When a Medicare Advantage plan exits the market, the disruption can feel alarming — especially if you've built relationships with specific doctors, rely on a particular drug formulary, or have budgeted around a specific monthly premium. But a detailed analysis from KFF (formerly the Kaiser Family Foundation) offers meaningful reassurance: the large majority of Medicare beneficiaries whose plans were terminated heading into 2025 had robust Medicare Advantage alternatives available in their area for 2026. That's genuinely good news, but it comes with an important asterisk — available doesn't automatically mean equivalent, and the work of finding the right replacement plan falls squarely on the beneficiary.
Plan terminations in Medicare Advantage are not rare events. Insurers exit markets, consolidate plan offerings, or withdraw from specific counties for a range of business and regulatory reasons. In recent years, several major insurers — including Humana, UnitedHealthcare, and regional carriers — have trimmed their Medicare Advantage footprints in response to rising medical costs, CMS reimbursement changes, and profitability pressures. For 2025, the scale of plan exits was notable enough that CMS and advocacy organizations tracked the downstream effects closely. The KFF analysis specifically examined whether beneficiaries left behind by these terminations had meaningful choices waiting for them, or whether they faced a coverage cliff.
The findings are broadly encouraging. In most counties where plan terminations occurred, affected beneficiaries had access to multiple Medicare Advantage options for 2026 — often three or more plans from different insurers. In densely populated urban and suburban counties, the number of available plans frequently runs into the double digits, giving beneficiaries real leverage to shop for the combination of premium, network, and drug coverage that fits their situation. Rural counties, as has historically been the case, showed more variation — some rural beneficiaries had fewer alternatives, and in a small number of cases, access to Medicare Advantage itself was more limited, making traditional Medicare with a Medigap supplement policy a more relevant fallback.
If your Medicare Advantage plan was terminated, the single most important thing to understand is your Special Enrollment Period (SEP). CMS grants affected beneficiaries a SEP that allows them to enroll in a new Medicare Advantage plan or return to Original Medicare outside the standard Annual Enrollment Period (AEP), which runs October 15 through December 7 each year. This SEP typically begins when you receive notice of your plan's termination and extends through the end of February of the following year, though exact windows can vary. You should receive written notice from your plan at least 90 days before termination — if you haven't received that notice and believe your plan is ending, call 1-800-MEDICARE (1-800-633-4227) immediately to confirm your coverage status.
One critical risk during plan terminations is passive auto-enrollment. If you do nothing after your plan terminates, CMS may auto-enroll you in another plan in your area — but that plan may not match your doctors, your prescriptions, or your budget. Auto-enrollment is a safety net, not a recommendation. Before accepting whatever plan CMS assigns, use Medicare's Plan Finder tool at Medicare.gov to enter your specific prescriptions and preferred providers and compare what's actually available to you. The difference between plans in the same county can be dramatic: one plan might charge a $0 monthly premium with a $4,500 out-of-pocket maximum, while another charges $85 per month but caps your annual costs at $3,000 — a meaningful difference depending on how much care you use.
Drug coverage is where plan terminations can sting the most, and it deserves special attention during any plan switch. Medicare Advantage plans include Part D drug coverage, and formularies — the lists of covered drugs and their cost tiers — vary significantly between plans. A medication that costs you $10 per month under your old plan might cost $60 or more under a new one if it's placed on a higher formulary tier. When comparing replacement plans, pull up your complete medication list and run it through the Plan Finder's drug cost estimator. This tool calculates your estimated annual drug costs under each plan, which is far more useful than comparing premiums alone. Also check whether your preferred pharmacy is in-network — some plans offer lower cost-sharing at preferred pharmacies, and switching plans could change which pharmacies offer you the best pricing.
Provider network continuity is the other major concern. Medicare Advantage plans use networks of doctors, hospitals, and specialists, and those networks don't transfer when you switch plans. Your primary care physician, cardiologist, or orthopedic surgeon may not be in-network under your new plan — and going out of network in a Medicare Advantage HMO can mean paying the full cost of care. Before enrolling in any replacement plan, call your most important providers directly and ask whether they participate in that specific plan. Don't rely solely on the insurer's online directory, which can be outdated. A quick phone call to your doctor's billing office takes five minutes and can save you thousands of dollars in unexpected out-of-network charges.
For beneficiaries who find that no Medicare Advantage plan in their area adequately covers their doctors or drugs, returning to Original Medicare (Parts A and B) combined with a standalone Part D drug plan and a Medigap supplemental policy is a legitimate and often underappreciated option. Original Medicare gives you access to any provider in the country who accepts Medicare — which is the vast majority of physicians and hospitals. A Medigap Plan G policy, for example, covers most cost-sharing under Original Medicare, leaving you responsible only for the Part B deductible ($257 in 2025). Medigap premiums vary by age, location, and insurer, but this combination can provide predictable costs and broad access that some Medicare Advantage plans can't match.
One important caveat about Medigap: in most states, if you're past your initial Medicare enrollment period, insurers can use medical underwriting to deny you coverage or charge higher premiums based on your health history. However, a plan termination does trigger guaranteed issue rights in many states, meaning insurers must sell you a Medigap policy without medical underwriting during that window. If you're considering this route, act quickly — guaranteed issue windows are time-limited. Additionally, if you live in California, Idaho, Illinois, Kentucky, Louisiana, Maine, Maryland, Missouri, Nevada, New Jersey, New York, Oklahoma, or Oregon, your state has a birthday rule that gives you an annual 30-day window to switch Medigap plans without underwriting, regardless of plan terminations.
The broader policy picture behind these terminations matters for understanding what's ahead. Medicare Advantage insurers have faced significant financial pressure in 2024 and 2025, driven by higher-than-expected medical utilization, CMS adjustments to risk adjustment payments, and new requirements around prior authorization and coverage transparency. Some analysts expect continued market consolidation through 2026 and 2027, meaning plan terminations may not be a one-time event for some beneficiaries. Building the habit of actively reviewing your Medicare coverage each Annual Enrollment Period — rather than auto-renewing — is the most durable protection against being caught off guard. Even if your plan isn't terminated, its benefits, premiums, and formulary can change significantly from one year to the next, and the best plan for you in 2025 may not be the best plan in 2026.