Medicare Advantage plans continue to evolve across New Hampshire, but in some counties, those changes can mean losing access to certain plans or major healthcare providers. One of the most significant concerns for Granite State residents has been how Medicare Advantage networks interact with large hospital systems—especially Dartmouth Hitchcock Medical Center, one of the region’s most prominent providers.
Why Medicare Advantage Coverage Varies by County
Medicare Advantage (Part C) plans are offered by private insurance carriers, and each plan must renew its contract with Medicare every year. Carriers choose which counties they will cover based on:
- Provider availability and negotiated contracts
- Enrollment numbers and projected costs
- Regional healthcare trends
- Hospital system participation
This means that plans available in Hillsborough County may not be offered in Grafton, Sullivan, or Carroll counties—and vice versa. As a result, many New Hampshire beneficiaries experience county-level shifts from year to year.
The Role of Dartmouth Hitchcock in Network Changes
Dartmouth Hitchcock Medical Center (DHMC) and its affiliated Dartmouth Health clinics serve a large portion of western and central New Hampshire. However, not all Medicare Advantage carriers contract with Dartmouth Hitchcock, and some plans that once did have reduced participation over time.
When a major system like Dartmouth Hitchcock is not in-network for a Medicare Advantage plan, it can significantly affect beneficiaries in counties such as Grafton, Sullivan, Cheshire, and parts of Merrimack—areas where Dartmouth is the primary or preferred provider.
How This Impacts Medicare Beneficiaries
When carriers change their network agreements or exit certain counties, beneficiaries may experience:
- Loss of in-network access to Dartmouth Hitchcock providers
- Higher out-of-pocket costs for specialists or hospital services
- Fewer Medicare Advantage plan choices in the county
- The need to switch plans or return to Original Medicare
- Confusion about which doctors will accept their coverage in the upcoming year
These changes are especially challenging for patients who rely on Dartmouth Hitchcock for chronic condition management, specialty care, or ongoing treatment plans.
Why Plans Leave Certain New Hampshire Counties
Medicare Advantage plan exits often occur due to:
- High cost of contracting with regional hospital systems
- Limited provider competition in rural counties
- Low enrollment numbers in sparsely populated areas
- Shifts in Medicare reimbursement and plan star ratings
When a carrier discontinues a plan in a county, all beneficiaries enrolled in that plan receive a non-renewal notice and are granted a Special Enrollment Period to make changes.
What Beneficiaries Should Do If Their County Loses Coverage
If your county is affected by Medicare Advantage exits or network reductions involving Dartmouth Hitchcock, consider the following steps:
- Review upcoming Medicare Advantage plans to confirm whether DHMC is in-network
- Compare plans across multiple carriers for 2026
- Consider returning to Original Medicare with a Medigap plan, which allows you to see any Medicare-accepting provider
- Check prescription drug coverage separately if moving away from Advantage plans
- Talk with a local Medicare advisor who understands New Hampshire’s county-level differences
Staying Prepared for 2026
While next year’s county-level Medicare Advantage changes will not be finalized until plan information is released, the trend of selective participation—especially around large systems like Dartmouth Hitchcock—is expected to continue. For many New Hampshire residents, especially in rural counties, annual plan reviews are more important than ever.
With the right guidance, you can navigate these changes confidently and ensure that your Medicare coverage remains reliable and compatible with the doctors and hospitals you trust.
