10/23/2025
Great info about the phasing out of VBA and UHC Medicare Advantage Plans, and what is available moving forward from Representative Becca Balint:
Dear Neighbor,
I want to keep you up to date on major changes that will impact you if you get your health insurance through a Medicare Advantage plan.
As you may have already heard, there will be a dramatic reduction in Medicare Advantage plans available to Vermonters starting in 2026. If you are a Medicare Advantage member, you will need to make decisions about your insurance to avoid penalties and ensure you don't have a lapse in coverage. This can be overwhelming news, so I want to make sure Vermonters have all they need to navigate this change. Keep reading to learn more.
Two private insurers — UnitedHealthcare and Blue Cross Blue Shield (Vermont Blue Advantage) — recently announced they will not offer their individual Medicare Advantage plans in Vermont as of January 1, 2026. A third insurance company, Humana, will continue to offer Medicare Advantage coverage but only in Bennington, Caledonia, Essex, Orange, Windham, and Windsor counties. Vermonters who live outside those counties will need to enroll in traditional Medicare, and could do so starting October 15, 2025, when the open enrollment period began
What do I need to know?
UnitedHealthcare and Vermont Blue Advantage currently cover the majority of Vermonters enrolled in Medicare Advantage. I understand that these changes are disruptive and will leave tens of thousands of Vermonters with very few options when navigating Vermont’s Medicare Advantage market. As your congresswoman, I want to make sure you are aware of what your options are moving forward and what resources are available to navigate through these changes:
Coverage on all current plans will continue through December 31, 2025.
If you lose coverage under your current Medicare Advantage plan, you have the option to enroll in an alternative Medicare Advantage plan during the Medicare Advantage Annual Enrollment Period which is happening right now: October 15 through December 7, 2025.
If your Advantage plan is discontinued in your area, you will need to enroll in traditional Medicare as well as a Part D plan for drug coverage. CMS requires drug coverage to avoid penalties.
You will also have a Special Enrollment Period to get a secondary insurance plan, called a Medicare Supplement plan or Medigap. Medigap coverage is optional and there are several Medigap plans available with varying degrees of coverage. Should you choose not to get a Medigap plan, you will be responsible for the cost sharing amounts that Medicare A and B do not cover- this includes hospital deductibles, medical deductibles, and typically a 20% coinsurance for services.
The Special Enrollment Period for Medigap plans is also called “guaranteed issue open enrollment” and waives any underwriting. The period lasts for 63 days after your current coverage ends. This means you can enroll in Medigap until March 4, 2026.
You must provide the discontinuation letter sent by your current insurer as proof you are eligible for guaranteed issue rights and the extended enrollment period. Please do not throw this letter away!
Who can help?
To accommodate the need for assistance, the Vermont Area Agencies on Aging have increased staffing of the Vermont State Health Insurance Program (SHIP) and HelpLine at 1-800-642-5119. Counselors are available to answer questions, discuss individual needs, and provide information about Medicare options. Appointments with SHIP counselors are booking quickly. If you aren't able to meet with them before the end of open enrollment, you can also get information online at www.medicare.gov or by calling 1-800-MEDICARE which is staffed 24 hours/day, 7 days/week.
Don't forget to ask about Part D (prescription drugs) and Medigap plans if you are switching to original Medicare.
If you need assistance with a Federal Agency, please call my Vermont District Office at (802) 652-2450.
Sincerely,
Becca Balint
Member of Congress
The official U.S. government website for Medicare, a health insurance program for people age 65 or older and younger people with disabilities.
