About 1,100 Medicare Advantage members in Montana lose their PacificSource plan when the Oregon-based insurer leaves the state at the end of 2026. The count comes from information PacificSource gave the Montana Commissioner of Securities and Insurance, the state’s insurance regulator. Open enrollment for 2027 coverage closes December 7, which leaves a short window to pick a replacement.
What PacificSource told Montana regulators
PacificSource spokesperson Amber Conger confirmed the exit to the Daily Montanan on May 21. “This includes exiting the individual market, as well as the state of Montana,” she said. The company’s Montana individual plans run through December 31, 2026, and the Medicare Advantage business is among the lines being closed.
Medicare Advantage is the smallest of the company’s Montana lines. The figures given to the commissioner show about 11,000 people in individual plans, 15,000 in small-group plans, 4,500 in large-group plans and 1,100 in Medicare Advantage. Medicare Advantage plans are sold by private insurers as an alternative to Original Medicare.
For those 1,100 members, the question is what to do before December 7. Staying put is not an option, because the plan will not exist in 2027. Members need another Medicare Advantage plan, or Original Medicare paired with a drug plan and, usually, a Medigap supplement.
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Ethan Holmes, a spokesperson for the commissioner’s office, said “Anytime a health insurance provider pulls out of the Montana market, consumers are impacted.” He said affected people will have to shop for new plans. The office’s Insurance Consumer Service bureau takes questions from Montanans about their coverage.
PacificSource has operated in Montana since 2012 and is contracted with more than 90% of the state’s providers. It keeps offices in Helena and Billings. The company largely left Washington in 2024 and has cut back in Idaho and Oregon, so the Montana exit follows a pattern of shrinking its footprint.
Montana workers are affected too. Employees in the state will lose positions, and severance may be offered to those who qualify, according to the Daily Montanan, which says the company has not finalized how many jobs are involved. In Oregon, where PacificSource is based, the company reportedly planned to lay off 381 employees, about one-fifth of its workforce, in October 2025.
Letters, deadlines and the January 1 default
PacificSource’s own update page says members whose coverage is affected will get a notification letter 180 days before the coverage end date. Notices for January 1, 2027 end dates began July 1. The page adds that Medicare Advantage service-area changes will be shared later, in line with guidance from the Centers for Medicare & Medicaid Services.
Until the contract ends, care continues as usual. The company tells members to keep scheduling appointments and filling prescriptions, and to confirm that their preferred doctors are in any new plan’s network. Medicare customer service for PacificSource members is 888-863-3637.
Members who do nothing land in Original Medicare on January 1, 2027, with no supplemental coverage, Live Insurance News reports. Original Medicare has no annual out-of-pocket maximum, so a hospital stay or cancer treatment can carry open-ended costs unless a Medigap policy is added.
A Medigap policy is the usual fix. Members who lose Medicare Advantage coverage get a 63-day guaranteed-issue window after the coverage ends, which means insurers cannot turn them down for health reasons. Plans A, B, C, D, F and G are on offer, though C and F are closed to anyone first eligible for Medicare on or after January 1, 2020.
Two timing traps sit inside that window. A Medigap application filed in January may not start until February 1, and Montana has no birthday rule letting people switch Medigap plans each year without underwriting. Going more than 63 days without creditable drug coverage can also bring a permanent Part D late-enrollment penalty.
A thinner Medicare Advantage market for 2027
The number of Medicare Advantage prescription drug plans available in Montana falls from 32 in 2026 to 23 in 2027, a 28% drop, according to the same report. PacificSource’s exit lands in a market that is already narrowing. The report says neither Humana nor UnitedHealthcare has released Montana-specific numbers for its national plan cuts.
About 80,720 of Montana’s 270,312 Medicare beneficiaries, roughly 30%, are in Medicare Advantage, compared with about 51% nationally. Blue Cross and Blue Shield of Montana offers Medicare Advantage in 39 of the state’s 56 counties. The report says no Medicare Advantage plan has ever operated in eastern Montana.
County decides the menu. In a county with several carriers, members can compare drug lists, networks and premiums across the remaining plans. In a county without Advantage plans, the comparison is Original Medicare with a Medigap policy and a stand-alone drug plan.
Comparing plans before December 7
Medicare’s Find a Medicare plan tool is the free official place to compare what is sold in a ZIP code. Members can enter their prescriptions and pharmacy, then check each plan’s doctors. Annual enrollment runs October 15 to December 7, and a new plan starts January 1, 2027.
Free counseling is available through Montana’s State Health Insurance Assistance Program at 1-800-551-3191. Counselors can walk through a Medigap quote and a drug-plan comparison by phone.
The larger decision is whether to stay in Medicare Advantage at all. Original Medicare with a Medigap policy swaps network limits for a monthly premium, and the 63-day clock starts when PacificSource coverage ends. The date on the mailed letter, not the news cycle, is what members should hold to.
Need a new plan before December 7?
A member who misses December 7 wakes up on January 1 in Original Medicare with no supplement, no cap on hospital bills and a Medigap window that is already running. A drug left off a new formulary or a specialist outside a new network usually shows up only after the first claim.
The 2027 Medicare Open Enrollment Decision Kit puts a cost calculator spreadsheet in front of the choice, comparing plans on cost, drugs and doctors, along with a prescription-by-plan comparison. It also covers Medigap guaranteed-issue rights when a Medicare Advantage plan leaves, with a call script for the insurer.
Compare replacement plans with the open enrollment kit and its Medigap call script →
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This article was produced with AI assistance and edited for accuracy against the sources linked above.
