Vermont Business Magazine Vermont Blue Advantage announced its decision today to not offer Medicare Advantage plans in 2026. The Medicare Advantage market in Vermont has been severely affected by payers choosing to leave the Medicare Advantage market and high utilization of medical care by Vermont Blue Advantage members. These combined forces make the Vermont Medicare Advantage market unsustainable for Vermont Blue Advantage to be able to offer reasonably priced and affordable products to serve as an alternative to traditional Medicare coverage.
“Vermont Blue Advantage has been incredibly proud to serve Vermonters for the last 5 years,” said Pam Getsie, Vermont Blue Advantage Plan President. “We’ve been able to successfully help our members improve their health and manage their chronic conditions all while ensuring they have access to high quality care and service.”
Blue Cross Blue Shield of Vermont remains committed to serving the state of Vermont and offers Medicare Supplemental plans as an option, including Vermont Medigap Blue and Vermont Blue 65 Supplement plans. Individuals interested in understanding their options for coverage in Vermont may explore options on Medicare.gov or work with a local agent.
Vermont Department of Financial Regulation Statement
Vermont residents should take time to learn about whether their coverage will be impacted and what options are available. Plans that are making changes or terminating coverage must send notices to members that advise of the upcoming changes in coverage. Members enrolled in discontinued Medicare Advantage plans will continue to be covered under their current plans through December 31, 2025. Members will need to choose a new Medicare Advantage plan or a Medicare Supplement plan to replace their coverage.
An alternative Medicare Advantage plan can be selected during the Medicare Advantage Annual Enrollment Period, October 15 through December 7. As of 2026, there are few plans left in Vermont’s Medicare Advantage market. If members would like to select a Medicare Supplement plan, they will be eligible for guaranteed issue open enrollment in any plan in the Vermont Medicare Supplement market until 63 days after the coverage ends. If your coverage ends December 31, 2025, guaranteed issue (no underwriting) rights in the Medicare Supplement market last from now until March 4, 2026. The notice you receive from your insurer announcing a plan withdrawal is proof you need to access guaranteed issue rights. Don’t throw it away!
Things to Consider
When selecting a health plan for 2026, carefully consider which types of networks and restrictions are appropriate for your health needs. During the Medicare Advantage Annual Open Enrollment Period, call to ask if your current providers are in network. Not all Medicare Advantage plans have the same networks of providers.
Medicare Supplement plans have no network restrictions and are accepted everywhere Medicare is accepted. Regardless of which type of plan you select, emergency services will be available and treated as “in network”. In a health emergency, head to the emergency room nearest to you.
Switching Health Insurance Plans
The discontinuance of a Medicare Advantage plan allows members to shop for other health insurance plans, including Medicare Supplement plans.
To switch to a different Medicare Advantage plan, members must enroll during the Medicare Advantage Open Enrollment period from October 15 through December 7.
For Medicare Supplement insurance coverage, the guaranteed issue period begins when you receive notice that your plan is discontinued and ends 63 days after the termination of your Medicare Advantage plan. Guaranteed issue means you will not be refused coverage based on your health history.
Whether you select your 2026 coverage through Medicare Advantage or Medicare Supplement, you will need to share your new health insurance information with your provider, just as you would any time you change insurance.
If you decide to leave the Medicare Advantage market and return to Original Medicare with Medicare Supplement for 2026, please do not forget to enroll in Medicare Part D prescription drug coverage. You must choose a prescription drug plan, or Medicare part D plan during the Medicare Advantage Annual Enrollment Period, October 15 through December 7 to have coverage beginning January 1, 2026.
Can I Switch to a New Plan Before Open Enrollment? Can I Do It Now?
You can begin shopping for a Medicare Supplement plan now for a January 1, 2026, effective date. You will have until March 4, 2026, to buy a plan. You must choose a prescription drug plan, or Medicare part D plan during the Medicare Advantage Annual Enrollment Period, October 15 through December 7 to have coverage beginning January 1, 2026. For Medicare Advantage, you must select an alternative Medicare Advantage plan during the Medicare Advantage Annual Enrollment Period, October 15 through December 7, to ensure coverage begins on January 1, 2026.
Additional Information
Vermont State Health Insurance Assistance Program (SHIP)
Counselors are available to answer questions, discuss your needs and provide information about options. Call 1-800-642-5119.
The Department does not regulate Medicare Advantage plans. Medicare Advantage plans are offered and managed by private insurance companies. View Medicare Supplement insurance rates in Vermont on the Department website.
The Centers for Medicare and Medicaid Services (CMS)
CMS is the government agency that approves these private plans, sets the rules they must follow and pays them to provide benefits to enrollees. For questions about Medicare Advantage Plans, please visit the CMS website or call 1-800-MEDICARE.
The CMS Boston Office accepts complaints against Medicare Advantage companies in Vermont. Call 617-565-1188 from 8 am to 5:30 pm weekdays.
For general insurance-related questions, contact DFR Consumer Services by phone 800-964-1784 or email.
Connect with the Vermont Department of Financial Regulation on Facebook, LinkedIn or X.
About Vermont Blue Advantage and Blue Cross Blue Shield of Vermont:
Vermont Blue Advantage is an independent licensee of the Blue Cross and Blue Shield Association. For more information, visit vermontblueadvantage.com.
Blue Cross and Blue Shield of Vermont is Vermont’s only local, not-for-profit health plan. For over 30 years, the company has been enhancing the health and well-being of Vermonters by offering innovative plans to individuals, seniors, and businesses. Our employees are dedicated to developing new ways to support high-quality care and programs and events that promote wellness. Blue Cross and Blue Shield of Vermont is an independent licensee of the Blue Cross and Blue Shield Association.
10.1.2025. Montpelier. Blue Cross and Blue Shield of Vermont www.bluecrossvt.org
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