Iowa Medicare Plans Ending in 2027: Who Is Affected and What to Do

If your plan is not being offered in your county next year, your insurer was required to mail you a non-renewal notice, generally by early October. Read it, because it is easy to mistake for junk mail. Also read your Annual Notice of Change, mailed by September 30, which spells out next year’s costs and coverage. To confirm directly, compare plans for your ZIP code on the Medicare Plan Finder at Medicare.gov, check the SHIIP-SMP list of affected plans and counties at shiip.iowa.gov, or call SHIIP at 1-800-351-4664. You can also upload your notice to our free Medicare Letter Check and we will explain exactly what it means.

The Iowa Insurance Division says more than 87,000 Iowans got notices that a Medicare Advantage, Cost, or Part D plan will not continue in their county for 2027. The largest single change is Wellmark, which is ending all of its Medicare Advantage coverage in Iowa (and South Dakota) after December 31, 2026, rather than pulling back from a few counties. Medica is ending Medicare Advantage PPO coverage in Harrison, Mills, and Pottawattamie counties, and a UnitedHealthcare HMO-POS plan and a Humana PPO plan are also ending. Other plans are shrinking their service areas county by county. The complete list of affected Medicare Advantage, Cost, and Part D plans by county is published by SHIIP-SMP at shiip.iowa.gov.

That is what the Iowa Insurance Division reported when open enrollment opened. Wellmark and Medica were the Medicare Advantage PPOs that carried in-network Mayo Clinic coverage for Iowans, and with both of those PPOs ending, no Medicare Advantage plan sold in Iowa is expected to include Mayo Clinic as in-network for 2027. This matters most in northern Iowa, where many people travel to Rochester, Minnesota for specialty care. If Mayo access is the reason you chose your plan, Original Medicare is the route worth pricing, because Mayo accepts Original Medicare and a Medigap policy can cover most of the cost sharing. Networks can change, so confirm directly with both the plan and Mayo before you enroll rather than relying on a plan directory.

In most cases yes, and this is the part people miss. When your Medicare Advantage plan is non-renewing and you return to Original Medicare, federal rules give you a guaranteed-issue right to buy certain Medicare Supplement (Medigap) policies without medical underwriting, generally from 60 days before your coverage ends to no later than 63 days after. An insurer cannot turn you down or charge you more because of your health history during that window. As Iowa’s SHIIP-SMP director put it, the ability to switch to Original Medicare with guaranteed issue is a rare opportunity. Outside a guaranteed-issue window, Iowa insurers can medically underwrite Medigap applications, so letting this window lapse can mean you cannot get the policy later at any price.

Yes, it is different, and Iowa is one of the few places this still comes up. A Medicare Cost plan is an older type of Medicare health plan authorized under Section 1876 of the Social Security Act. Its defining feature is flexibility: unlike Medicare Advantage, if you get covered Part A or Part B services outside the plan’s network, those services are still covered under Original Medicare, with Original Medicare’s deductibles and coinsurance. You can also generally join or leave outside the usual windows. Cost plans are nearly extinct, with only about 11 contracts left nationwide as of 2025, mostly in Minnesota, Wisconsin, Iowa, the Dakotas, and one Illinois county, after the 2015 MACRA law accelerated their phase-out. If your Cost plan is ending, you are losing that out-of-network flexibility, so compare carefully before assuming a Medicare Advantage plan is an equivalent replacement.

You have more than one window, and the dates matter. The Annual Enrollment Period runs October 15 to December 7, 2026, with coverage starting January 1. Because your plan is non-renewing, you also get a Special Enrollment Period that runs December 8 through the last day of February 2027. The Iowa Insurance Division flags December 31, 2026 as the practical deadline: it is the last day someone whose plan was cancelled can choose new coverage that starts January 1 without a gap. If you enroll in January or February instead, your coverage starts the first of the following month, which can leave you briefly uncovered. Separately, mind the Medigap guaranteed-issue window described above, which runs on its own clock.

Iowa’s State Health Insurance Assistance Program is SHIIP-SMP, run by the Iowa Insurance Division. It offers free, unbiased Medicare counseling from about 430 trained volunteer counselors and serves more than 55,000 Iowans a year. Reach it at 1-800-351-4664 or shiip.iowa.gov, where the list of affected 2027 plans and counties is posted. The national Medicare helpline, 1-800-MEDICARE (1-800-633-4227), is available 24 hours a day. These cost nothing and are the right first stop. Demand peaks during open enrollment, so if you cannot get through or you want the comparison done for you against your own doctors and prescriptions, that is what our $99 Find My Medicare Plan service is for.