Several top health insurers will reduce Medicare Advantage availability in 2026 as they face lower reimbursements and higher medical costs. Here is what is changing, why it is happening, and how you can prepare.
What is changing in 2026
Leading insurers, including UnitedHealth, Humana, and CVS Health’s Aetna, plan to pull back their Medicare Advantage offerings in 2026. These changes will vary by county and state, but the trend is the same: fewer plans and tighter coverage footprints.
- UnitedHealth: Exiting 109 counties, affecting about 180,000 people. Shutting down over 100 plans, many in PPO formats.
- Humana: Will offer plans in 46 states, down from 48 in 2025. Coverage footprint falls to about 85% of counties, down from 89%.
- CVS Health (Aetna): Prescription drug plans offered in 100 fewer counties. Overall Medicare Advantage presence falls to 43 states and 2,159 counties, down from 44 states and 2,259 counties.
Why insurers are cutting back
Insurers say three forces are pressuring their Medicare Advantage lines:
- Lower government reimbursement: The Centers for Medicare and Medicaid Services (CMS) has implemented payment changes since 2024 to curb spending. That trims plan revenue and narrows margins.
- Higher utilization: Seniors are using more care, especially outpatient services and procedures. When use rises faster than premiums and reimbursements, plans see losses in certain markets.
- Rising care costs: Labor, supplies, and drug prices are up. Combined with lower risk adjustment payments tied to member health conditions, many counties become harder to serve profitably.
UnitedHealth summarized the situation as a combination of CMS funding cuts, higher costs, and increased utilization creating headwinds no organization can ignore.
Who is most impacted
The cutbacks are not uniform. People in rural counties, or in places with fewer competing plans, may feel the biggest changes. PPO members at UnitedHealth may see plan closures or be mapped to different options. Some members could lose preferred out-of-network access if PPO choices shrink.
On the flipside, some plan types will expand. For example, CVS Health plans to add offerings for people who qualify for both Medicare and Medicaid in 16 new states. Humana plans to launch new plan types in four states across 177 counties, and says 83% of its standalone Part D drug plans will have lower premiums in 2026.
State and county changes
Here are notable footprint shifts mentioned by the insurers:
- UnitedHealth: Leaving 109 counties, affecting roughly 180,000 members.
- Humana: Moving from 48 to 46 states for Medicare Advantage offerings; footprint in about 85% of counties.
- CVS Health (Aetna): From 44 to 43 states, and 2,259 to 2,159 counties for Medicare Advantage; 100 fewer counties for prescription drug plans.
Specific county and zip-level details will appear in plan finders as carriers file final bids and CMS approves them. If you rely on a specific doctor, hospital, or medication, you should verify 2026 in-network status and formularies during open enrollment.
What to do before open enrollment
Open Enrollment for Medicare Advantage typically runs from October 15 to December 7. Here is a simple checklist to stay ahead of 2026 changes:
- Check your county: Use the Medicare Plan Finder to see 2026 plans in your county once they are posted. Look for any notices from your current insurer.
- List your providers and meds: Confirm that your doctors, clinics, and hospitals remain in-network. Check your exact medications and dosages on the 2026 formulary.
- Compare PPO vs HMO: If a PPO is closing, review HMO options or other PPOs with comparable networks. Check referral rules and out-of-network coverage.
- Review total costs: Balance premiums with copays, deductibles, and out-of-pocket maximums. For many, a slightly higher premium can still save money if drug or specialist costs drop.
- Look at dual-eligible options: If you qualify for Medicare and Medicaid, review new plan options in your state. Benefits may be richer for care coordination and transportation.
- Call your doctors: Ask if they plan to stay in-network for your preferred 2026 plan. Provider directories can lag updates.
Quick FAQs
Will my plan be discontinued? It depends on your county and carrier. Watch for an Annual Notice of Change (ANOC) letter and log in to your member portal for updates.
Can I keep my doctors? Only if your plan continues to include them in-network. Always verify with both the plan and your provider’s office.
Are premiums rising? It varies. Some standalone Part D plans from Humana will have lower premiums, while other premiums and copays may rise as benefits are adjusted.
What if my plan exits my county? You should be offered a Special Enrollment Period to choose another plan or return to Original Medicare with or without a Part D plan.
Expect fewer Medicare Advantage choices in some counties in 2026. Plan ahead, verify your doctors and drugs, and compare options during open enrollment to avoid coverage surprises.
To contact us click Here .
