For years, Medicare Advantage (Part C) grew steadily, attracting nearly half of all Medicare beneficiaries with extra benefits and streamlined coverage. That trajectory is shifting. Heading into 2026, several of the largest insurers in the country are pulling back -- exiting counties, terminating plans, and reducing benefits. If you rely on a Medicare Advantage plan, these changes may directly affect you.
This article walks through what is happening, why, and -- most importantly -- what you can do if your plan is affected.
What Is Happening to Medicare Advantage in 2026?
Medicare Advantage enrollment is expected to decline for the first time in years. The Centers for Medicare & Medicaid Services (CMS) projects enrollment will drop to roughly 34 million in 2026, down from approximately 35 million in 2025. An estimated 2.6 million people were enrolled in plans that have been terminated for the 2026 plan year, and forced disenrollment rates have jumped to around 10% -- a sharp increase from the historical average of roughly 1%.
The three largest Medicare Advantage carriers -- UnitedHealthcare, Humana, and Aetna -- are all scaling back their footprints:
- UnitedHealthcare is offering plans in one fewer state and 109 fewer counties than the prior year, exiting a total of 225 counties.
- Humana is offering plans in three fewer states and 194 fewer counties.
- Aetna is closing approximately 90 Medicare Advantage plans across 34 states, exiting roughly 100 counties.
On average, beneficiaries now have access to 32 Medicare Advantage prescription drug (MA-PD) plans in 2026, down from 34 in 2025. Some states are seeing sharper drops -- New Hampshire lost access to 13 plans, and Minnesota lost 11 after one insurer exited the state entirely.
Why Are Insurers Pulling Back?
Several factors are driving the contraction.
Rising Medical Costs
Seniors have been utilizing more medical services, and the cost of that care has risen faster than expected. After years of relatively low utilization during and immediately following the pandemic, the rebound in healthcare use has squeezed insurer margins. When a plan becomes unprofitable in a given county, the insurer may choose to exit rather than absorb ongoing losses.
Lower Government Reimbursement Rates
CMS sets the payment rates that Medicare Advantage plans receive for each enrolled beneficiary. Analysts estimate that by 2026, effective government reimbursement has fallen roughly 20% from 2023 levels due to policy changes. This includes adjustments to the risk-adjustment model (known as V28), which was designed to address coding practices that historically inflated payments.
The MedPAC Overpayment Report
The Medicare Payment Advisory Commission (MedPAC), which advises Congress on Medicare policy, reported that the federal government will pay an estimated $76 billion more for Medicare Advantage enrollees in 2026 than it would have spent if those same individuals were in Original Medicare. That translates to MA spending running roughly 14% higher than fee-for-service costs.
Two main factors drive this gap:
- Coding intensity: MA plans tend to document more diagnoses for their enrollees, which inflates risk scores and increases the per-beneficiary payments they receive from the government.
- Favorable selection: MA plans have historically attracted somewhat healthier enrollees, but payments have not fully adjusted for this difference.
MedPAC has estimated that without reform, cumulative overpayments could reach $1.2 trillion over the next decade. This ongoing scrutiny may lead to further payment adjustments, which could in turn put additional pressure on plan availability.
Shifts in Plan Design
Beyond geographic exits, many insurers are restructuring their remaining plans. Some are prioritizing HMO models, which feature more limited provider networks but give insurers greater control over costs. Several major carriers have also reduced over-the-counter (OTC) health product allowances and other supplemental benefits for 2026.
What Happens When a Plan Exits Your Area
If you are enrolled in a Medicare Advantage plan that is being terminated or leaving your county, there is a defined process and timeline.
Notification Requirements
CMS requires your plan to notify you in writing if your plan will not be renewed. You should have received this notice by October 1, 2025, or at least 90 calendar days before the non-renewal takes effect. The notice must include:
- A clear statement that your plan is ending
- Information about alternative plans available in your area, including other Medicare Advantage plans and standalone Part D options
- Details about your guaranteed-issue Medigap rights (explained below)
- Information about your Special Enrollment Period (SEP) rights
If you did not receive a notice but suspect your plan has been terminated, contact your plan directly or call 1-800-MEDICARE (1-800-633-4227) to confirm your enrollment status.
Your Enrollment Options
When your plan is terminated, you generally have several paths forward:
Switch to another Medicare Advantage plan. Depending on your area, there may still be multiple MA plans available. Use the Medicare Plan Finder at Medicare.gov to compare what is offered in your ZIP code.
Return to Original Medicare. You can move back to Original Medicare (Parts A and B). If you do, you will likely want to also enroll in a standalone Part D prescription drug plan for medication coverage. The standard Part D maximum deductible for 2026 is $615, and the annual out-of-pocket cap on drug costs is $2,100.
Add a Medigap (Medicare Supplement) policy. If you return to Original Medicare, a Medigap plan can help cover costs like deductibles and coinsurance. Importantly, if your Medicare Advantage plan was terminated -- rather than you voluntarily leaving -- you may have guaranteed-issue rights. This means a Medigap insurer cannot deny you coverage or charge you more because of pre-existing health conditions. You generally have 63 days from the end of your MA coverage to exercise these rights. Act within this window, as missing it may permanently limit your Medigap options.
Special Enrollment Periods
If your plan exits your area, you qualify for a Special Enrollment Period (SEP) that allows you to make changes outside of the standard enrollment windows:
- Annual Enrollment Period (AEP): October 15 through December 7. During this window, you can switch to any available MA plan or return to Original Medicare with a Part D plan. Changes take effect January 1.
