Medicare Advantage members in central and northern Wisconsin who hold an Aspirus Health Plan card have a deadline coming. The Wausau-based insurer is leaving Medicare Advantage for 2027 in 21 Wisconsin counties, according to Becker’s Payer Issues. Its individual members have until December 7, the last day of Medicare’s open enrollment period, to choose new coverage.
Becker’s reported the exit on September 30 in a list of insurers leaving Medicare Advantage next year, citing CMS data. The trade publication says Aspirus “offered plans in 21 Wisconsin counties.” It did not publish a county-by-county list or a membership total for the exit.
The exit follows a rough year for the plan. In February, the federal Centers for Medicare & Medicaid Services suspended new Medicare Advantage enrollment into the plan, Becker’s reported at the time. The agency acted after Wisconsin regulators ordered Aspirus to stop signing up new members or renewing policies tied to its claims processor, UCare, which Minnesota regulators had taken over.
For members, the question is practical. Anyone on an Aspirus Medicare Advantage plan has to find out whether the county on their address is one of the 21, and if so, pick a replacement before open enrollment closes. A member who lets the date pass does not keep the old plan. Under Medicare’s rules for plans that end, the default is a move to traditional Medicare, with no drug plan and no supplement attached.
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What the numbers show, and what they do not
The count of 21 counties comes from Becker’s Payer Issues, which says it drew on CMS data. The article, by Jakob Emerson, does not name the counties. Aspirus keeps a service area map on its Medicare plans page, and that map is where a member can see whether a home county was in the footprint.
A second reading of the same federal data points the same way. MyMedicarePlans, which publishes plan changes from the CMS Medicare Advantage landscape files, shows no Aspirus Health Plan Medicare Advantage plans in Wisconsin for 2027, on a page dated October 1. It also reports that every one of Wisconsin’s 72 counties has at least one plan leaving or changing.
Neither source gives a membership figure for the exit. The last public number came in February, when Becker’s reported Aspirus had more than 6,000 Medicare Advantage members.
How the year got here
The earlier trouble is laid out in Becker’s February report. CMS issued the sanction on February 24 and said Aspirus was in violation of its federal contract, which requires Medicare Advantage organizations to accept new enrollees. The order followed a January 20 Wisconsin directive to pause writing or renewing Medicare Advantage business tied to UCare.
Wisconsin’s Office of the Commissioner of Insurance said Aspirus had to report weekly on moving policyholders to a new claims administrator, with a July 31 target. A Minnesota Department of Health spokesperson said the administrator’s services were “fully functional” for Aspirus during UCare’s wind-down.
Aspirus’s own Medicare site told brokers that the plan “is no longer enrolling new members in their 2026 Medicare Advantage plans” and that “Nothing changes for current members.” That statement covers 2026, not the year ahead, and it says nothing about 2027 counties.
Becker’s did not report a stated reason for the 2027 exit, and the story does not say the sanction caused it. Aspirus’s own Medicare site says enrollment depends on contract renewal.
What happens if nothing is chosen
KFF, the health policy research group, described the default in its October 27 analysis of plans ending nationally. People in terminated plans “must proactively enroll in another Medicare Advantage plan if one is available in their area.” Otherwise, they are switched to traditional Medicare.
Traditional Medicare does not include most prescription drug coverage. Anyone landing there needs a separate Part D plan to keep drug coverage, and a lapse without comparable coverage can bring a late penalty later. KFF also says people whose Advantage plan is terminated qualify for a Medigap special enrollment period with guaranteed issue rights, so a supplement insurer cannot deny them or charge more for a pre-existing condition.
That right matters most for members with ongoing health needs, who would otherwise face underwriting. Members should confirm the window and its length in the notice from the plan or with the state insurance office.
The calendar
KFF’s open enrollment guide says the period runs October 15 to December 7, with changes taking effect January 1. In that window, members can move to another Medicare Advantage plan, return to traditional Medicare, or add a Part D plan.
Medicare’s Plan Finder is the free official comparison tool. Entering a ZIP code, doctors and every prescription shows which 2027 plans are sold in the county and what each costs.
A workable order is to start with the county check, then the medications, then the doctors and hospitals a household actually uses. A plan that looks cheaper on premium can cost more once drugs and out-of-network visits are counted.
Is your county one of the 21 Aspirus is leaving, and what do you switch to?
For an Aspirus member in one of those counties, a missed December 7 means a New Year with no plan chosen, a default to traditional Medicare and possibly no drug coverage. The choice is tougher when the replacement has to cover specific medications and specific doctors.
The 2027 Medicare Open Enrollment Decision Kit includes a cost calculator spreadsheet that compares plans on cost, drugs and doctors, a prescription-by-plan comparison and a provider call script. It also includes the Open Enrollment calendar, so every date from now until December 7 is on one page.
This article was produced with AI assistance and edited for accuracy against the sources linked above.
