The Medicare annual open enrollment period began last week. Up to 5 million retirees with Medicare Advantage plans stand to lose coverage at the end of the year as insurance companies pare back offerings for 2026.^[1] Nationwide, the number of non-special-needs Medicare Advantage plans fell 10% year over year, from 3,719 in 2025 to 3,373 in 2026.^[2] The average county level plan choice for beneficiaries dropped from 42 to 39 this year.^[3] In Vermont, 92.2% of Medicare Advantage enrollees lost their plan for 2026, effectively eliminating most private Medicare options in the state.^[4] In New Hampshire, Anthem and Martin's Point are exiting the individual Medicare Advantage market entirely, and Aetna is withdrawing from most counties. Those changes will affect an estimated 77,000 residents.^[5] KFF reports 55% of the roughly 70 million Americans eligible for Medicare are enrolled in a private Medicare Advantage plan in 2026.^[6] Heather Schreiber, founder of HLS Retirement Consulting, said losing a Medicare Advantage plan provides an opportunity for enrollees to transition to traditional Medicare with a Medigap plan, particularly if their health has declined since first enrolling.^[7] Schreiber noted Medicare Advantage plans typically carry lower monthly premiums, with some offered at $0, compared to the 2026 traditional Medicare standard premium of $202.90 per person per month.^[8]