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For years, Medicare Advantage enrollees could generally expect to keep their coverage from one year to the next. However, that stability is starting to look less certain. A new peer-reviewed study published in JAMA found that roughly 2.9 million Medicare Advantage members, or about 1 in 10 enrollees, are being forced to leave their plans in 2026 because insurers have exited the markets where those plans were offered.
If you're enrolled in Medicare Advantage, this matters even if you're currently happy with your plan. A plan termination could mean being forced to find new coverage. Understanding what's happening now could help you avoid money mistakes before coverage changes take effect.
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Why millions of Medicare Advantage members are losing their plans
Researchers from John Hopkins Bloomberg School of Public Health and Georgetown University found that approximately 10% of Medicare Advantage beneficiaries in HMO and PPO plans will experience forced disenrollment in 2026 because their plan is no longer available in their county.
That's a dramatic jump from the average annual rate of about 1% between 2018 and 2024.
Practically speaking, this means millions of seniors who expected to renew their existing coverage are instead being required to choose a different option for next year.
What's causing insurers to leave Medicare Advantage markets?
The study points to several factors behind the increase in plan exits. Researchers noted changes to Medicare Advantage payment policies, adjustments to risk-scoring methods, and higher-than-expected health care utilization among beneficiaries. Insurers have cited financial pressures and uncertainty around future reimbursement rates as reasons for reducing their Medicare Advantage footprints.
The result is that some carriers have decided certain counties or plan offerings are no longer financially attractive. Rather than continue operating those plans, they've chosen to withdraw from those markets altogether.
Who appears to be most affected?
The disruption is not evenly spread across the country. The researchers found that beneficiaries enrolled with smaller insurance carriers were more likely to face forced disenrollment. Rural communities were also disproportionally affected.
In some states, more than 20% of Medicare Advantage enrollees are losing their plans. Vermont experienced one of the most significant impacts, with more than 90% of Medicare Advantage enrollees impacted by plan exits.
Even if your state is not among the hardest hit, plan availability can vary significantly from county to county, making it important to verify your specific coverage.
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What happens if your Medicare Advantage plan is terminated?
If your insurer stops offering your plan, you won't be able to keep it by renewing coverage. Instead, you'll receive a notice that your plan is ending and will need to choose another Medicare Advantage plan or return to Original Medicare.
Many beneficiaries assume they'll automatically be moved into a similar plan. Sometimes insurers offer a replacement option, but not always. Provider networks, prescription drug coverage, premiums, deductibles, and supplemental benefits can all differ from your previous plan.
That's why you should consider reviewing any replacement coverage carefully rather than assuming it matches what you had before.
The risk of defaulting back to Original Medicare
When a Medicare Advantage plan ends, some beneficiaries may ultimately find themselves back in Original Medicare if they don't select a new plan. While Original Medicare provides broad access to providers nationwide, it doesn't include the out-of-pocket spending cap that Medicare Advantage plans offer.
Original Medicare also leaves beneficiaries responsible for deductibles, coinsurance, and other expenses unless they have supplemental coverage such as a Medigap policy. Depending on your circumstances and state rules, obtaining a Medigap plan after leaving Medicare Advantage may not always be as simple as many retirees expect.
If you're affected, consider evaluating all available options before making a decision, rather than defaulting to Original Medicare.
Why this year's disruption stands out
Medicare Advantage has experienced years of steady growth, with enrollment surpassing 34 million beneficiaries nationwide. Historically, forced disenrollment was relatively uncommon. The sudden increase from roughly 1% annually to about 10% in 2026 represents a significant shift from what beneficiaries have become accustomed to.
Researchers described the change as a substantial reversal of the stability that Medicare Advantage members have generally enjoyed over the past decade. For many seniors, this may be the first time they've had to navigate a plan termination and search for replacement coverage.
What to do if you think your plan may be affected
If you're enrolled in Medicare Advantage, a few simple steps can help you determine whether action is needed:
- Review any notices or letters from your insurance company
- Log in to Medicare.gov and confirm your plan's status for 2026
- Compare available Medicare Advantage plans in your area if your current plan is ending
- Verify your doctors, hospitals, and prescriptions are covered under any replacement plan you're considering
- Review whether Original Medicare plus a Medigap policy makes sense for your situation
- Pay close attention to enrollment deadlines and special enrollment opportunities
Taking these steps early may provide more flexibility than waiting until the last minute.
Bottom line
Millions of Medicare Advantage members are discovering that their coverage is changing, whether they planned for it or not. If your plan is being discontinued, the most important step is to review your options early.
Health care expenses also tend to rise with age, even for retirees who remain relatively healthy. Taking time now to evaluate your next coverage options could help you avoid unexpected medical bills later and potentially save money in retirement. A plan that looks simple on the surface may have very different costs when you actually start using it.
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