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:
| Date | What Happens |
|---|---|
| May 31, 2026 | Clear Spring Health coverage ends permanently |
| June 1, 2026 | Automatic rollback to Original Medicare Parts A & B if no new plan chosen |
| July 31, 2026 | Deadline — last day of your Special Enrollment Period for a new plan |
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
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- Medicare Advantage vs. Original Medicare 2026: Which Is Right for You?
- Best Medigap Plans 2026: Which Medicare Supplement Saves Most?
- Medicare Extra Help 2026: Save Up to $5,900 on Drug Costs
- Long-Term Care Planning for Seniors 2026: What It Really Costs
- Medicare IRMAA 2026: How to Reduce Your High-Income Surcharge
