Medicare Advantage (MA) beneficiaries are facing significant changes as major insurers announce reductions in their offerings for 2026. Notable companies like Aetna CVS Health, UnitedHealthcare, and Blue Cross Blue Shield have confirmed cutbacks, impacting not just their plans but also those provided by smaller insurers that operate in specialized markets. These terminations are largely attributed to rising costs and decreased reimbursement rates from the federal government for patient care.
This shift is expected to result in nearly one million fewer beneficiaries enrolled in Medicare Advantage compared to the previous year, according to the Centers for Medicare & Medicaid Services (CMS). Those aged 65 and older, who predominantly utilize MA plans, will need to navigate these changes carefully. Certain regions may experience more drastic reductions, creating a disparity in available options based on geographic location.
UCare, a nonprofit health plan primarily serving Minnesota and western Wisconsin, is projected to be particularly impactful, with plans set to terminate coverage in 2026, affecting approximately 158,000 beneficiaries. Concerns are rising among enrollees, many of whom have relied on UCare since its inception in 1998. Local officials report a sense of panic, with enrollees struggling to understand the reasoning behind the cuts and apprehensive about changing plans.
Insurers explain that increased benefit usage and inadequate payment rates have necessitated these drastic measures. Blue Cross Blue Shield noted that new enrollees often present with more chronic conditions, leading to heightened healthcare needs and costs that aren’t matched by government reimbursements. Consequently, this trend may result in fewer choices, diminished benefits, and escalated costs for MA members.
Despite the trend of reductions, some insurers, such as Humana and Clover Health, are expanding their MA offerings nationwide. An analysis of the MA market reveals that while 1,949 counties across the U.S. will see at least one plan vanish, 798 counties will gain at least one new option. Urban areas seem to fare better, with counties like Dallas County, Texas, adding plans due to their higher populations of older residents, whereas rural regions tend to suffer.
In New Hampshire, the fallout is keenly felt, as rural areas witness substantial cuts in options. Experts suggest that without a larger senior population, insurers in less populated regions face challenges with enrollment and profitability, leading to fewer offerings.
For those whose Medicare Advantage plans are canceled, open enrollment presents an opportunity to switch to a new plan or revert to Original Medicare. Beneficiaries should closely review their Annual Notice of Change (ANOC) letter, which typically arrives by September 30 each year, outlining crucial changes for the upcoming year.
The Medicare Open Enrollment period runs from October 15 to December 7, 2025, allowing individuals to select from alternatives available in their area. Additionally, there is a secondary enrollment period that runs from January 1 to March 31, 2026, providing more flexibility for enrollees to adjust their coverage.
It’s crucial for beneficiaries to act swiftly during the enrollment window, as those who miss the opportunity may default to Original Medicare without additional prescription drug coverage under Medicare Part D. This circumstance could prove financially burdensome as they would face full retail prices for medications until the next enrollment period in 2027.
To assist with the transition, beneficiaries are encouraged to utilize the Plan Finder tool on Medicare.gov to review available plans. Comparisons should be made not just on premiums and out-of-pocket expenses but also on the drug formulary and provider networks, which also face considerable changes.
Beneficiaries might explore options like Medigap or Medicare Cost Plans if they need to switch back to Original Medicare, as these can provide broader coverage alternatives without the typical underwriting hurdles during open enrollment. Additionally, seeking assistance from local State Health Insurance Assistance Programs (SHIP) or reliable Medicare agents can provide personalized support throughout this challenging process.
In summary, as the Medicare Advantage landscape adjusts significantly for 2026, beneficiaries must proactively engage in the open enrollment period to ensure they secure adequate coverage that meets their healthcare needs.
