If you're one of the roughly 33 million Americans enrolled in a Medicare Advantage plan, 2026 is shaping up to be a year that demands your full attention. Research from the Johns Hopkins Bloomberg School of Public Health has put a striking number on a trend that has been quietly building: approximately 1 in 10 Medicare Advantage enrollees could face forced disenrollment in 2026, meaning their insurer is either pulling out of their county entirely, shrinking its service area, or discontinuing the specific plan they're enrolled in. That translates to an estimated 4 million people who didn't choose to leave their plan — their plan is leaving them.
This isn't a minor administrative inconvenience. For a 72-year-old managing diabetes with a specialist she's seen for eight years, or a 78-year-old whose preferred hospital is in-network under his current HMO, a forced plan exit can disrupt care in ways that are both medically and financially significant. Understanding why this is happening, what your rights are, and what steps to take right now can make the difference between a smooth transition and a costly coverage gap.
The underlying driver of this wave of disenrollments is financial pressure on insurers. Medicare Advantage plans are paid a fixed monthly amount per enrollee by the federal government, based on a complex formula tied to health risk scores and county-level benchmarks. In recent years, CMS has tightened those payment rates while simultaneously increasing scrutiny of how insurers code patient diagnoses — a practice that had inflated risk scores and, by extension, insurer revenues. Several large carriers, including Humana and UnitedHealthcare, have publicly disclosed that their Medicare Advantage businesses are under significant margin pressure. When a plan isn't profitable in a given county or region, the business decision is often to exit. The enrollees left behind bear the consequences.
According to CMS.gov data, the Medicare Advantage market offered approximately 4,800 plans nationwide in 2025, with an average of 43 plans available per county. That number sounds reassuring — plenty of options, right? But plan availability varies enormously by geography. In dense urban counties, you may have 60 or more plans to choose from. In rural areas, you might have five or fewer, and when one of those exits, your realistic alternatives shrink fast. The same CMS data shows that roughly 30% of Medicare Advantage plans received 3 stars or below in 2025 quality ratings, meaning a significant share of the market is already underperforming on the metrics CMS uses to evaluate member experience, chronic disease management, and access to care.
If your plan is being discontinued, federal law gives you a Special Enrollment Period. Specifically, you have the right to enroll in a new Medicare Advantage plan or switch back to Original Medicare (Parts A and B) starting when you receive your termination notice and running through the end of February of the following year, or for a defined window tied to your plan's end date. This SEP is separate from the Annual Enrollment Period (AEP), which runs October 15 through December 7 each year, and the Open Enrollment Period (OEP), which runs January 1 through March 31. Your SEP rights exist on top of those windows, not instead of them. The critical thing to understand is that this SEP is time-sensitive — if you miss it and your plan ends, you could face a gap in coverage or be auto-assigned to a plan CMS selects on your behalf.
Auto-assignment sounds like a safety net, but it functions more like a last resort. CMS will attempt to place you in a plan with the same insurer if one is available in your area, or in a plan with a high star rating if not. What CMS cannot do is guarantee that your current doctors are in-network, that your specific prescription drugs are on the new plan's formulary, or that your monthly premium stays the same. A beneficiary who was paying $0 per month for a Medicare Advantage plan with a $3,500 out-of-pocket maximum might find themselves auto-enrolled in a plan with a $25 monthly premium and a $7,550 out-of-pocket maximum — the legal limit CMS allows for in-network costs in 2025. That's a meaningful financial difference, especially on a fixed income.
For beneficiaries who are forced out of Medicare Advantage and want to return to Original Medicare, the Medigap (Medicare Supplement) opportunity deserves serious attention. Normally, Medigap insurers can use medical underwriting outside of your initial enrollment window — meaning they can charge you more or deny you coverage based on pre-existing conditions like heart disease, COPD, or diabetes. But a plan termination or involuntary disenrollment typically triggers a guaranteed issue right, which means insurers must sell you a Medigap policy at standard rates regardless of your health status. This is one of the most valuable consumer protections in Medicare, and it has a hard expiration: you generally have 63 days from the loss of your Medicare Advantage coverage to exercise it. Miss that window and you're back to medical underwriting, which can make Medigap unaffordable or unavailable for people with serious health conditions.
