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Providence Medicare Advantage Plans 2027

Reviewed by Russell Noga, Licensed Medicare Insurance Broker (all 50 states) | Last updated October 8, 2026

Yes. Providence Health Plan is leaving Medicare Advantage entirely for 2027, in its 6 Oregon counties, 6 Washington counties and Orange County, California, and the whole health plan is shutting down.

Providence members will receive non-renewal letters. Coverage continues through December 31, 2026, and members get a Special Enrollment Period and generally a guaranteed issue right to buy certain Medigap plans.

See Medicare Advantage plans 2027.

✔ Licensed across all 50 states
✔ Built on CMS 2027 data
✔ No-cost plan comparison

Key Highlights

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Yes. Providence Health Plan is leaving Medicare Advantage entirely for 2027, in its 6 Oregon counties, 6 Washington counties and Orange County, California, and the whole health plan is shutting down.

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Read your Annual Notice of Change or non-renewal letter.

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If your plan ends, you get a Special Enrollment Period and generally a guaranteed issue right to certain Medigap plans.

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Nationally, the average 2027 Medicare Advantage premium is $12 a month, down from $14.37 (CMS).

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The Annual Enrollment Period is October 15 to December 7, 2026.

Compare plans and enroll online

What We Know About Providence for 2027

Providence 2027 Detail
Oregon Leaving 6 counties
Washington Leaving 6 counties
California Leaving Orange County
Health plan Shutting down

Benefits Providence Plans May Offer

Providence Plans May Include

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Hospital and medical coverage matching Original Medicare Part A and B

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Part D prescription drug coverage on most plans

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Routine dental, vision and hearing benefits

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Fitness programs and over-the-counter allowances

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Telehealth visits and care coordination programs

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A yearly out-of-pocket maximum on every plan

Benefits are not offered by every plan. They differ by plan and county and may change for 2027. Review the Evidence of Coverage for each plan before enrolling.

Providence Medicare Advantage Plans, Exploring Providence Medicare Advantage Plans

If Your Plan Is Ending

Keep an eye out: a non-renewal letter will arrive if your plan is ending. You stay covered through December 31, 2026. Taking no action sends you back to Original Medicare with no drug coverage.

Guaranteed issue: when your Medicare Advantage plan exits your area, you can generally purchase certain Medicare Supplement plans with no health questions asked, up until 63 days after that coverage ends.

Find & Compare Plans Online

Speak with a licensed insurance agent

1-833-641-4938TTY 711

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How to Tell If Your Plan Is Ending

Step by Step

1

Check your mail. Plans that are not renewing send a non-renewal notice by early October.

2

Read your Annual Notice of Change. It lists every 2027 change if your plan continues.

3

Search your plan in Medicare Plan Finder. If it does not appear for 2027 in your county, it is not offered.

4

Call the plan. Ask whether your plan and county continue in 2027.

Replacement Options by Area

Area Other 2027 Changes to Know
Oregon Regence leaves 3 southern Oregon counties; HCSC exits; SCAN enters
Washington Kaiser leaves 3 counties; MultiCare enters 3 counties; SCAN offers plans in parts of the state
Orange County, CA California has 394 plans for 2027; SCAN, Alignment and others offer plans

Providence Medicare Advantage Plans, Tailored Health Services within the Providence Network

Keeping Your Providence Doctors

Providence hospitals and doctors may still accept other Medicare Advantage plans or Original Medicare after the health plan closes. Call your doctors and ask which 2027 plans they will accept before you choose.

Ask Your Doctors

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Which 2027 Medicare Advantage plans your doctors accept

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Whether they accept Original Medicare (needed for Medigap)

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Hospital network for each plan

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Pharmacy network for your drugs

How Medicare Advantage Works

Medicare Advantage, sometimes called Part C, lets you receive your Medicare benefits through a Medicare-approved private insurer. These plans cover everything Original Medicare Part A and Part B cover, with the exception of hospice care, which Original Medicare continues to pay for. Most also bundle Part D drug coverage, and many may tack on extras like routine dental, vision and hearing benefits.

In exchange, Providence plans generally use networks of doctors and hospitals, and may require referrals or prior authorization for some services. Every Medicare Advantage plan has a yearly out-of-pocket maximum for covered medical care, which Original Medicare does not have. You keep paying your Part B premium, plus your plan’s premium if it has one.

Feature HMO PPO
Out-of-network care Not covered except emergencies and urgent care Covered at a higher cost
Referrals for specialists Usually required Usually not required
Premiums Usually lower Usually higher
Out-of-pocket maximum In-network limit In-network limit plus a higher combined limit
Best for Lower costs, local care Flexibility, travel, keeping specific doctors

Pros and Cons of Medicare Advantage

Advantages

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Often a low or $0 premium

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A yearly out-of-pocket maximum

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Drug coverage usually included

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Dental, vision and hearing benefits may be included in many plans

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One card and one plan

Tradeoffs

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Networks; except for emergencies, HMOs require in-network care

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Prior authorization and referrals are common

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Copays add up if you use a lot of care

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Plans and networks can change every year

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Moving to Medigap later may involve health questions

Providence Drug Coverage for 2027

Most Providence Medicare Advantage plans include Part D drug coverage. Each plan has its own formulary, drug tiers and pharmacy network, and plans commonly charge less at preferred pharmacies and through mail order. For 2027, any plan’s Part D deductible can be up to $700, and the out-of-pocket cap on covered drugs is $2,400.