- SEP for plan terminations: If your plan is terminated, you have a Special Enrollment Period that runs from December 8 through the last day of February of the following year. This gives you additional time to find replacement coverage.
- Medicare Advantage Open Enrollment Period (MA OEP): From January 1 through March 31, anyone already in a Medicare Advantage plan can switch to a different MA plan or drop MA and return to Original Medicare with a standalone Part D plan. You may use this once during this window.
How to Check If Your Plan Is Affected
If you are unsure whether your Medicare Advantage plan is changing or leaving your area for 2026, take these steps:
1. Review Your Annual Notice of Change (ANOC)
Your plan should have sent you an Annual Notice of Change (ANOC) in the fall of 2025. This document outlines any modifications to your plan's benefits, costs, provider network, or service area for the coming year. If your plan is ending, the ANOC or an accompanying letter will state that clearly.
2. Check Medicare.gov
Visit the Medicare Plan Finder and enter your ZIP code to see which plans are available in your area for 2026. The updated Plan Finder now includes provider network information, so you can check whether your doctors participate in a given plan without leaving the site.
3. Call 1-800-MEDICARE
Medicare's helpline (1-800-MEDICARE / 1-800-633-4227) is available 24 hours a day, 7 days a week. Representatives can confirm your current enrollment status and walk you through your options. TTY users can call 1-877-486-2048.
4. Contact Your State Health Insurance Assistance Program (SHIP)
Every state has a SHIP program that provides personalized Medicare counseling at no cost to you. SHIP counselors can help you compare plans, understand your rights, and navigate enrollment. You can find your local SHIP at shiphelp.org or by calling 1-800-MEDICARE.
5. Verify Provider Networks Directly
If you are considering a new plan, confirm that your doctors, specialists, and preferred hospitals are in-network by calling their offices directly. Provider directories can sometimes contain outdated information, so direct verification is a reliable step.
What These Trends Mean for Beneficiaries
The contraction of Medicare Advantage does not mean the program is going away. Tens of millions of people remain enrolled, and many areas still have a substantial selection of plans. However, the landscape is shifting, and there are several practical implications to be aware of.
Fewer Choices in Some Areas
Rural and less densely populated areas may feel the impact most acutely. When an insurer exits a county, beneficiaries in that region may have significantly fewer -- or, in some cases, no -- Medicare Advantage options. Urban areas generally retain more choices, but even some metropolitan regions are seeing reductions.
Reduced Supplemental Benefits
Even in plans that are continuing, some benefits are being trimmed. OTC allowances, dental and vision coverage limits, and meal delivery programs may be less generous than in prior years. Review your plan's Evidence of Coverage document carefully to understand what is and is not included.
Cost Considerations
The standard monthly Part B premium for 2026 is $203.90. If you remain in a Medicare Advantage plan, you will continue paying this premium plus any plan-specific premium. If you switch to Original Medicare, budgeting for a Medigap policy and standalone Part D plan will change your monthly cost structure. Medicare Advantage plans have a maximum out-of-pocket (MOOP) limit of $8,250 for in-network services in 2026, which provides a ceiling on your costs -- something Original Medicare alone does not offer.
For prescription drug coverage, the 2026 Part D out-of-pocket cap of $2,100 applies whether you have drug coverage through a Medicare Advantage plan or a standalone Part D plan. Additionally, insulin costs are capped at $35 per month under both Part D and Medicare Advantage drug plans.
The Broader Policy Picture
The MedPAC overpayment findings and ongoing CMS payment adjustments suggest that the financial dynamics of Medicare Advantage may continue to evolve. Future rate changes could affect which plans remain viable and where. Staying informed about annual plan changes -- and reviewing your coverage each fall during the Annual Enrollment Period -- is an important habit.
Steps to Take Now
If you are currently in a Medicare Advantage plan, or considering one, here are practical steps to protect your coverage:
- Read all mail from your plan and from Medicare carefully. Notices about plan changes, terminations, and enrollment rights are time-sensitive.
- Mark enrollment deadlines on your calendar. The MA OEP runs from January 1 through March 31. The next AEP runs from October 15 through December 7.
- Compare plans annually. Even if your plan is not being terminated, benefits and costs change from year to year. Use the Medicare Plan Finder at Medicare.gov to compare your options.
- Ask for help if you need it. SHIP counselors provide objective, no-cost guidance. Call 1-800-MEDICARE to connect with your state program.
- Understand your Medigap rights. If your plan is terminated, you may have a limited window to enroll in a Medigap policy with guaranteed-issue protections. Do not let this window pass without making an informed decision.
The Bottom Line
The Medicare Advantage market is going through a period of meaningful change. Major insurers are reducing their footprints, benefits are being adjusted, and millions of beneficiaries are navigating new coverage decisions. While this can feel unsettling, you have rights and options. CMS notifications, Special Enrollment Periods, and guaranteed-issue Medigap protections exist specifically to ensure that you are not left without a path forward.
The most important thing you can do is stay informed and act within the enrollment timelines that apply to your situation. Whether you choose another Medicare Advantage plan, return to Original Medicare, or explore a Medigap policy, the right choice depends on your healthcare needs, your budget, and the options available where you live.
For personalized assistance, reach out to your State Health Insurance Assistance Program (SHIP) or call 1-800-MEDICARE (1-800-633-4227).