Clear Spring Health Closing May 31: 12,000 Seniors Need New Plan Now

If you are among the 12,000 seniors enrolled in a Clear Spring Health Medicare Advantage plan, this is the most important article you will read this month. Clear Spring Health has announced it is permanently closing all of its Medicare Advantage plans effective May 31, 2026, leaving tens of thousands of beneficiaries without coverage. The good news: a federally protected Special Enrollment Period gives you until July 31, 2026 to find a new plan — but the clock is ticking.

As a senior health expert, I want to walk you through exactly what is happening, what your rights are, and how to find the best replacement plan before your current Clear Spring Health Medicare Advantage coverage disappears on June 1.

What Is Happening With Clear Spring Health in 2026?

Clear Spring Health, a Medicare Advantage insurer that served seniors across multiple states, has made the decision to exit the Medicare Advantage market entirely. Effective May 31, 2026, all Clear Spring Health Medicare Advantage plans will be terminated. This is not a benefit reduction or a plan redesign — it is a complete and permanent shutdown of the insurer’s Medicare Advantage business.

According to the Centers for Medicare & Medicaid Services (CMS), when a Medicare Advantage plan involuntarily disenrolls its members due to a plan termination, all affected beneficiaries are automatically granted a Special Enrollment Period (SEP). This SEP is your federally guaranteed right to transition into new coverage without a gap in protection.

Clear Spring Health Special Enrollment Period: Critical Dates

Here is the exact timeline every affected senior must understand before acting:

If you do not act by July 31, 2026, you remain on Original Medicare only — with no prescription drug coverage, no dental or vision extras, and no out-of-pocket annual limit. This is a serious financial risk for most seniors.

What Happens If You Do Nothing?

Many seniors assume something will automatically happen. Here is the reality of inaction:

• No Medicare Part D prescription drug coverage — 100% out-of-pocket drug costs
• No dental, vision, or hearing benefits that your Clear Spring plan may have included
• No gym or SilverSneakers fitness benefit
• No annual out-of-pocket cap — Original Medicare has unlimited cost exposure
• Possible lifetime Part D late enrollment penalty if you go 63+ days without creditable drug coverage

The Part D late enrollment penalty adds 1% to your premium for every month without coverage — and it follows you for life. A 12-month gap means a 12% permanent surcharge added to your drug plan premium forever. Act before July 31 to avoid this.

Your 3 Best Options for Replacement Coverage

Option 1: Enroll in a New Medicare Advantage Plan

During your SEP, you can enroll in any Medicare Advantage plan available in your ZIP code. For most seniors, this is the fastest path to restoring comparable coverage. Use the Medicare Plan Finder at Medicare.gov to compare plans side-by-side by monthly premium, drug formulary, provider network, and extra benefits. The 2026 maximum out-of-pocket cap for in-network services under Medicare Advantage is $9,250.

Option 2: Original Medicare + Medigap + Part D

A plan closure triggers a guaranteed-issue right for Medigap. This means insurers cannot deny you coverage or charge higher premiums based on health status — a significant protection for seniors with pre-existing conditions. Medigap Plan G covers the Part B deductible and all coinsurance, giving you nationwide provider freedom. You would also need a standalone Part D drug plan, but many seniors find this combination offers the most predictable costs long-term.

Option 3: Dual-Eligible Programs (if you qualify)

If you have both Medicare and Medicaid, you qualify for a Dual Special Needs Plan (D-SNP), which coordinates both types of coverage and typically has very low or zero premiums. Contact your state Medicaid office to check eligibility.

How to Find and Enroll in a New Plan: 5 Best Resources

• Medicare Plan Finder: Medicare.gov/plan-compare — compare every available plan in your ZIP code for free
• 1-800-MEDICARE (1-800-633-4227): Available 24/7; representatives can walk you through options and enroll you by phone
• SHIP (State Health Insurance Assistance Program): Free, unbiased counseling in every state. Find your local counselor at shiphelp.org
• Licensed Medicare broker: Can compare plans from multiple insurers at no charge to you
• Clear Spring Health customer service: Must provide you written notice and enrollment instructions; call them if you have not received your letter

What to Look For in Your New Plan

• Drug formulary: Confirm every current medication is covered at an affordable tier — this is the single most important check
• Provider network: Verify your primary doctor, all specialists, and preferred hospitals are in-network before enrolling
• Prior authorization requirements: Some plans require pre-approval for procedures; ask for the plan’s PA list
• Continuity of care: If you are mid-treatment for a serious condition, federal rules allow up to 90 days of continuity with your current providers at in-network cost sharing after enrollment
• Extra benefits match: Compare dental allowances, vision coverage, and fitness benefits between options

