It usually takes until Thanksgiving for the State Health Insurance Assistance Program, which offers free counseling to Medicare beneficiaries, to run out of appointments.
Not so this year.
Local SHIP staffers were booked solid early in October — basically as soon as Vermonters learned that most Medicare Advantage plans would exit the state next year.
“There's been, you know, just a deluge,” said Vermont SHIP director Sam Carleton.
For 2026, most Vermonters on Medicare Advantage plans will revert back to traditional Medicare (Parts A & B). But they’ll also need to take action to enroll separately in a Part D plan for drug coverage. People should also consider supplemental insurance — often referred to as Medigap plans — to help offset the cost of the coinsurance and deductibles associated with Parts A and B.
There are still resources to help you navigate this moment. Here’s a rundown.
Where to get help
1-800-MEDICARE is the federal government’s Medicare helpline, and it is available 24/7 during open enrollment. Someone can help you compare plans over the phone and even enroll you in one. You can also compare plans and enroll online.
Vermont’s Office of the Health Care Advocate offers free and confidential help if you have questions about health insurance or access to care. Call 1-800-917-7787 or submit an online help request at vtlawhelp.org/health. They’ve also put together this useful guide.
Even though Vermont’s SHIP is no longer taking individual appointments, it is organizing statewide webinars. Reach out to your local agency on aging to find out how to sign up.
Are there any Advantage plans I can choose instead of going back to original Medicare?
Probably not. Advantage plans are made available based on where you live, and in most of Vermont, no insurer is offering an Advantage plan on the individual market. Only Humana is left, but its plans are only available in Bennington, Caledonia, Orange, Windham and Windsor counties.
If you get your Advantage plan through a current or former employer, you should check with them directly to see if your plan is still available next year.
Is there any financial help available?
Depending on your income, the state’s Medicare Savings Programs could cover your Medicare Part B premium. Thanks to a new law, the program will have higher income limits starting Jan. 1, 2026. If you only qualify under the new limits, you’ll have to wait until the new year to apply.
You may also qualify for help paying for prescription drugs through Extra Help or VPharm.
Deadlines to keep in mind
Open enrollment ends Dec. 7. If you’re losing your Medicare Advantage plan, you have a longer, special enrollment period, which ends Feb. 28, 2026, to sign up for a prescription drug plan. You’ll want to sign up by Dec. 31, however, to avoid a lapse in coverage at the beginning of the year.
You have until March 4, 2026 to enroll in a Medigap plan if you lost your Advantage plan. The notice you received from your insurer that they are discontinuing coverage serves as proof of eligibility — do not throw it away.