The Medigap plans most commonly chosen by beneficiaries returning to Original Medicare are Plan G and Plan N. In 2025, Plan G — which covers nearly all Medicare cost-sharing except the Part B deductible ($257 in 2025) — carries average monthly premiums ranging from roughly $100 to $200 depending on your age, gender, tobacco use, and state of residence. Plan N is typically $20 to $40 cheaper per month but requires copays of up to $20 for office visits and up to $50 for emergency room visits. Neither plan covers prescription drugs, so you'd also need to enroll in a standalone Part D plan, with premiums averaging around $40 to $50 per month for mid-tier coverage in most markets. When you add it up, returning to Original Medicare with a Medigap policy and Part D plan can cost $150 to $250 per month more than a $0-premium Medicare Advantage plan — but it also eliminates the network restrictions and prior authorization requirements that many Medicare Advantage enrollees find frustrating.
If you want to stay in Medicare Advantage rather than return to Original Medicare, your SEP gives you the ability to shop the full market of plans available in your zip code. The best starting point is Medicare.gov's Plan Finder tool, which lets you enter your specific prescription drugs, preferred doctors, and zip code to generate a side-by-side comparison of available plans ranked by estimated annual cost. Don't just look at the monthly premium — factor in the plan's drug formulary tier structure, its annual out-of-pocket maximum, whether your specialists are in-network, and whether the plan requires referrals to see specialists (HMO) or allows you to self-refer (PPO). A $0-premium HMO that doesn't include your cardiologist is not a good deal at any price.
State-level resources can also be invaluable during this process. Every state has a State Health Insurance Assistance Program, universally known as SHIP, which provides free, unbiased counseling from trained volunteers who have no financial stake in which plan you choose. Unlike insurance agents or brokers — who are compensated by the plans they sell — SHIP counselors can walk you through your options without any conflict of interest. You can find your state's SHIP contact through the Medicare.gov website or by calling 1-800-MEDICARE (1-800-633-4227).
It's also worth understanding the timeline of how plan exits unfold. Insurers are required to notify CMS of their intent to exit a market by a specific deadline, and CMS then requires them to send written notice to affected enrollees. By law, you must receive notice of a plan discontinuation no later than 90 days before the plan ends. That notice will arrive by mail and will include information about your SEP rights and, in some cases, a list of alternative plans in your area. Do not set that letter aside. The 90-day clock starts ticking the moment the plan ends, not the moment you open the envelope.
For beneficiaries in rural areas, the calculus is particularly difficult. If you live in a county where only two or three Medicare Advantage plans operate and one exits, your remaining choices may be limited to plans with higher premiums, narrower networks, or fewer supplemental benefits like dental, vision, and hearing coverage — benefits that Original Medicare does not cover at all. In some rural counties, the most practical response to a forced disenrollment may actually be returning to Original Medicare with a Medigap policy, even at higher monthly cost, simply because the remaining Medicare Advantage options don't include the providers you rely on.
Looking ahead, the pressure on Medicare Advantage insurers is unlikely to ease quickly. CMS has signaled continued scrutiny of risk adjustment practices, and several major carriers have already announced benefit reductions for 2026 — trimming supplemental benefits, raising copays, and tightening prior authorization requirements even in plans that aren't being discontinued outright. The Johns Hopkins research underscores that the era of ever-expanding Medicare Advantage benefits, fueled by generous federal payments, may be giving way to a period of contraction. For beneficiaries, that means the annual review of your Medicare coverage — something many people skip because it feels tedious — has never been more important.
The bottom line is straightforward: if you receive a notice that your Medicare Advantage plan is being discontinued or that you're being disenrolled, treat it as urgent. You have rights, you have options, and you have a defined window to act. Use Medicare.gov's Plan Finder, call your state's SHIP program for free counseling, and if you're considering Medigap, move quickly to protect your guaranteed issue rights. The worst outcome is doing nothing and ending up in a plan chosen for you rather than by you.