What Is Happening to Medicare Advantage in 2026?
A major shakeup is reshaping Medicare Advantage this year. According to a new study by researchers at the Johns Hopkins Bloomberg School of Public Health, nearly 2.9 million Medicare Advantage enrollees face forced disenrollment in 2026. That figure represents roughly 10% of all members enrolled in non-employer HMO or PPO plans — a tenfold increase compared to historical averages.
Between 2018 and 2024, the annual forced disenrollment rate averaged just 1%. However, that rate climbed sharply to 6.9% in 2025 and has now reached 10% for 2026 coverage. Consequently, millions of seniors must actively search for new health coverage at a time when plan options are narrowing.
Furthermore, the scale of disruption is unprecedented. The Medicare Advantage program currently covers more than 34 million enrollees — over half of all eligible Medicare beneficiaries nationwide. Therefore, even a 10% disenrollment rate translates into an enormous real-world impact on seniors across the country.
Why Are Insurers Exiting the Market?
Financial Pressures Are Driving Insurer Retreats
Several financial and regulatory factors are pushing insurers to exit Medicare Advantage markets. First, the Centers for Medicare and Medicaid Services (CMS) finalized lower benchmark payment rates for 2025 and 2026. Many insurers argue these rates do not keep pace with rising medical costs.
Additionally, the Inflation Reduction Act triggered a major redesign of the Part D prescription drug benefit. This shift significantly increased costs for insurers who had not priced those risks accurately. At the same time, CMS began phasing in the v28 Risk Adjustment model, which reduces reimbursements for many health conditions insurers had previously used to boost revenue.
Regulatory Changes Added Further Strain
Moreover, CMS tightened rules around prior authorization and star ratings. These changes reduced the ability of insurers to limit care costs or qualify for quality bonus payments. As a result, plans that relied heavily on benefit-rich offerings found their margins shrinking.
Together, these pressures created a financial environment where maintaining certain plans was no longer viable for many insurers. Rather than operating at a loss, they chose to exit unprofitable markets entirely.
Who Is Most Affected by These Plan Exits?
PPO Enrollees and Rural Beneficiaries Face the Greatest Risk
Not all members face equal risk. PPO enrollees represent nearly 50% of those being disenrolled, even though PPO plans serve a broad portion of the Medicare Advantage population. These plans carry higher costs and less predictable revenue, making them the first target for insurer cutbacks.
Rural beneficiaries also face disproportionate harm. They account for 28% of those losing coverage, yet only 15% of rural enrollees have access to a replacement plan in their county. In some rural counties, all Medicare Advantage plans have exited entirely, leaving seniors with no private alternative to Original Medicare.
Minority and Low-Income Seniors Are Vulnerable
In addition, a disproportionate share of Medicare Advantage enrollees are Black, Hispanic, and Asian American seniors. These populations often choose Medicare Advantage specifically because of lower upfront premiums and added benefits. Losing their plan creates not just financial stress but disruption to their established provider relationships.
Which Major Insurers Are Pulling Back?
Large Carriers Are Reducing Their Footprints
Several of the country’s largest health insurers have significantly scaled back their Medicare Advantage offerings. Humana exited multiple markets in 2025, affecting more than 100,000 enrollees. For 2026, the company further reduced its presence. Aetna (part of CVS Health) dropped plans across multiple states, losing approximately 400,000 enrollees — roughly 10% of its Medicare Advantage membership.
Cigna reduced service areas across eight states, including Florida, Texas, and Illinois, affecting roughly 5,400 beneficiaries. Several Blue Cross Blue Shield affiliates also made major moves. Blue Cross Blue Shield of Kansas City exited the Medicare Advantage market entirely, citing financial and regulatory pressures. Premera Blue Cross withdrew from Washington state, affecting over 30,000 members.
Smaller Carriers Are Also Exiting
Notably, small carriers represent nearly half of all plan exits. For enrollees in markets dominated by smaller regional insurers, replacement options may be limited or nonexistent. This dynamic further reduces competition in an already consolidating market.
What Should You Do If Your Plan Is Ending?
Act Quickly During Open Enrollment
If your Medicare Advantage plan is ending, you should receive a letter in early October. That notice explains your plan will no longer be available on January 1. Importantly, your current plan still covers you through December 31. Do not let your coverage lapse.
If you take no action before December 31, CMS automatically enrolls you in Original Medicare on January 1. However, you still have until the end of February to select new health and drug coverage. Therefore, the safest approach is to actively compare available plans during the Annual Enrollment Period, which runs from October 15 to December 7.
Steps to Find a New Plan
- Contact Medicare directly at 1-800-MEDICARE or visit Medicare.gov.
- Use the Medicare Plan Finder tool to compare available options in your county.
- Consult a licensed Medicare insurance broker for personalized guidance.
- Review your prescriptions and preferred doctors before choosing a new plan, since networks and formularies vary widely.
What This Means for the Future of Medicare Advantage
Disruption Is Likely to Continue
Researchers at Johns Hopkins predict that this disruption is not a one-time event. Instead, we are entering a two-to-three-year cycle of significant market restructuring. CMS continues to phase in policy changes that reduce overpayments and close loopholes insurers previously exploited. Consequently, more plan exits and benefit reductions are likely through 2027.
Competition May Decline in Some Markets
At the market level, widespread exits reduce competition — particularly in regions where only a few insurers have ever operated. Less competition generally leads to fewer plan choices, higher premiums, and reduced supplemental benefits for seniors.
Policymakers Must Respond
Researchers and consumer advocates are urging policymakers to address the gaps this disruption creates. Understanding where forced disenrollments are occurring — and for which populations — is essential to developing targeted solutions. Without policy intervention, the most vulnerable seniors, particularly those in rural and low-income communities, risk being left with inadequate or no private coverage options.
