Dozens of health systems across the country have been terminating their Medicare Advantage contracts. These terminations have left hundreds of thousands of older adults and people with disabilities struggling to figure out how to find new specialists and hospitals that their Medicare Advantage plan will cover. Now, Elizabeth Casolo and Jakob Emerson report for Becker’s that several insurers which had been offering Medicare Advantage HMOs and PPOs are pulling out of Medicare Advantage, leaving more than 1.5 enrollees scrambling to find health care coverage.
For several years now, hospitals and other providers have been complaining that insurers offering Medicare Advantage wrongly deny coverage to their patients and payment for the services they provide. Insurers compromise patient safety, delaying care and endangering the health and well-being of patients, say the health care providers. Insurers force providers to go through resource-intensive hoops in order to get permission to deliver care and still, at times, refuse to pay for it. Insurers, not surprisingly, have been profiting wildly from Medicare Advantage.
Insurers now claim that their expenses are rising and are pulling out of Medicare Advantage markets they see as unprofitable. Of course they are. Why bother to operate in areas with slim profit margins when they can expand their offerings in areas with rich profit margins? Profits remain insurers’ priority.
Which insurers are moving away from certain Medicare Advantage markets?
- Elevance Health: It is pulling out of markets where “we did not see a path to attractive economic performance,” says its CFO. 150,000 people are losing coverage.
- Humana: It is leaving areas and dropping MA plans that are “unprofitable.” 500,000 people are losing coverage.
- UnitedHealthcare: 600,000 people are losing coverage.
- Aetna: As many as 400,000 people are losing coverage.
- Cigna: Health Care Service Corp. bought its Medicare Advantage business in March 2025.
- UCare: It is leaving MA in 2026. 158,000 people are losing coverage.
- Samaritan Health Plans, part of Corvallis in Oregan: nearly 14,000 are losing coverage.
- Carle Health in Illinois: It is ending its insurance business, including its Medicare Advantage business.
These insurance company exits notwithstanding, Medicare Advantage continues to grow as traditional Medicare’s upfront cost become increasingly unaffordable to people with Medicare. But growth has slowed some, with enrollment up seven percent in 2023 and again in 2024 and four percent this year. Some 34 million people with Medicare are now enrolled in an MA HMO or PPO.
Here’s more from Just Care:
- More hospitals are dropping Medicare Advantage
- Doctors and hospitals face increasing claims denials
- Hospitals find a lot wrong with Medicare Advantage
- When your doctors leave your Medicare HMO, will the government protect you?
- How to switch to Traditional Medicare from Medicare Advantage?