Tier Typical Drugs Typical Cost
Tier 1 Preferred generics Lowest copay
Tier 2 Generics Low copay
Tier 3 Preferred brand-name drugs Moderate copay
Tier 4 Non-preferred drugs Higher copay or coinsurance
Tier 5 Specialty drugs Highest coinsurance

Each plan sets its own tiers. Review every plan’s formulary.

A drug you take may not be on a plan’s 2027 formulary, or it may come with a rule such as prior authorization. Even then, you have options:

If Your Drug Is Not Covered

1

Request a transition fill. During the first 90 days of a new plan or plan year, plans generally have to provide a temporary supply of a drug you already take, giving you time to change drugs or ask for an exception.

2

Talk to your doctor about other options. A covered drug from the same class could work just as well for less money.

3

Ask for a tiering or formulary exception. Your doctor sends a statement explaining why you need the drug or a lower copay. Plans have to decide within set time limits.

4

Challenge a denial. When the plan turns you down, you have the right to appeal through several levels of review.

See steps to appeal a Medicare Part D denial.

How to Compare Providence Plans for 2027

How to Compare

1

Review your Annual Notice of Change. It spells out every 2027 change to the plan you have now.

2

Verify your doctors and hospitals. Make sure every provider is in the 2027 network, not only the 2026 network.

3

Review your prescriptions. Verify every drug, the tier it falls on and any step therapy or prior authorization rules.

4

Look at the full annual cost. Total up the premium, usual copays and drug costs, and review the out-of-pocket maximum.

5

Look at star ratings. Medicare scores plans on quality and service using a 1 to 5 star scale.

6

Sign up by December 7. Coverage under your new plan begins January 1, 2027.

2027 Enrollment Dates

Enrollment Period Dates What You Can Do
Annual Enrollment Period October 15 to December 7, 2026 Join, change or drop a Medicare Advantage or Part D plan effective January 1, 2027
Medicare Advantage Open Enrollment January 1 to March 31, 2027 In Medicare Advantage, you can change to another plan or go back to Original Medicare one time
Initial Enrollment Period 7 months around your 65th birthday month Sign up for Medicare and choose your first plan
Special Enrollment Periods Varies Switch plans after events such as a move, a loss of other coverage or your plan exiting your area

Annual Enrollment is when most people make changes. If you like your current plan, no action is needed; it renews on its own. Even so, review your Annual Notice of Change, since networks, premiums, copays and drug lists can all change on January 1.

Special Needs Plans

Special Needs Plans (SNPs) are Medicare Advantage plans designed for particular groups. Their benefits, networks and drug lists are shaped around the members they serve, and many come with care coordinators. In 2027, SNPs are one of the few places large insurers are adding plans, even while cutting PPOs.

Type Who Qualifies What Is Different
Dual Special Needs Plan (D-SNP) People with both Medicare and Medicaid Coordinates both programs; costs are often very low, with extra benefits
Chronic Condition SNP (C-SNP) People who have qualifying conditions like diabetes, heart failure or chronic lung disease Doctors, drugs and programs designed around the condition
Institutional SNP (I-SNP) People who live in a nursing home or need that level of care at home Care delivered where the member lives

Turning 65 in 2027

When you turn 65 in 2027, you get a seven-month Initial Enrollment Period: the three months before your birthday month, the birthday month itself and the three months that follow. If you sign up in the first three months, coverage begins on the first day of your birthday month.

Turning 65 Checklist

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Enroll in Part A and Part B, unless you have qualifying employer coverage and decide to postpone Part B

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Choose between Medicare Advantage and Original Medicare plus Medigap

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Enroll in a drug plan, or a Medicare Advantage plan that includes drugs, to avoid a late Part D penalty

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If you go with Medigap, purchase during your six-month Medigap Open Enrollment Period

Star Ratings

Each fall, Medicare gives every Medicare Advantage and Part D plan a rating of 1 to 5 stars, based on factors such as preventive care, how well chronic conditions are managed, member complaints, customer service and accuracy of drug pricing. You can see the ratings in Medicare Plan Finder.

Using Star Ratings

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Ratings of 4 stars or more are generally a good indicator of quality and service

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A special enrollment period lets you move into a five-star plan once during the year

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A new plan may not have a rating yet, and that alone isn’t a bad sign

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Ratings reflect the plan as a whole, not how well it covers your particular doctors and drugs

Medicare Advantage or Medigap?

