3,000 Whidbey seniors face health coverage gaps as insurers exit island market

Thousands of Medicare beneficiaries on Whidbey Island must change health insurance plans before December 7.

Kaiser Permanente and Wellcare will no longer offer individual Medicare Advantage plans to Island County residents in 2027. UnitedHealthcare has also withdrawn some of its plans from the county. Annette Barca, a volunteer coordinator with Island Senior Resources, estimates that more than 3,000 seniors have lost their plans for the coming year. This volume has strained local insurance advisers and agents.

The withdrawals reduce options during the annual open enrollment period, which began on October 15. Beneficiaries whose plans are discontinued qualify for a special enrollment period through February 28, 2027. This extension allows them additional time to select replacement coverage. Those who do not act will revert to original Medicare automatically. They may need to enroll in a separate Medicare Part D plan for prescription drugs.

Insurers cite financial sustainability as the primary driver for the exits. Naomi DeMartini, owner of Insurance Whidbey, stated that companies make business decisions based on the cost and use of medical care. "It's a tough environment right now," DeMartini said. "So if companies see that they're not in areas where they're able to be sustainable, they will pull out." Kaiser has also reduced its number of out-of-network providers, effectively eliminating local options on Whidbey. Barca attributed Kaiser's exit to the lack of available providers on the island.

The changes create complexity for residents who have relied on stable coverage for years. DeMartini called the current situation one of the largest she has seen in more than 12 years in the industry. Many affected seniors have been on the same plan for upwards of 15 years. They now face uncertainty about costs, doctor access, and travel distances for care.

Local resources are working to manage the influx of requests. SHIBA volunteers on Whidbey are putting in more than 40 hours a week. David de Wolf, an employee at Island Senior Resources, said advisers added several sessions specifically for people who lost their plans. Barca described the volume of cases as overwhelming. "The sheer numbers are overwhelming," Barca said.

Beneficiaries have three main paths forward. They can enroll in a different Medicare Advantage plan still available in the county. They can return to original Medicare and purchase a Medicare supplement plan, or Medigap, to cover out-of-pocket costs. They can also return to original Medicare without a supplement. People whose plans are discontinued may qualify for guaranteed-issue rights for certain Medigap policies. These rights allow them to buy coverage without being denied or charged more for pre-existing conditions, provided they meet eligibility requirements and application deadlines.

Kaiser's exit from individual plans is not expected to affect its retirement Medicare Advantage plans. DeMartini advised residents to verify whether their specific plan is ending before making changes. She urged locals to contact elected officials and the Centers for Medicare and Medicaid Services to signal that the current situation is unacceptable. "I think that people need to speak up and let their elected representatives and those in the government know what's going on," DeMartini said.