Medicare Plan Leaving Skamania County, WA: No Hospital

Skamania County has no hospital. State and CMS hospital lists show none anywhere in its roughly 1,658 square miles, from the Columbia River Gorge up to Mount St. Helens and the Mount Adams country. If your Medicare Advantage plan is leaving after 2026, that one fact should drive your decision more than anything on a plan brochure: every hospital you'd use is in another county, and often in another state.

The county is also unusual in how people get Medicare. Of its 3,036 Medicare enrollees in July 2026, 2,252 (74%) were in Original Medicare and only 784 (26%) were in Medicare Advantage and other health plans (CMS counts, July 2026). Statewide, the split is close to half and half. So if you got a plan-exit letter, you're in the minority here. My read, and it is only a read since CMS doesn't record why people choose: when every hospital is out of county, a coverage type with no network has obvious appeal.

The numbers

Skamania County, July 2026	People
Everyone on Medicare	3,036
Original Medicare	2,252
Medicare Advantage and other health plans	784
Stand-alone Part D drug plan	1,537
Drug coverage bundled in a Medicare Advantage plan	732
Medicare and Apple Health (dual-eligible)	410
Under 65, qualifying through disability	231

Source: CMS Medicare Monthly Enrollment, July 2026, data.cms.gov. OFM counts 12,150 county residents (April 2026) and 3,247 aged 65 or older (2025).

About 27% of the county is 65 or older, per OFM. The 732 people whose drug coverage runs through a Medicare Advantage plan are the ones with the most urgent homework, because that coverage ends with the plan.

Networks and the state line

Skamania touches Hood River and Multnomah counties in Oregon, and Clark, Cowlitz, Klickitat, Lewis and Yakima counties in Washington. Depending on where you live, the hospital you'd use could be one of the two acute-care hospitals in Vancouver, Skyline Hospital (a Critical Access Hospital in White Salmon, Klickitat County), or one across the river in Oregon.

Here's how the two roads handle that:

Original Medicare goes wherever Medicare is accepted, nationwide. An Oregon hospital counts exactly like a Washington one.
Medicare Advantage plans generally require you to use providers in the plan's network and service area for non-emergency care. Before choosing one, get a yes or no from the plan on each hospital and specialist you'd realistically use, on both sides of the river.

That isn't a recommendation either way. A Medicare Advantage plan has a yearly out-of-pocket limit and usually bundles drug coverage; Original Medicare has no yearly limit unless you add a supplement. But in a county with no hospital, the network question comes first.

Your dates

Nothing changes before New Year's Eve: the departing plan pays through December 31, 2026. Make your choice by then and coverage begins January 1, 2027. If you need longer, a special enrollment period for plan exits runs December 8, 2026 through February 28, 2027, with January choices taking effect February 1 and February choices March 1. Let the date pass without acting and you default to Original Medicare when 2027 begins, minus drug coverage (Extra Help members excepted).

If you head to Original Medicare, Washington law gives you a window, until March 4, 2027, to buy certain Medigap policies with no health questions. OIC says apply November 1 or later. And add a stand-alone Part D plan: for 2027 the deductible can't exceed $700, and out-of-pocket costs for covered drugs stop at $2,400. Plan letters, PEBB details and under-65 rules are on our Washington guide to a discontinued Medicare plan.

A caution about spring. If you land in Original Medicare by default, the January–March window you may have heard about won't let you move back into Medicare Advantage; that window is reserved for people already enrolled in a Medicare Advantage plan on January 1. For someone who defaulted, February 28 is the last day to pick a Medicare Advantage plan under the plan-exit rules. If you do join a new Medicare Advantage plan for January, you keep one change between January 1 and March 31 in case its network turns out not to reach your doctors.

For the 231 residents on Medicare through disability: supplement options under 65 are narrower in Washington, so talk to SHIBA before giving up Medicare Advantage.

Getting to appointments

Skamania County Senior Services in Stevenson runs the county's public transportation, and it is open to the general public. Buses follow set routes and can detour up to three-quarters of a mile if you call a day ahead. Dial-a-Ride takes people of any age to medical appointments (with a fare), and riders 60 and older can ride for medical and essential trips on a donation basis. Medicaid-covered medical rides need approval from a Medicaid screener at 1-800-752-9422. For regional trips, the county points people to the Gorge TransLink website. Call Senior Services at 509-427-3990.

Have this ready before you call anyone

The plan's letter, with the envelope it came in (a Medigap insurer may want proof of when it was mailed).
Your Medicare card and, if you have one, your Apple Health card.
Every prescription, with the dose.
The name and town of each doctor and hospital you use, including any in Oregon, White Salmon or the Vancouver area.

With that list, a counselor or a Medicare representative can check networks and drug costs in one call instead of three.

Unbiased help

Skamania County Senior Services, 710 SW Rock Creek Drive in Stevenson, is also the county's Community Living Connections contact for aging and disability services. Skamania's SHIBA sponsor is the regional Area Agency on Aging & Disabilities of Southwest Washington, whose office is in Vancouver and whose territory stretches across five southwest Washington counties. Its entry on OIC's SHIBA locator, when checked October 26, 2026, said it was not booking appointments and told callers to try Medicare at 1-800-633-4227. For a county where Vancouver is a long drive, the phone is the practical route anyway: SHIBA statewide at 800-562-6900 (weekdays 8:30 a.m. to 4:30 p.m.) or 1-800-MEDICARE, which answers 24 hours a day, except some federal holidays.

If you're among the 410 dual-eligible residents, remember that Extra Help members leaving a Medicare Advantage plan are reassigned to a stand-alone drug plan by CMS unless they already picked one for 2027, and can switch drug plans monthly afterward.

I've based this on federal Medicare regulations and Washington's insurance code; the plan's mailed notice is what fixes your personal deadlines. Before committing, get your situation confirmed by 1-800-MEDICARE, by SHIBA, or by a licensed agent.

Skamania County FAQ

Is there a hospital in Skamania County?

Not on Washington DOH or CMS hospital lists. The nearest ones are in neighboring counties or in Oregon, so check each one against any Medicare Advantage plan you consider. Original Medicare can be used at any hospital in the U.S. that accepts Medicare.

Can I use Oregon hospitals with Original Medicare?

Yes. Original Medicare works with any doctor or hospital that accepts Medicare, in any state. Medicare Advantage plans usually require network providers for non-emergency care.

How many Skamania County residents are in Medicare Advantage and other health plans?

CMS counted 784 of the county's 3,036 Medicare enrollees in Medicare Advantage and other health plans in July 2026, about 26%. The other 2,252, about 74%, were in Original Medicare.

Is there transportation to medical appointments in Skamania County?

Skamania County Senior Services runs public transportation open to everyone, including Dial-a-Ride for medical appointments. Riders 60 and older can ride for medical and essential trips on a donation basis. Call 509-427-3990.

Medicare Advantage plan leaving Skamania County: check your hospitals first