I am beginning a Medicare Advantage contraction counter as we move toward open enrollment and 2026
Given the ongoing financial challenges for insurers in general but specifically in Medicare Advantage (MA), we have already seen announcements of many high-profile contractions for 2026. In my August 14 blog here ( https://www.healthcarelabyrinth.com/what-is-in-store-for- medicare-advantage-in-2026/ ), I tell you all about the challenges and my prediction that contraction will be heavy but not what it was in 2025. I am already thinking my prediction could be wrong here given the recent announcements. We could in fact see contraction that comes close, rivals, or even exceeds what we saw in 2025. Thus, periodically I will write a quick blog – here is installment 1 – tracking the announced MA contractions for 2026.
2025 contraction overall
To refresh your memory on what happened in 2025, here are some important statistics for an alarming downsizing by plans:
- 1,615 counties saw reductions vs. 1,112 with increases. About half of all U.S. counties saw contraction and this was especially true for more rural areas. Over 70% of urban counties saw plan losses.
- 72 counties lost all MA-Part D (MA-PD) coverage.
- At least 18 organizations left MA in 2025, including a few prominent Blues.
- Between 1.8 million and 2 million MA enrollees had to find an alternative benefit package or insurer because of the massive contraction.
- Oliver Wyman found that approximately 1.3 million members for 2025 had to find an alternative when their Preferred Provider Organization (PPO) plans were sunset, while about 530,000 members who had Health Maintenance Organization (HMO) plans had to find new coverage.
- While individual MA plan offerings declined by 6.54% in 2025, Special Needs Plan (SNP) offerings actually increased 8.5% in 2025.
- In most years, less than 100,000 people need to change their plan or product because it is going away.
Big MA plan contraction in 2025
In terms of big MA plans themselves:
- From January 2024 to February 2025, Humana dropped by 404K. Its benefit and product changes in 2025 forced over 500,000 to move to new plans.
- Aetna dropped by 253K from January 2025 to February 2025. Its changes in 2025 forced 450,000 to find new plans.
- Centene also contracted in the timeframe by 69K.
- United, too, reduced offerings in 2025. About 250K had to find new plans, although United grew enrollment overall from 2024 to 2025.
2026 contraction so far
Here are the 2026 contractions that have been announced so far. We will get word now through about October of all contractions from financial disclosures from publicly traded entities, insurance and regulatory disclosures, press releases, and information gathered by agents and brokers.
- United said it will seek to shed more than 600,000 lives in 2026 by ending unprofitable plans.
- CVS Health’s Aetna announced it will end nearly 90 Medicare Advantage plan benefit packages (PBPs) across 34 states in 2026. Most are PPOs. No firm number of impacted individuals was announced.
- Elevance Health will eliminate unprofitable MA plans and says that will impact 150,000 individual and group members. But Elevance will continue its investments in SNPs in 2026, a huge trend in the industry. Elevance currently has 2.3 million MA enrollees. Elevance Health will exit the standalone Part D (PDP) program as well. Elevance has 400,000 PDP members and is the sixth-largest plan in PDP.
- Minnesota-based UCare will exit the MA market in 2026 except for its SNPs due to financial losses. It has about 187,000 MA members in Minnesota and Wisconsin. It is the second largest MA carrier in the market.
- Oregon-based Samaritan Health Plans will exit MA in 2026. Samaritan has nearly 14,000 MA members in its HMO and SNP plans, although Samaritan plans on retaining its Dual Eligible SNP (D-SNP) only.
- Urbana, Ill.-based Carle Health will shutter its entire insurance business at the end of 2025. This includes Health Alliance and FirstCarolinaCare’s MA plans. Health Alliance has about 27K lives and First Carolina about 6K.
The 2026 growers
None of this is to say that some plans are not growing. Even those contracting are investing in SNPs as one example. These other plans have announced expansions: Blue Cross Blue Shield Wyoming, SCAN Health Plan and Peak Health.
2026 impact thus far
All told, it appears the displacement number is likely over 1 million already for 2026 and that will rise. We have yet to hear from other big plans who may contract again in 2026 There could be some regional and local players cutting back as well.
#medicareadvantage #margins #enrollment #2026 #partd #pdp
— Marc S. Ryan
