Medicare Advantage plan terminated in Cowlitz County? Start here

Cowlitz County leans harder on Medicare Advantage than most of Washington. In July 2026, CMS counted 29,288 people on Medicare here, and 19,798 of them (67.6%) were in Medicare Advantage and other health plans. Statewide that share was 49.7%. CMS doesn't publish how many people get plan-ending letters, but the earlier you start, the more room you have to compare.

Cowlitz County Medicare at a glance

Source: CMS Medicare Monthly Enrollment, CMS counts, July 2026. Counts are people, not plans. Percentages computed from those counts.

What a two-thirds share means if your plan is the one leaving

Look at the drug-coverage rows. 19,173 people in this county get their prescriptions through a Medicare Advantage plan, and only 5,412 carry a separate Part D plan. That tells you how most households here have set things up: one card covers the doctor and the pharmacy. When that card goes away, two things go with it, not one. If you end up in Original Medicare without picking anything, your medical coverage keeps going but your drug coverage does not.

The disability and dual-eligible rows matter too. Both run above the state rate. About 1 in 9 Cowlitz enrollees qualifies for Medicare through a disability rather than age, and that group has fewer Medigap options under 65. Roughly 1 in 6 has Apple Health as well, which brings different rules and some extra protection. If either describes you, skip ahead to the sections written for you below before you decide anything.

The county itself has about 114,900 residents (OFM, April 2026), and OFM put 25,298 of them at 65 or older in 2025, a little over 22%.

One hospital, a river border, and your doctors

The Washington Department of Health's 2025 hospital list shows one hospital in Cowlitz County: PeaceHealth St. John Medical Center at 1615 Delaware Street in Longview. That makes one question more important than usual: is your new coverage going to work at the hospital you would actually be taken to?

The county also sits on the Columbia River across from Columbia County, Oregon, and Kelso is 48 miles north of Portland according to the City of Kelso. If you see specialists on the Oregon side or in Vancouver, keep that in mind when you compare:

• Original Medicare lets you use any doctor or hospital in the U.S. that accepts Medicare. A Portland specialist and the Longview hospital are both fine if they take Medicare.
• Medicare Advantage plans may limit non-emergency care to a network and a service area. Before you join one, check each doctor, the hospital and your pharmacy by name in the plan's 2027 directory. An Oregon specialist may or may not be included.

Write your providers down, including the once-a-year ones like a cardiologist or eye surgeon. That list does more for you than any brochure.

The federal dates, kept short

Your plan keeps paying claims through December 31, 2026. That date is the one to build around. Choose new coverage by then and it starts January 1, 2027, with no break.

• Now through December 7: Medicare's fall Open Enrollment. Any change starts January 1.
• December 8, 2026 to February 28, 2027: a special enrollment period just for people whose plan is ending. A choice made in December still starts January 1; one made in January starts February 1; one made in February starts March 1.
• If you choose nothing: Medicare moves you to Original Medicare on January 1. You will have no drug plan unless you pick one. People with Extra Help are the exception: CMS reassigns them to a stand-alone Part D plan if they do not choose their own.
• Medigap: if you go to Original Medicare, Washington law (RCW 48.66.055) and federal law let you buy certain Medicare Supplement policies without health questions. OIC says to apply no earlier than November 1. The right ends 63 days after your plan ends, which is March 4, 2027.

Waiting into January or February is allowed, but a month without drug coverage means paying full pharmacy prices, and a gap of 63 days or more can bring a Part D late penalty that lasts as long as you have Medicare drug coverage. The full rules, including which Medigap plan letters you can get, are in our statewide guide to a discontinued Medicare plan in Washington.

If you have Apple Health, or you are under 65

Apple Health and Medicare (5,145 people here): you get the same plan-ending window as everyone else, plus a monthly chance to switch stand-alone drug plans. If you qualify for full Medicaid benefits, you can also join an integrated dual plan, which Washington calls Apple Health Medicare Connect, in any month where one is offered. If you have Extra Help and do nothing, CMS places you in a drug plan, but it may not cover your specific medicines well. Check it.

Under 65 on Medicare (3,412 people here): OIC says your options are more limited. Federal law generally does not require Medigap insurers to sell to people under 65, and Washington is not on CMS's list of states that require it. As we read it, Washington's plan-ending guaranteed issue law has no age limit, but insurers only have to offer policies they sell to new customers. Call SHIBA before dropping Medicare Advantage for Original Medicare.

Money tight? The Medicare Savings Program through the Health Care Authority helps pay Medicare premiums and has no asset test. You can apply at washingtonconnection.org.

Help close to home, and what to expect when you call

SHIBA. In Cowlitz County, the SHIBA sponsor listed by OIC is the Area Agency on Aging & Disabilities of Southwest Washington, based at 201 NE 73rd St. in Vancouver. When I checked OIC's local SHIBA office page on October 26, 2026, the listing said: "Currently not accepting appointments. For assistance, call Medicare at 1-800-633-4227." The statewide SHIBA line is still open: 800-562-6900, 8:30 a.m. to 4:30 p.m., Monday through Friday.

Community Living Connections. The same agency runs a Cowlitz office at 760 Ocean Beach Hwy, Suite G, in Longview: 360-577-4929, toll free 800-682-2406. It serves older adults, persons with disabilities, and their families.

Medicare itself. 1-800-MEDICARE (1-800-633-4227, TTY 1-877-486-2048) answers 24 hours a day, except some federal holidays, and Medicare Plan Finder lets you enter your drugs and pharmacy to compare 2027 options for your ZIP code.

Getting to a new doctor. RiverCities Transit runs the buses in Longview and Kelso and charges a reduced fare to people 65 and older and Medicare cardholders. The Cowlitz-Wahkiakum Council of Governments also lists Community in Motion's Reserve-A-Ride for older adults and people with disabilities in Cowlitz County who need rides to medical appointments.

A licensed agent can help too. Ask which companies the agent works with; you never have to buy anything to get answers.

Federal Medicare rules and Washington law decide how this works, and the dates in your own plan letter are the ones that apply to you, so check your situation with 1-800-MEDICARE, SHIBA or a licensed agent before you switch.

Related pages: Washington statewide guide · Kelso · Longview

Cowlitz County questions

Sources

1. CMS Medicare Monthly Enrollment, July 2026
2. WA OFM population estimates by age, 2025
3. WA DOH 2025 hospital year-end reports
4. City of Kelso: About Kelso
5. Washington OIC: Is your Medicare Advantage plan changing or leaving?
6. Washington OIC: Find a local SHIBA office
7. Community Living Connections directory
8. RiverCities Transit fixed route fares
9. CWCOG: Resources for seniors
10. RCW 48.66.055
11. WA HCA: Medicare Savings Program