Agencies that help Mainers navigate Medicare are overbooked as enrollment deadline looms
Linda Cousins had already picked her Medicare plan when she qualified last year, but then she received a call from a woman claiming to be from the insurance company. Cousins, of Limington, said the caller pressured her into switching to a private Medicare Advantage plan with a different company.
When Cousins got paperwork about the new plan in the mail, she knew something was wrong. Cousins called Jamie Gleason, a health insurance advocate who had helped her enroll in her original plan, and Gleason helped her get back to her original Medicare plan.
Cousins said she couldn’t have navigated the complicated process on her own.
“It is dreadfully confusing, and it's too much for the average person to understand it all,” Cousins said. “The help is not out there to help us. There is some but not enough.”
Various area agencies on aging in Maine can help people like Cousins navigate Medicare enrollment. But all of their appointments are booked up through the end of the year as they face unusually high demand for enrollment assistance as multiple insurance providers have ended private Medicare Advantage plans and the federal government delayed releasing information about premiums. Open enrollment for Medicare ends Dec. 7.
Medicare is the federal health insurance program for all Americans 65 and older, as well as some with certain disabilities. When people enroll in Medicare, they can then choose to stick with original Medicare or pick from a number of Medicare Advantage plans, which are approved by Medicare and offered by private insurance companies. Medicare Advantage plans often bundle all the coverage into one plan, rather than break it up into Medicare Part A (hospital coverage), Part B (medical coverage) and Part D (prescription coverage). Advantage plans may also provide additional coverage
benefits.
An estimated 36,000 Mainers will lose their Medicare Advantage plans next year as carriers — including Aetna, Anthem, Martin’s Point Health Care and UnitedHealthcare — are all ending at least one of their plans, according to the Bangor Daily News. This means people will need to find new Advantage plans or revert to original Medicare and search for prescription coverage.
Maine has five area agencies on aging that provide one-on-one appointments to navigate Medicare enrollment, among other services. They each are seeing high demand for their assistance this year.
Southern Maine Agency on Aging, which serves most of Cumberland and York counties, has seen a 37 percent increase in calls about Medicare over the previous year. It filled all 500 appointment slots within two weeks of open enrollment.
Seniors Plus, which covers Androscoggin, Franklin and Oxford counties, booked all appointments by Oct. 15 and added ways to assist through email, mail and over the phone.
Spectrum Generations, which covers Kennebec, Knox, Lincoln, Sagadahoc, Somerset and Waldo counties plus Harpswell and Brunswick, had a waitlist of 134 people last week.
Vi Belanger, manager of community and memory services for Aroostook Agency on Aging, said her agency fully booked all 445 slots as of this week. Last year, it served 328 people.
“We’re only halfway through here. There’s a little less than a month left, and we’re still getting calls,” she said.
For those who are still calling for help, Belanger directs them to Medicare.gov, 1-800-Medicare or a trusted advisor.
Jamie Gleason is one of those trusted advisors. She spent nearly 20 years of her career helping people navigate Medicare. Now a community connector through the Grateful Undead, a volunteer organization in the Sacopee Valley area, Gleason had hoped to step back from Medicare enrollment, but the demand was too high. So far this year, Gleason has held 24 enrollment appointments, including with Cousins, with more scheduled through December.
Brandi Connor-Vargeson, Medicare supervisor for Seniors Plus, said many clients are calling because they are worried they won’t have coverage next year. A lack of information has also made work difficult for staff, volunteers and clients.
“The federal government still has not released any premium information for 2026,” Connor-Vargeson said last week. “It has made it hard to give clients accurate information about their monthly premium costs.”
The U.S. Centers for Medicare and Medicaid Services released information on 2026 Medicare premiums on Nov. 14.
In the Bangor area there was a “trifecta” of factors contributing to high demand for assistance, according to Ann Shea, Medicare supervisor for the Eastern Area Agency on Aging. In addition to terminated Medicare Advantage plans, Shea said multiple insurance providers also ended Part D plans, forcing Mainers to search for other prescription coverage.
Third, the drawn-out contract dispute between Anthem and Northern Light Health, the major health system in northern Maine, added extra uncertainty. After Northern Light and Anthem agreed to a contract, Shea expected some clients to cancel their assistance appointments and stick with their current plans, but few did.
“A lot of people have kept [the appointments] and wanted to consider other plans because they didn’t want to risk that happening again,” she said.
The Eastern Area Agency on Aging filled about 410 assistance appointments shortly after open enrollment began last month. There is a cancellation waitlist of about 50 people.
Megan Walton, CEO of Southern Maine Agency on Aging, said uncertainty at the federal level this year has made it difficult to train the agency’s 30 Medicare navigation volunteers, who are part of the State Health Insurance Assistance Program. Mainers saved on average $2,844 annually after working with a SHIP volunteer, according to the state.
Systems need to catch up to meet the needs of older adults as demand grows with an aging population, she said.
“We will absolutely continue to see huge demand, longer wait lists, more needs,” she said.
Southern Maine Agency on Aging has two more walk-in clinics available for Mainers looking for assistance: Nov. 20 and Dec. 4. The clinics are from 9 a.m. to 3 p.m. at 2320 Congress St. They operate on a first-come, first-served basis.
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