Roughly 2.6 million people enrolled in a Medicare Advantage prescription drug plan in 2025 had their coverage terminated at the end of the year, as insurers discontinued plans or pulled out of specific areas. This reduction in availability follows a trend where government reimbursement rates fell by roughly 20% from 2023 levels by 2026, while medical costs continued to climb. Consequently, major carriers have shed unprofitable business to protect earnings, resulting in fewer choices for the average Medicare beneficiary.
Market Withdrawal and Service Area Reductions
The pullback among major carriers has been significant. UnitedHealth Group Inc. exited 225 counties for 2026 while entering only 14. Humana Inc. left 198 counties, reducing its service area to 85% of U.S. counties from 89%, and exited three states entirely. Additionally, the Aetna unit of CVS Health Corp. offered standalone Part D plans in approximately 100 fewer counties compared to the previous year.
| Company |
Action for 2026 |
Details |
| UnitedHealth Group Inc. |
County Exits |
Exited 225 counties, entered 14 |
| Humana Inc. |
Service Area Reduction |
Reduced to 85% of U.S. counties; exited 3 states |
| CVS Health Corp. (Aetna) |
Part D Reduction |
Offered plans in ~100 fewer counties |
Impact on Beneficiary Choices
The result of these strategic withdrawals is a contraction in market options. The average Medicare beneficiary had access to 32 Medicare Advantage prescription drug plans for 2026, a decrease from 34 plans available a year earlier. Research indicates that most individuals affected by plan terminations still have other Medicare Advantage options available, though replacement plans may not match the specific benefits or networks of the discontinued coverage.
Enrollment Windows and Protections
Beneficiaries affected by plan terminations have specific enrollment rights. Insurers are required to mail an Annual Notice of Change by the end of September, detailing modifications for the coming year, along with a separate non-renewal notice for discontinued plans. The Medicare Annual Enrollment Period runs from October 15 to December 7. However, those whose specific plans are terminated qualify for a Special Enrollment Period, allowing them to select a replacement plan without a coverage gap.
Strategic Implications for Insurers
For investors, the retreat from unprofitable markets represents a deliberate margin management strategy. Companies such as UnitedHealth, Humana, and CVS are prioritizing earnings stability over membership growth. The focus for investors has shifted toward how effectively insurers manage medical costs relative to government payments. Looking ahead to 2027, Medicare Advantage plans are projected to receive an average federal payment increase of about 2.48%, worth roughly $13 billion, which may moderate the pace of market exits.