5 Immediate Action Steps for Clear Spring Health Members

• Step 1: Find your plan termination letter from Clear Spring Health — it contains your official SEP dates and enrollment instructions
• Step 2: List all current prescriptions, doctors, specialists, and anticipated procedures for the next 12 months
• Step 3: Visit Medicare.gov/plan-compare and enter your ZIP code to see available plans
• Step 4: Contact your local SHIP counselor at shiphelp.org for free, unbiased help comparing plans
• Step 5: Enroll before July 31, 2026 — do not wait until the last week as processing can take several days

The Bottom Line

Clear Spring Health’s exit from the Medicare Advantage market is disruptive, but it does not have to leave you unprotected. Federal law gives you until July 31, 2026 to secure new coverage, and your guaranteed-issue rights protect you from being denied Medigap coverage. Act now — compare your options carefully, check your drug formulary first, and use the free resources available. Do not wait until May 31 to start this process. The best plans fill available spots, and finding the right fit takes a few days of careful research.

Sources

• Medicare.gov Plan Finder
• CMS Special Enrollment Period Guidelines
• SHIP National Technical Assistance Center

URGENT: 6 Days Left — Your Clear Spring Health Action Checklist

As of May 25, 2026, you have 6 days before Clear Spring Health terminates all Medicare Advantage plans on May 31. If you have not yet chosen a replacement plan, follow this exact sequence today:

• Step 1 — Call 1-800-MEDICARE (1-800-633-4227): Confirm your Special Enrollment Period (SEP) is active. Your SEP window runs through July 31, 2026 — but acting before May 31 ensures zero gap in coverage.
• Step 2 — Verify your current prescriptions are covered: Go to Medicare.gov/plan-compare, enter your ZIP code, and filter plans by your specific drug list. A plan that covers all your medications could save you $3,000–$6,000 per year vs. a plan that doesn’t.
• Step 3 — Call your primary care doctor’s office: Ask which Medicare Advantage plans they currently accept. Switching to a plan that doesn’t include your doctor means finding a new physician — a major disruption for seniors with chronic conditions.
• Step 4 — Contact your State SHIP program: SHIP (State Health Insurance Assistance Program) counselors are free, unbiased, and can compare plans side-by-side with you in one phone call. Find yours at shiphelp.org or call 1-877-839-2675.
• Step 5 — Request continuity of care if mid-treatment: If you are currently undergoing cancer treatment, post-surgical recovery, dialysis, or any ongoing specialist care, your new plan is legally required to continue that care for 90 days at in-network cost. Request this in writing from your new plan immediately upon enrollment.

What Happens to Your Coverage on June 1 If You Do Nothing

This is the scenario many Clear Spring Health members are most worried about — and it has a clear answer. If you do not actively choose a new plan before May 31:

• You do NOT lose all Medicare coverage. Original Medicare (Part A hospital + Part B medical) remains active automatically. You will not be uninsured.
• You DO lose your Medicare Advantage extras: dental, vision, hearing, OTC allowances, gym benefits, transportation, and any supplemental benefits Clear Spring Health provided will end May 31.
• Your Part D drug coverage ends: Unless you had a separate Part D plan, your prescription drug coverage terminates June 1. This is the most urgent gap — generic medications you pick up monthly will become full out-of-pocket cost.
• Your SEP keeps you protected through July 31: You have until July 31, 2026 to enroll in a new Medicare Advantage plan or Part D drug plan without any penalty. However, every day without drug coverage is a financial risk.

Best Replacement Plans to Consider (2026 Options)

The right replacement depends on your county, income, and health needs — but here are the most important plan types to evaluate in the time you have:

• New Medicare Advantage plan (HMO or PPO): If you want to maintain the benefits Clear Spring Health provided (dental, vision, drug coverage in one plan), find a new MA plan through Medicare.gov/plan-compare. PPO plans give you the most provider flexibility. Average 2026 MA premium: $14/month.
• Original Medicare + Medigap + Part D: The most flexible and most predictable option. Medigap Plan G covers everything except your $257 Part B deductible — no surprise bills, no networks. Average Plan G premium for a 70-year-old: $130–180/month. Add a low-premium Part D plan for your specific medications.
• D-SNP (Dual Eligible Special Needs Plan): If you have both Medicare and Medicaid, you likely qualify for a D-SNP — a specialized MA plan with $0 premium and enhanced benefits for dual-eligible seniors. Call 1-800-MEDICARE to check eligibility.

Important: During your SEP, you have guaranteed-issue rights for Medigap plans — meaning insurers cannot deny you or charge more based on health conditions. This window rarely opens outside of initial Medicare enrollment, making this a rare second chance to get Medigap coverage without medical underwriting.

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