BEND, Ore. – A busy four-way intersection where the federal government, healthcare industry, insurance companies and pretty much all seniors meet – and sometimes collide, to varying levels of pain and confusion – is up ahead, as it is every fall around this time.

Welcome to the “open enrollment” period, which begins Thursday and extends to year-end. And for some 14,000 Central Oregonians, it’s not a year where you can just stay on the Medicare Advantage plan you already have – you have to pick a new one, or switch to “Original Medicare.”

And if that’s your intention, you can also buy a Medicare supplement, or “Medigap” policy, to cover what Original Medicare doesn’t.

Confused yet? If not, there's a pretty good chance you will be.

And you’re not alone – social media like Nextdoor is already bringing numerous worried seniors checking with others about they can and should do in coming weeks.

The good news is that PacificSource – which by the way is dropping all of its individual plans across Oregon – will continue offering three Medicare Advantage plans in Central Oregon for the coming year. But one popular plan has been dropped and replaced, and all three have new names (that are simpler to remember).

Once again, as in 2026, PacificSource is the only insurer offering Medicare Advantage plans for most of Central Oregon for 2027, although there’s a new option, Devoted Health, for Crook County residents.

Recent mailings from PacificSource began with a brief letter that said “Medicare is facing challenges, both nationally and on a local level,” but assured: “We’re here for you.”

A follow-up letter confirmed that the Medicare Essentials Choice Rx 36 plan (which costs $28 a month) “will not be available in 2027,” but added: “The good news is you have options. We offer other Medicare Advantage plans that could meet your health coverage needs for next year,” and urged members to call for assistance.

Several other insurers offering Medicare Advantage plans have left the region in recent years, explained insurance agent Sabrina Stout of Sage Health Insurance in Bend. She spends much of her days, especially at this time of year, taking calls and holding meetings, webinars (and hands) to guide seniors through their plan options and filing out the paperwork, etc.

Another, multi-page mailing from PacificSource is clearly the type required by the federal government, laying out all the details and warning that those who don’t act by year-end will lose prescription drug coverage and only be covered by Original Medicare. It goes on to offer a list of alternative Medicare Advantage enrollment options – but they are really only in the three Portland-area counties.

No 'in-network' changes for 2027

Stout shared another piece of good news: St. Charles, Summit Health, Praxis Health and Mosaic Community Health remain “in-network” for Medicare Advantage patients next year, avoiding another fearful period of contract negotiations, as seen in recent years.

Then there are the mailings and other ads offering options of Medigap plans through other companies, all of course claiming they can save seniors money.

One of the three newly named PacificSource Medicare Advantage plans, Cascade Classic, will mean a rise in premiums, to $98 a month, but includes drug , dental and vision coverage. But hospital stays will cost about $485 a day for the first three days, plus a $385 medical deductible.

One example of tradeoffs, if someone instead switches to what’s known as a “Plan G” Medicare Supplement (“Medigap”) has higher monthly premiums, usually starting at $250 to $300, rising when a beneficiary ages.

But it’s designed to fill the 20% gap left by Original Medicare’s Parts A (hospital) and B (medical)– and has significantly lower hospital costs, under $300 for a stay that would cost over $1,800 under a Medicare Advantage plan.

So one’s age and current medical situation can play a big role in what plan and path to choose. And Stout is making sure seniors know that “if you choose a Medicare Advantage out of the gate, or right now if you’ve got the option (due to a plan ending), you may not be able to move to a supplement in the future, because they are allowed to deny coverage, based on your answers to health questions.”

And that’s true for the rest of your life.

“So that makes it tough, because at 65 or 70, you might be perfectly healthy, but nobody knows what may happen,” Stout said. “Nobody has a crystal ball to know that, at 80, you break a hip or something.” So one could, for example, go for the lower-premium option and squirrel away some of those savings, in case of later hospital stays.

And Stout says it’s important not to rush your decisions.

"If you’re talking to somebody that makes you feel pressured one way or another, that’s a red flag,” she said. “And make sure you understand the consequences are for whatever option you choose before making the decision. … They should be advising you as to what options are available and what that means for you, but not necessarily steering you in one direction or another.”

Then there are the changes that are tied to federal decisions, such as the maximum prescription drug deductible rising from $615 annually this year to $700 in 2027. The out-of-pocket maximum to pay for covered prescriptions also goes up, from $2,100 to $2,400.

Sometimes, the details and tradeoffs of two options end up being something a wash.

There are some folks on PacificSource Medicare Advantage who won’t have to make any changes, even though for example, the Essentials Choice 2 plan has been rebranded as the Oregon Basic plan. Classic RX is new, and Premier RX used to be RX 36.

“There’s always little nuance changes, as far as they may adjust the premium or the co-pay for a doctor visit,” Sout said. “But this is the first time in a handful of years that we’ve seen a significant change where they’ve added plans, removed plans and changed plans’ names.”

With more than half of Deschutes County’s Medicare Advantage customers having to choose a new plan, about 13,000 in total, it’s going to be almost as “fun” a fall/winter of choices and numbers as spring tax filing season - for different reasons, of course.