This story was originally produced Oct. 26 by the Keene Sentinel. NHPR is republishing it in partnership with the Granite State News Collaborative.
Cheshire County's only hospital is out of network for the county's sole Medicare Advantage plan in 2027, but that may change.
Humana, the only Medicare Advantage insurer in Cheshire County, has one plan that as of Friday afternoon did not include Cheshire Medical Center in Keene or Dartmouth Hitchcock Medical Center in Lebanon in its network, according to the federal Medicare.gov, which compares coverage options for Medicare.
However, a Dartmouth Health spokesperson said the health system is negotiating an agreement to join Humana's Cheshire County Medicare Advantage network.
"We expect Cheshire and all Dartmouth Health system members to be in-network with Humana Medicare Advantage for 2027, pending completion of the agreement," the Dartmouth Health spokesperson said. "Until an agreement is finalized and signed by both parties, Cheshire cannot be listed as an in-network provider in the plan's directory."
Dartmouth Health is not included in Humana's Medicare Advantage network for 2026 because of a contractual dispute, The Sentinel reported last year.
Without the approval, seniors with Medicare Advantage in Cheshire County would have to travel farther from home for in-network care or be prepared to pay significantly more for specialty care, hospitalizations, diagnostic tests and more at Cheshire Medical Center and other Dartmouth Health facilities.
For patients whose care is already established at Cheshire Medical, that might mean finding new in-network providers that take new patients, which can be difficult, particularly when it comes to specialty care.
The Dartmouth Health spokesperson said there's no timeline for completing the agreement, and representatives from Humana were not available for comment by late Friday morning.
The Medicare open enrollment period began about a week ago, and is set to run through Dec. 7. Benefits go into effect Jan. 1.
Medicare Advantage is a cheaper private alternative to traditional Medicare. Its premiums are lower than traditional Medicare, but it has more restrictions on care, such as requiring an insurer's authorization for diagnostic tests, specialists or hospitalizations and having narrower provider networks. Traditional Medicare, by contrast, covers the vast majority of hospitals and providers in the United States.
Humana's network for the Medicare Advantage plan that covers Cheshire County residents currently includes Brattleboro Memorial Hospital in Brattleboro and Monadnock Community Hospital in Peterborough. Catholic Medical Center in Manchester is also included, according to Humana's website.
If Cheshire Medical Center and other Dartmouth Health facilities are included in the plan, seniors on Medicare Advantage in Cheshire County would be able to get in-network care — which is substantially cheaper — closer to home. The inclusion would also mean that Dartmouth Hitchcock Medical Center, the only level 1 trauma center in New Hampshire, would be in network. Level 1 trauma centers typically handle patients with complex or life-threatening conditions, and they have capabilities that smaller hospitals don't.
Medicare Advantage providers have been steadily leaving New Hampshire in recent years. That trend is also playing out nationally as health care costs rise and these plans become less profitable, according to the nonprofit KFF, which studies and documents healthcare issues.
Cheshire County's offerings went from four Medicare Advantage plans from two insurers this year to a single plan from Humana in 2027. Coos and Carroll County were slated to have no Medicare Advantage plans for 2027, according to the N.H. Department of Insurance, but Gov. Kelly Ayotte announced on Thursday that Medicare Advantage coverage from Devoted Health will be available for these residents next year.
For help with enrollment, Cheshire County residents can contact the Aging and Disability Resource Center, formally ServiceLink, at 603-352-7707 or email help@nhcare-c.org.
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