Medicare Advantage has spent two decades selling a simple promise: more choices, extra benefits, and predictable coverage inside a private plan. But 2026 is delivering a disruption many seniors and disabled Americans rarely have to face at scale: their plan is disappearing, and they have to shop again—whether they want to or not.
A new study published this week found that nearly 3 million Medicare Advantage enrollees—about 1 in 10—were effectively forced to find new coverage in 2026 because insurers exited markets or pulled plan options.
Where the disruption is worst
The pain isn’t evenly spread. In seven states, the study found that more than 40% of Medicare Advantage members were left scrambling due to plan exits. The most extreme case: Vermont, where about 92% of enrollees were affected. The other high-impact states cited were Idaho, Wyoming, North Dakota, South Dakota, Maryland, and New Hampshire.
That “uneven geography” matters because it means some communities experience a minor reshuffle, while others face a full-blown coverage reset—networks, benefits, prescriptions, and all.
Why plans are pulling back now
Insurers have been warning about tighter economics in Medicare Advantage:
- Medical costs rose more than expected in parts of the program.
- Government reimbursement tightened, pressuring margins.
- Plans responded the way businesses often do: reduce exposure, trim offerings, or leave certain counties/states entirely.
The industry story is basically: “We can’t price this the way we used to, and we’re not going to lose money to stay in every market.”
Why forced switching is a big deal (even if you can pick another plan)
On paper, switching is just “choose a new plan.” In real life, it can mean a cascade of changes:
- Your doctors may be out-of-network in the new plan.
- Drug formularies can change, affecting what’s covered and what you pay.
- Extra benefits (dental, vision, hearing, gym programs, transportation) can shrink or vanish.
- Prior authorization rules can differ dramatically.
- Your out-of-pocket exposure may increase even if the premium looks similar.
It’s not just paperwork. It’s continuity of care—and for many people, continuity is the whole point of coverage.
What to do if your Medicare Advantage plan is ending
If you receive a notice that your plan is being discontinued or pulled from your area, here are the practical steps that matter most:
- Confirm your deadline and your enrollment window
Plan exits typically trigger a special opportunity to choose new coverage. Don’t assume you can “handle it later.” - Start with your doctors and hospitals
Make a short list of must-keep providers, then check which plans include them in-network. - Audit your prescriptions
Compare formularies and pharmacy networks. A plan can look great until your monthly medications jump in price. - Compare total yearly costs—not just premiums
Look at deductibles, copays, specialist visits, and the annual out-of-pocket maximum. Premiums can be bait; cost-sharing is the bill. - Consider traditional Medicare as a serious fallback
In disrupted markets, some people may find that Original Medicare + Part D (and possibly Medigap, depending on eligibility and state rules) offers more stability—even if it’s not always the cheapest upfront. - Get unbiased help
Your local State Health Insurance Assistance Program (SHIP) can help you compare options without selling you anything. If you’re overwhelmed, this is the fastest route to clarity.
The bigger takeaway: Medicare Advantage is growing, but it’s not frictionless
Medicare covers roughly 60 million Americans, and about half are in Medicare Advantage. For years, plan choice expanded, and forced disruptions were relatively rare. This year’s numbers suggest that stability can break—quickly—when payment formulas shift and medical costs rise.
For policymakers, the warning is obvious: if Medicare Advantage is going to remain the “default” for millions, the system has to handle volatility without dumping the burden onto older and medically complex people. For enrollees, the lesson is more personal: treat every annual enrollment period like a real decision, not a renewal ritual—because in 2026, a lot of renewals aren’t an option anymore.
