Vermont Business Magazine Most Vermonters on Medicare Advantage Plans will return to Original Medicare (Parts A & B) in 2026 and will need to enroll separately in a Part D plan for drug coverage.
"There are no Medicare Advantage Plans available in all counties," said Vermont Department of Financial Regulation Commissioner Kaj Samsom.
The only Medicare Advantage plan remaining in the state is offered by Humana and only in select counties mostly in southern and central Vermont.
The Office of the Health Care Advocate, Vermont Legal Aid provided the following information how Medicare enrollees can proceed.
MEDICARE PART B
- In 2026, the Medicare Part B premium is projected to be $206.50 per month.
- If you were on a Medicare Advantage Plan in 2025, you were paying this as part of your monthly premium.
MEDICARE PART D
- Take action to sign up for a Part D Plan during the Annual Open Enrollment Period by December 7th.
- If you are losing your Medicare Advantage Plan and don’t sign up by December 7th, you can still sign up between December 8th and December 31st to get a January 1st start date for your prescription coverage.
- Signing up after December 31st will result in a gap in prescription coverage.
- The last day to sign up for a Part D plan through your Special Enrollment Period is February 28th.
PROGRAMS THAT HELP WITH MEDICARE COSTS
- Medicare Savings Programs will pay your Medicare Part B premium.
- These programs will have new, higher income limits starting January 1, 2026.
- If you only qualify under the new limits, apply after January 1.
PRESCRIPTION ASSISTANCE
- If you enroll in a Medicare Savings Program, you will automatically get a program called Extra Help.
- Extra Help pays the basic portion of your Part D plan premium.
- With Extra Help, you pay no deductible and have low co-pays.
VPHARM
- VPharm is a State of Vermont pharmacy assistance program.
- It works with your Medicare Part D plan to help lower prescription costs.
- You pay a monthly premium and have low co-pays.
- You may not need VPharm if you have Extra Help.
MEDIGAP (MEDICARE SUPPLEMENT) PLANS
- Medigap plans help cover costs not paid by Parts A & B (like deductibles & coinsurance).
- You can only sign up for Medigap plans if you have Original Medicare.
- If your Advantage plan is ending, you qualify for Guaranteed Issue Rights:
- You cannot be denied or charged more based on health.
- Application Deadline: March 4, 2026
- If you qualify for a Medicare Savings Program called QMB, you should not need to purchase a Medigap Plan.
- Save the notice from your Advantage plan as proof of eligibility.
- Medicare Supplement Rates | Department of Financial Regulation
MEDICARE ADVANTAGE (PART C)
- Most Medicare Advantage Plans in Vermont are ending on December 31st, 2025.
- Only Humana will offer plans in five counties: Bennington, Caledonia, Orange, Windham, and Windsor. Visit its website to conduct a by-county search that shows where its plans are available.
- Original Medicare offers more provider flexibility and usually no prior approval for services.
NEED HELP?
The Office of the Health Care Advocate is a free and confidential resource for Vermont residents who have questions about health insurance or access to care.
Vermont Legal Aid. 1-800-917-7787. Vtlawhelp.org/health
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.
To support vital journalism, access our archives and get unique features like our award-winning profiles, Book of Lists & Business-to-Business Directory, subscribe HERE!