Medicare Advantage Original Medicare + Medigap
Monthly premium Often low or $0 (2027 average $12, CMS) Higher; varies by plan letter, age and ZIP
Doctors Usually a network Any provider in the U.S. that accepts Medicare
Costs when you get care Copays and coinsurance up to a yearly maximum Low and predictable; on Plan G, little or nothing once the Part B deductible is met
Drug coverage Usually included Add a separate Part D plan
Dental, vision, hearing Many plans may include some coverage Not included
Changing later Every year during Annual Enrollment Health questions in most states once your Medigap Open Enrollment Period ends

Help Paying Medicare Costs

When your income and savings are limited, two programs can greatly lower your Medicare costs:

Medicare Savings Programs

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Run by your state Medicaid office

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May cover your Part B premium, and in some cases deductibles and coinsurance

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Income and asset limits vary by state

Extra Help (Part D)

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Run by Social Security

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Lowers Part D premiums, deductibles and copays

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Those enrolled in a Medicare Savings Program qualify automatically

If you qualify for both Medicare and full Medicaid, you may also be able to join a Dual Special Needs Plan. See help for low-income Part D beneficiaries.

Getting Help

You do not need to compare plans by yourself, and help should not cost you anything. Here are the free options:

Free Help Comparing Plans

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Available any time: Medicare Plan Finder on Medicare.gov

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1-800-MEDICARE (1-800-633-4227), reachable 24 hours a day on all seven days of the week

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Your State Health Insurance Assistance Program (SHIP), which provides free, unbiased counseling

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A licensed agent or insurance broker, who can compare plans across several insurers for free

Gather your Medicare card, a list of your drugs and doses, your doctors and your preferred pharmacies before you call. That way a long conversation becomes a quick one.

Bottom Line

The Bottom Line

Check whether your Providence plan continues for 2027, compare your options and enroll between October 15 and December 7, 2026.

Compare plans and enroll online

Frequently Asked Questions

➤ Is Providence leaving Medicare Advantage in 2027?

Yes. Providence Health Plan is leaving Medicare Advantage entirely for 2027, in 6 Oregon counties, 6 Washington counties and Orange County, California. The whole Providence Health Plan is shutting down, so all members need new coverage.

➤ When does my Providence coverage end?

Your Providence Medicare Advantage coverage continues through December 31, 2026. Choose a new plan by December 7, 2026, during Annual Enrollment so your new coverage starts January 1, 2027, without a gap. Watch for your non-renewal letter.

➤ What happens if I do nothing?

If you do not choose a new plan, you return to Original Medicare on January 1, 2027, without drug coverage. You could then face a late enrollment penalty for Part D, so choose a plan or add Part D before your coverage ends.

➤ Can I buy Medigap after Providence leaves?

Generally yes. Because your plan is leaving, you have a guaranteed issue right to buy certain Medigap plans without health questions, usually until 63 days after your coverage ends. Keep your non-renewal letter as proof.

➤ Can I keep seeing Providence doctors?

Possibly. Providence hospitals and doctors may accept other Medicare Advantage plans or Original Medicare. Call your doctors to ask which 2027 plans they will accept, then choose a plan that includes them. If you choose Medigap, any provider that accepts Medicare will work.

➤ What other Oregon and Washington changes should I know?

In Oregon, Regence leaves 3 southern counties, HCSC exits and SCAN enters. In Washington, Kaiser leaves 3 counties and MultiCare enters 3 counties. Compare the plans offered at your ZIP code before choosing. Plan choices vary by county.

➤ Where can I get free Medicare help?

SHIBA offers free counseling in Washington, and Oregon and California residents can use their State Health Insurance Assistance Program (SHIP), called HICAP in California. You can also call 1-800-MEDICARE or work with a licensed agent at no cost.

➤ What happens if my Providence plan is not renewing?

Your coverage continues through December 31, 2026, and you get a Special Enrollment Period to pick a new plan. You generally also have a guaranteed issue right to buy certain Medigap plans, usually within 63 days after your coverage ends, so you do not lose access to coverage.

➤ When can I change my Providence coverage for 2027?

You can change during Annual Enrollment, October 15 to December 7, 2026, and the new coverage starts January 1, 2027. If you are already in a Medicare Advantage plan, you also get one change between January 1 and March 31, 2027, during Medicare Advantage Open Enrollment.

Have Questions?

Speak with a licensed insurance agent

1-833-641-4938

TTY users 711

Mon-Fri: 8am-9pm ET

Find & Compare Plans Online

Speak with a licensed insurance agent

1-833-641-4938TTY 711

Mon-Fri: 8am-9pm ET

ZRN Health & Financial Services, LLC, a Texas limited liability company

( Medicare Expert )

Russell Noga is the CEO of ZRN Health & Financial Services, and head content editor of several Medicare insurance online publications. He has over 15 years of experience as a licensed Medicare insurance broker helping Medicare beneficiaries learn about Medicare, Medicare Advantage Plans, Medigap insurance, and Medicare Part D prescription drug plans.

CompareMedicareAdvantagePlans.org
215 RR 620 South Austin, TX 78734

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