Medicare Advantage has spent the last two decades growing into the dominant way Americans over 65 receive their Medicare benefits — today, more than half of all Medicare beneficiaries are enrolled in a Medicare Advantage plan rather than Original Medicare. But 2025 and 2026 have brought a jarring reversal of that growth story. Insurers are exiting Medicare Advantage markets at a pace not seen since the program's early years, and the beneficiaries caught in the middle are facing real, immediate disruption to their healthcare coverage.
The exits are being driven by a combination of financial pressures that have been building for several years. Medicare Advantage plans are paid a fixed monthly rate by the federal government for each enrollee, and those rates are set by the Centers for Medicare and Medicaid Services (CMS). In recent years, CMS has tightened the payment formula while simultaneously cracking down on the risk-score inflation that many insurers used to boost their reimbursements. At the same time, medical costs — particularly for post-acute care like skilled nursing and home health — have risen sharply. The result is that plans that were marginally profitable are now losing money, and insurers are making the business decision to exit rather than absorb the losses. Major national carriers including Humana and UnitedHealthcare have already announced significant county-level pullbacks for 2026, and regional plans in states like Texas, Florida, and the Midwest have followed suit.
For the beneficiary sitting at home who just received a letter saying their plan is being discontinued, the most important thing to understand is that you are not left without options — but you do have a deadline. When a Medicare Advantage plan exits your area, CMS automatically grants you a Special Enrollment Period (SEP). This SEP allows you to switch to a different Medicare Advantage plan in your area, or to drop Medicare Advantage entirely and return to Original Medicare (Parts A and B). This SEP typically runs from the date you receive your notice of plan discontinuation through the end of February of the following year, though the exact window depends on when the plan exit takes effect. Do not wait until the last week — processing delays and plan availability questions can create real problems if you procrastinate.
One of the most consequential decisions you can make during this SEP is whether to return to Original Medicare and pair it with a Medicare Supplement (Medigap) policy. Under normal circumstances, if you've been enrolled in Medicare Advantage for more than 12 months, insurers can use medical underwriting to deny you a Medigap policy or charge you higher premiums based on your health history. But when your plan is involuntarily discontinued — meaning the insurer exits the market, not that you chose to leave — you receive guaranteed issue rights. This means any Medigap insurer operating in your state must sell you a policy at standard rates, regardless of your health conditions. This is a significant protection, and it has a strict 63-day window from the date your Medicare Advantage coverage ends. Miss that window and you lose the guaranteed issue right, potentially permanently.
Not all Medigap plans are available in all states, and premiums vary enormously by location, age, and insurer. In 2026, Plan G is the most comprehensive Medigap option available to new enrollees (Plan F was closed to new enrollees after January 1, 2020). Plan G covers everything Original Medicare covers except the Part B deductible, which is $257 in 2026. Monthly premiums for Plan G range from roughly $90 to $300 depending on your state, your age, and the insurer — which is exactly why shopping multiple carriers matters. Plan N is a lower-premium alternative that requires copays of up to $20 for office visits and up to $50 for emergency room visits that don't result in inpatient admission. For beneficiaries in good health who don't visit specialists frequently, Plan N can offer meaningful monthly savings compared to Plan G.
If you decide to stay within Medicare Advantage rather than switching to Original Medicare plus Medigap, use your SEP to compare the remaining plans in your county carefully. The Medicare Plan Finder tool at Medicare.gov allows you to enter your specific prescription drugs and preferred doctors to see which plans cover them and at what cost. Pay close attention to the plan's Maximum Out-of-Pocket (MOOP) limit — in 2026, CMS set the MOOP ceiling at $9,350 for in-network costs and $14,000 for combined in- and out-of-network costs. Plans can set their MOOP lower than the ceiling, and a plan with a $4,500 MOOP is meaningfully more protective than one at $8,000 if you have significant health needs. Also check whether your current primary care physician and any specialists you see regularly are in the new plan's network — a plan that looks affordable on paper can become very expensive if your doctors are out-of-network.
The geographic dimension of these plan exits deserves special attention. Insurers are not pulling out of all markets equally. The exits are concentrated in rural counties, lower-income urban ZIP codes, and regions where hospital systems have successfully negotiated higher reimbursement rates from insurers. If you live in a metropolitan area with strong competition among health systems, you may find that several Medicare Advantage plans remain available. But if you live in a rural county — particularly in states like Mississippi, Arkansas, Wyoming, or parts of the Great Plains — you may find that your choices have narrowed to one or two plans, or in some cases, none at all. Beneficiaries in counties with zero Medicare Advantage plans available are automatically returned to Original Medicare, and CMS has specific protections in place to ensure they can access Medigap coverage.
For low-income beneficiaries who rely on Medicare Advantage plans that bundle in Extra Help (the Low Income Subsidy for Part D drug costs) or that offer supplemental benefits like dental, vision, and hearing coverage, the plan exits create a particularly painful disruption. Many Medicare Advantage plans in 2025 and 2026 have reduced or eliminated supplemental benefits as part of their cost-cutting measures, even before exiting entirely. If you were relying on your plan's dental benefit to cover dentures or your vision benefit to cover glasses, check whether any replacement plan in your area offers comparable benefits — and read the fine print carefully, because benefit limits, waiting periods, and covered services vary significantly between plans.
The Annual Enrollment Period (AEP), which runs from October 15 through December 7 each year, remains the primary window for most beneficiaries to make plan changes that take effect January 1. If your plan is being discontinued for 2026, you should have received a notice by September 30, 2025, giving you time to act during AEP. If you missed that window or received late notice, your SEP provides a safety net. The Open Enrollment Period (OEP), which runs January 1 through March 31, allows Medicare Advantage enrollees to make one additional switch — but it does not allow you to switch from Medicare Advantage back to Original Medicare with guaranteed Medigap issue rights unless you qualify for a separate SEP.
The bottom line is this: the Medicare Advantage market is going through a genuine shakeout, and the beneficiaries who fare best will be the ones who treat their coverage as something that requires active annual review rather than a set-it-and-forget-it decision. Pull out your current plan's Annual Notice of Change (ANOC), which arrives each September, and read it carefully. If your plan is exiting, act quickly, use your guaranteed issue rights if you're switching to Medigap, and use Medicare.gov's Plan Finder to compare every remaining option in your county before making a decision. Your State Health Insurance Assistance Program (SHIP) offers free, unbiased counseling — find your local SHIP counselor at shiphelp.org — and they can walk you through your specific options without trying to sell you anything.