Medicare & Other Elder Health Coverage

Important info for Medicare beneficiaries

A capacity crowd turned out at the Wentworth Library on Tuesday, to learn about changes in Medicare and related elder insurance plans for 2026. The session was sponsored by the Sandwich Community Nurse Association as the first in a series of health-related educational forums.

Presenters were the mother-daughter team of Nancy and Olivia Papp, former Sandwich residents – many will remember Nancy as the proprietor of Mocha Rising, the forerunner of The Foothills. They run Portside Independent Insurance, a health and life insurance brokerage in Portsmouth.

Other brokers were invited but could not attend. The forum was quickly put together to provide timely information ahead of the annual open enrollment period for Medicare-related coverage, which runs from October 15 through December 7.

It’s an especially important time for elders to pay close attention to their coverage. “This is not a normal year for health insurance,” Nancy Papp said, “especially for the over-65 crowd.”

The reasons boil down to three:

• Medicare Advantage -- the so-called Medicare Part C plan that bundles hospital, doctor, diagnostic coverage and extras such as dental and vision care – is essentially disappearing in New Hampshire. Nearly 80,000 people statewide are losing Medicare Advantage, with 4,816 facing cancellation in Carroll County. The reason: Insurers have been losing money on these plans despite federal subsidy.

• Options for Medicare D, which covers prescription drugs, are drastically shrinking. “We have nine Part D plans to choose from next year,” Papp reported. “A couple of years ago we had more than 25.” Premiums for the remaining plans are rising, sometimes sharply.

•  Premiums for Medicare supplemental insurance, also known as “medigap” plans, are rising. This coverage helps pay for copays (a portion of medical bills that consumers must pay) and deductibles (the annual amount consumers pay until insurance kicks in).

  People losing Medicare Advantage will revert to Medicare Part A (hospital coverage) and Part B (doctors, lab tests, x-rays) and will need to shop for “stand-alone” coverage for Part D (Rx drugs) and medigap plans.

  Importantly, these former Advantage plan consumers have guaranteed access to medigap policies regardless of any preexisting medical conditions. They also have a Special Enrollment Period that extends into the first couple of months of 2026. Others who wish to switch from one medigap plan to another must fill out a complicated form listing current and expected medical conditions (such as a looming joint replacement), which will increase their premium.

  Papp encourages people to shop carefully for Medicare Part D (drug) coverage. “Make sure the formulary covers your drugs,” she cautioned. “Every year I get calls from people saying ‘I should have shopped! Why are my drugs costing $100 a month more?’”

  The forum made clear that shopping for health insurance – particularly for Medicare beneficiaries – is no simple task. There are many plans with multiple terms and widely varying premiums.

  The Sandwich Community Nurse Association (SCNA) provides a list of resources consumers can consult to help them make informed choices.

  Below are some government resources:

  • NH Department of Health and Human Services: Carroll County NH ServiceLink Aging and Disability Resource Center

  • NH Insurance Department: www.insurance.nh.gov/consumers/medicare-and-seniors

  • www.medicare.gov has a comparison shopper for 2026 plans

    Richard Knox for the SCNA