10/15/2026
Response to New York Times article, “Millions Lose Private Medicare Plans and Face
Rising Costs”, October 9, 2026
It is always disruptive and often painful when one is forced to make a change in
healthcare coverage. But let’s not be alarmist about Medicare Advantage companies
vacating rural markets. Medicare Advantage Plans aren’t sensible in rural areas.
Advantage Plans need to achieve critical membership mass and develop a provider
network to properly serve a market. That’s not possible in a rural area where there are
few physicians and residents typically travel for specialized care.
The article reports that 187 counties will have no Medicare Advantage Plan available in
2027 but that is out of 3069 counties, according to the article, citing KFF, a non-profit
policy organization. That means 94% of counties do have an Advantage Plan offering.
Some would say that’s quite remarkable.
The article quotes an insurance representative that a client in Minnesota losing an
Advantage Plan and returning to original Medicare will have to pay $330 a month for a
Medigap Plan. People have a choice in supplement options and that sounds like a
description of an individual deciding to purchase the most expensive Medigap Plan
available. Minnesota has a supplement option similar to a high-deductible G in other
states at a fraction of that monthly premium and with an out-of-pocket maximum lower
than most Advantage Plans. A prescription drug premium and out-of-pocket drug costs
would need to be added for a true comparison.
An important issue not mentioned in the article is that if one’s Advantage Plan abandons
a service area, then those affected have a guaranteed issue right to enroll in a Medicare
supplement of their choice. Those voluntarily choosing to return to original Medicare
from an Advantage Plan and applying for a Medicare supplement will face medical
underwriting and the possibility of being rejected or increased premiums in most states.
This open enrollment season is more volatile than in recent years but those who choose
an Advantage Plan should understand that the Plans can change networks, rules and
enhanced benefits every year as well as decide to enter or vacate a market. Our
system is profit-driven and if Plans don’t feel a market is profitable enough, they will
abandon it.
