake Champlain, offer unusual points of interest for visitors and locals alike. With a state as rich in traveling attractions, it should be little wonder that some of them come with a quirk or two.

Montpelier

Summer Farmers Market in Montpelier, Vermont. Editorial credit: Phill Truckle / Shutterstock.com

Montpelier, while being Vermont’s charming capital, is the tiniest among all US state capitals with just around 8,000 residents. For comparison, the second-smallest, Pierre in South Dakota, has a population of about 14,000. Established in 1787, this historic town warmly welcomes visitors with a variety of landmarks, including the Vermont History Museum and the sprawling 200-acre Hubbard Park. The State House is also open to the public for tours. Just a short drive west, less than an hour away, lies Lake Champlain, one of the Northeast’s most beloved watersides.

The town’s name pays homage to Montpellier, a beautiful city in southern France. This naming reflected the high regard for France at the time, especially for their support during the US War of Independence. Interestingly, Montpelier has experienced its share of flooding, with significant damage occurring in the years 1927, 1992, and most recently in 2023.

Elmore

Elmore, a charming small town in Lamoille County with fewer than 900 residents, is a favorite spot for autumn leaf-peepers. Located north of Montpelier, this peaceful town has its own unique charm, including several local landmarks sharing the name ‘Elmore,’ which adds to its character. It’s important to note that Elmore town is separate from East Elmore. To the west, Elmore Mountain overlooks the area, while Elmore State Park lies just north of the town itself. Enjoying waterside beauty, Elmore Lake is often listed among Vermont’s most picturesque lakes, with its waters flowing into the Lamoille River through Elmore Pond Brook. Like Montpelier, Elmore is situated east of Lake Champlain. For those seeking a more bustling scene or a change of pace, the vibrant city of Burlington, just an hour’s drive west, makes for a perfect day trip or weekend getaway.

Stowe

Stowe, with a lively population of 5,300, is Vermont’s top spot for adrenaline seekers and the eccentrics among us, earning its reputation as the state’s premier ski and snowboard destination. The Stowe Mountain Resort proudly calls itself the “ski capital of the east”—that’s the eastern United States. Nestled near the breathtaking Mount Mansfield, Stowe offers more than just winter fun; warmer months bring plenty of activities like hiking and mountain biking in the beautiful Cady Hill Forest.

The town also has a rich history, being the home of Jake Burton Carpenter (1954-2019), the visionary behind Burton Snowboards and a trailblazer in making snowboarding an international sport. While some might have called him eccentric when he launched his company in 1977, today he’s celebrated as a true pioneer whose legacy keeps inspiring young snow sports enthusiasts, like those at Mount Mansfield Winter Academy, a special school dedicated to nurturing the next generation of champions.

Manchester

Manchester, a town with 4,500 residents located in southwest Vermont, is popular among art and architecture enthusiasts. It features Hildene, the estate of Abraham Lincoln’s son Robert, which boasts an impressive Georgian Revival house and grounds. The town’s American Museum of Fly Fishing showcases numerous rods, flies, and related gear, attracting many superstitious anglers. Manchester is also home to Orvis, a renowned fishing and clothing company. The Southern Vermont Arts Center hosts exhibitions, and includes a sculpture garden and performance space. Nature lovers should visit Mount Equinox, west of town, or explore the Green Mountain National Forest to the south.

Eccentric fact: Jonathan Goldsmith, known for portraying “The World’s Most Interesting Man” in Dos Equis commercials, resides in Manchester. Stay quirky, my friends.

Brattleboro

Brattleboro, with a population of 12,100, sits along the Connecticut River and features a variety of attractions and oddities. Located just west of New Hampshire—in which the Connecticut River forms the border—and just north of Massachusetts, the town is an ideal midpoint for exploring the wider New England region. Outdoor enthusiasts will appreciate Fort Dummer State Park, welcoming hikers, bikers, and campers alike. Among the more renowned eccentric figures in history, British writer Rudyard Kipling moved to Brattleboro after marrying a Vermont woman in 1892. Their home, Naulakha, references his birth and childhood in India. Kipling believed that Brattleboro’s conservative small-town culture created an

Woodstock

Woodstock, a town with 3,000 residents located in upstate New York, is separate from the famous 1969 cultural event. This southeastern town attracts architecture enthusiasts, particularly for the First Congregational Church, built in 1807 and featuring a bell cast by American revolutionary Paul Revere, and the Norman Williams Public Library, completed in 1884. For outdoor activities, visitors can walk in Woodstock Town Forest, located south of the town, or enjoy panoramic views from the Marsh Billings Rockefeller National Historical Park, the only part of the US National Park system in Vermont besides the Appalachian Trail. Recently, Woodstock has modernized its infrastructure with digital technology, launching the “Wireless Woodstock” initiative in 2011, which provides free Wi-Fi across the entire town. It’s not quirky; it’s just cool.

Vermont’s Quirky Small Towns May Also Be Its Best

These small Vermont towns show the state’s sometimes quirky, but never boring character. Architecture fans will find unusual, beautiful examples state-wide. Montpelier is an oddly pint-sized capital with heavyweight history. Brattleboro has long attracted strange, sometimes brilliant types, whether foreign or domestic. Manchester is interesting enough for the World’s Most Interesting Man. And with abundant natural parks, the Green Mountains, and the majesty of Lake Elmore and Lake Champlain, the quirks of Vermont’s best features should attract even the most straight-laced visitors.

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Vermont

Vermont postal worker allegedly threw away mail she was supposed to deliver for months

Published

1 day ago

March 4, 2026

Press Room

Vermont postal worker allegedly threw away mail she was supposed to deliver for months

Crime

During a search of a dumpster where the worker allegedly discarded the mail, police found several packages and holiday cards.

A Vermont postal worker was cited and suspended for allegedly throwing away mail that was supposed to be delivered to other people, according to police.

Natasha Morisseau, 34, of North Troy, was cited on nine counts of petty larceny and five counts of unlawful mischief, Vermont State Police said in a statement. She works as a mail carrier for the town’s United States Postal Service (USPS) office.

Officers were first alerted to the discarded mail on the afternoon of Jan. 23, according to police. Upon finding the mail in a dumpster on Elm Street in North Troy, they determined that none of it was for that address.

Police identified Morisseau as a person of interest and learned that she was a postal employee. They confirmed that she had regularly been throwing away a small amount of mail under her care since at least October 2025, according to the statement.

After searching the dumpster and Morisseau’s mail vehicle, officers found opened and unopened packages, along with several holiday cards, one of which contained money. Morisseau was later cited Feb. 14 and is due to appear March 17 in Vermont Superior Court, police said.

Since Jan. 23, Morisseau has been suspended by USPS, and all recovered mail has been given back to them for delivery, according to the statement. The case has been forwarded to the USPS’ Inspector General for further review.