Are Medicare Advantage Plans Leaving the Hill Country? What Retirees Must Do Before December 7

I’m hearing a version of the same question from retirees considering Boerne, Fredericksburg, Wimberley, Dripping Springs, and New Braunfels: “Is my Medicare Advantage plan going away, and will I have to find care in Austin or San Antonio instead?”

The honest answer is: some people will need to choose a different plan for 2027, but there isn’t one blanket answer for the whole Hill Country. Medicare Advantage availability depends on your county, and a plan ending doesn’t necessarily mean every plan is leaving your area. The network that remains, however, may not fit your doctors, prescriptions, or travel habits.

Medicare Open Enrollment runs October 15 through December 7, 2026. Any change you make during that period generally takes effect January 1, 2027. If you’re affected, don’t wait for a neighbor’s experience or assume your current coverage will continue unchanged. Start with the letter from your plan, then check the exact options for your county.

What a plan exit actually means

A Medicare Advantage insurer can stop offering a plan, end its Medicare contract, or stop offering a plan in a particular service area. In each case, the immediate question is whether your specific plan will cover you next year. The Plan Non-Renewal Notice is sent in October to people whose plan is leaving Medicare; it tells you to look for coverage for the coming year. Read it carefully and keep it.

There’s a wider backdrop, too. KFF’s analysis of CMS data found that the average Texas beneficiary has 27 Medicare Advantage prescription-drug plan options for 2027, compared with 36 in 2026. That’s an average across Texas, not a count of the choices in your county, and not proof that every Hill Country county has lost nine plans. What it does signal is change: a statewide average can conceal very different local choices. KFF’s analysis also notes that plan availability and provider networks vary.

That matters when a local specialist or hospital is a long drive away. A replacement plan may be available but use a network that sends you toward Austin or San Antonio. Don’t treat “a plan is available” as the same thing as “my care is accessible.” And don’t assume that every plan serving a nearby city serves your address: availability is county-specific.

CMS reports that Medicare Advantage remains broadly available nationally in 2027. That overall picture is useful context, but it can’t tell you whether your doctor, prescriptions, or preferred hospital are covered under a plan where you live. CMS’s advice to beneficiaries is to “review their coverage, compare options, and pick the plan that best suits their needs and budget.” I’d add one more item: check whether the network suits your actual life in the Hill Country.

First, check whether your plan is changing

Open every Medicare notice you receive, including the plan’s Annual Notice of Change and any non-renewal notice. Then:

1. Confirm the county used for your plan. Look up your residential address rather than relying on a nearby town name.
2. Check the plan for 2027. Use Medicare Plan Finder to see what’s offered in your area.
3. Verify your providers directly. Ask each doctor’s office and preferred hospital whether they expect to be in-network for the specific 2027 plan. If you split time between homes or travel for care, ask how the plan handles non-emergency care away from home.
4. Review prescriptions and costs. Check your medications against the 2027 formulary, pharmacy arrangements, premiums, copays, and out-of-pocket limit, not just the headline premium.
5. Get answers before enrolling. If the notice is unclear, contact your plan or Medicare at 1-800-MEDICARE.

The Medicare Open Enrollment rules allow you to join, drop, or switch Medicare Advantage plans, change drug coverage, or move between Medicare Advantage and Original Medicare. Your request must reach the plan by December 7 for a change generally effective January 1.

Should you compare Original Medicare and Medigap?

If your Medicare Advantage plan is ending, you can compare another Advantage plan with Original Medicare. With Original Medicare, you may also consider a Medicare Supplement Insurance policy, known as Medigap, and a separate Part D plan for prescription drugs.

These options work differently. Medicare Advantage plans use plan-specific networks and rules. Original Medicare generally lets you see providers who accept Medicare, while Medigap can help cover certain out-of-pocket costs under Original Medicare. Medigap has its own premium, and it does not include Part D prescription coverage. Compare the full package, including access, drug coverage, premiums, and expected cost-sharing, rather than deciding from one benefit or price.

Timing matters. If your Advantage plan is leaving Medicare or no longer covers your area and you switch to Original Medicare, you may have a federal guaranteed-issue right to buy certain Medigap policies without medical underwriting. Medicare says that, in this situation, you generally must apply beginning 60 days before your Advantage coverage ends and no later than 63 days afterward. This right applies when switching to Original Medicare, not simply when choosing another Advantage plan. Rules and the available policy choices can depend on your circumstances, so confirm your rights and deadlines with Medicare’s Medigap guidance and keep your plan’s termination notice.

If you don’t make a new selection during Open Enrollment, you may be moved to Original Medicare when your plan ends, depending on your situation. That does not automatically arrange Medigap or a stand-alone drug plan for you. Medicare also lists a special enrollment period for people whose plan contract isn’t renewed: December 8 through the last day in February. That can provide another chance to change coverage, but I wouldn’t use it as a reason to put off comparing your options. The Medicare special-enrollment rules explain the details.

High-income retirees: don’t confuse plan choice with IRMAA

IRMAA, the income-related adjustment to Medicare Part B and Part D premiums, is a separate consideration from whether your Advantage plan is leaving. Choosing a different Advantage plan doesn’t, by itself, remove an IRMAA adjustment. Social Security generally uses income information from two years earlier when determining these adjustments; for 2027, that typically means your 2025 tax return. The exact 2027 income thresholds and amounts should be confirmed when officially published.

If a plan includes prescription-drug coverage, consider how any Part D IRMAA may sit alongside the plan’s own premium. For background on the income lookback and why a one-time income event can affect later Medicare costs, see our IRMAA Shock article. For broader relocation budgeting, our Hill Country property-tax stress-test guide covers another cost worth examining before choosing a home and community.

My short checklist before December 7

• Read the plan’s 2027 notice and identify whether your current coverage is ending or changing.
• Compare available plans for your exact county on Medicare.gov.
• Confirm your doctors, hospitals, prescriptions, and pharmacies for the plan year starting January 1.
• If considering Original Medicare, check Medigap eligibility and application dates before you switch.
• Factor premiums and any applicable IRMAA into your retirement income planning in Texas.
• Keep copies of notices and enrollment confirmations.

The best places to retire in Texas are about more than scenery, wineries, or a beautiful ranch-style home. For a satisfying life after moving, healthcare access needs to work alongside the lifestyle. If you’re retiring in Texas Hill Country, take time now to compare the coverage you can actually use, not just the plan with the most familiar name.

CTA: Schedule a private meeting with a fiduciary financial advisor today by calling (512) 593-8380 or by visiting: https://calendly.com/portafoliocapital/15min

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