About 2.6 Million Seniors Are Being Pushed Off Their Medicare Advantage Plans for 2026

About 2.6 million Medicare Advantage enrollees are losing the plan they signed up for this year, not because they chose to switch, but because their insurer pulled out. For seniors who built a routine around a specific doctor, drug list or benefit, that decision was made for them.

What You Should Know

Roughly 13 percent of enrollees in Medicare Advantage prescription drug plans, about 2.6 million people, will have their 2026 plan terminated, according to a KFF analysis. A separate study published in JAMA, reported by AJMC and TheStreet, found the broader forced-disenrollment rate is projected to reach about 10 percent for 2026, up from an average of roughly 1 percent between 2018 and 2024 and 6.9 percent in 2025.

If a plan is terminated, enrollees get a notice and a special enrollment period to pick a new plan or return to traditional Medicare. Those who take no action may be defaulted into traditional Medicare and could need to enroll separately in a standalone Part D drug plan, according to the KFF-based reporting.

The Pressure Point

The squeeze is uneven. PPO enrollees make up nearly half of those disenrolled, and rural beneficiaries face a far higher disenrollment rate, about 28 percent, than urban enrollees at roughly 15 percent, AJMC reported, citing study author Mark Meiselbach of Johns Hopkins. Small carriers accounted for nearly half of all plan exits.

Vermont is the extreme case: about 92 percent of its Medicare Advantage enrollees are projected to lose their plan for 2026 after a second straight year of insurer exits, according to AJMC.

The Receipts

Meiselbach told AJMC the shift reflects payment corrections: “We’ve recognized that we are probably overpaying for Medicare Advantage, and so efforts to reduce how much we pay are going to mean that some plans can no longer be profitable.” Insurers have also trimmed supplemental benefits, TheStreet reported.

What Happens Next

Enrollees whose plans were terminated should watch for the official notice and act during their special enrollment period, when some may qualify for a Medigap policy without medical underwriting, according to TheStreet. After that window closes, most must wait until the annual enrollment period that begins October 15 to make further changes.

References: KFF analysis via AOL | AJMC | TheStreet