Several Medicare Advantage insurers have announced they will no longer offer plans in New Hampshire and Vermont starting in 2026. These are business decisions made by the insurance carriers, not by Dartmouth Health. But we’re here to help you.
Joseph L. Perras, MD, President and CEO of Cheshire Medical CenterWe’ve been hearing from patients who have received a notice about their 2026 Medicare Advantage coverage. I can understand how worrying that must feel. It is a disruptive time for patients who suddenly need to choose a different Medicare Advantage plan carrier or consider Original Medicare for 2026.
Several Medicare Advantage insurers have announced they will no longer offer plans in New Hampshire and Vermont starting in 2026. These are business decisions made by the insurance carriers, not by Dartmouth Health. But we’re here to help you.
I recognize that these unexpected Medicare changes have created real frustration and uncertainty for many of our patients who are just trying to maintain their care and coverage. It was Humana’s unilateral decision not to renew contracts for certain Dartmouth Health members; this was not a decision made by our health system. The Cheshire Medical Center clinicians are part of Dartmouth Hitchcock Medical Center, a contractual relationship that has been in place since 1993. As someone who sees firsthand how these changes are affecting our patients, I share in our patients concern and frustration during this challenging time.
However, over the past year, Humana has changed leadership for its Medicare Advantage Northeast division. The new leaders contacted us recently and seemed unaware that their prior leadership team had made this decision. Cheshire, along with other Dartmouth Health members, has agreed to meet with the new Humana leadership team to discuss potentially rejoining their network, but given the timing, it is almost certain a new contract will not be developed before January 1, 2026.
It is a disruptive and confusing time when our patients suddenly need to choose a different Medicare Advantage plan carrier or consider transitioning back to Original Medicare. Transitioning back to Original Medicare also means deciding whether to purchase a separate Medicare supplemental plan to help cover costs that Original Medicare does not. This type of disruption creates continuity of care challenges for both patients and their healthcare providers.
We saw the first wave of this market disruption during the Medicare Annual Open Enrollment period in the fall of 2024. This fall’s Medicare Annual Open Enrollment Period is even more challenging for patients and providers alike, as carriers are pulling out of the NH and VT markets entirely or significantly reducing their footprints to a handful of counties in one or both states. This situation is not unique to our region – it is playing out this fall in rural markets across the country.
As it relates specifically to Humana Medicare Advantage, Cheshire, along with Dartmouth Health members DHMC, and Dartmouth Hitchcock Clinics, have been non-contracted or “Out-of-Network” for Humana Medicare Advantage plans since January 1, 2025. Two other Dartmouth Health members, Alice Peck Day Memorial Hospital and New London Hospital, have been out-of-network since February 2025.
Although this is outside of Dartmouth Health’s control, we are committed to providing external resource support for our patients and the community. Depending on their benefit plan, patients who are covered by a Humana Medicare Advantage PPO group retiree benefit plan from a former employer may still be able to seek care from Cheshire or another Dartmouth Health member via that benefit plan’s out-of-network options. These patients should check with their former employer to confirm out-of-network benefit coverage for 2026.
However, for patients choosing an individual HMO benefit plan from Humana Medicare Advantage for 2026 and who want to be seen at a Dartmouth Health location, these patients need to be aware that they may have to pay 100% out of pocket for these healthcare services, as HMO plans generally only include “In-Network” benefit coverage.
We encourage these patients to go to one of the following sources for further guidance during this year’s Medicare Annual Open Enrollment Period:
For Medicare-eligible patients and for those transferring from Medicare Advantage plans:
NH residents may contact the NHID’s Consumer Services Unit at 1-800-852-3416 or consumerservices@ins.nh.gov.
VT residents can visit the Vermont State Health Insurance Assistance Program (SHIP). Call 1-800-642-5119.
Sincerely,
Joseph L. Perras, MD
President & CEO
Cheshire Medical Center