Why Some Medicare Advantage Plans Are Ending in 2026 (and What You Can Do to Help Enrollees)

Medicare Advantage enrollment continues to surge, with projections showing two-thirds of beneficiaries enrolled by 2034. However, the landscape is undergoing significant shifts in 2026, and the future may look very different from the industry we recognize today.

Additional Challenges for Medicare Advantage Plans

• Stricter prior authorization rules
  New regulations are introducing stricter prior authorization rules to reduce red tape and improve patient experience. These changes will impact how insurers manage prior authorizations, potentially affecting the availability of specific treatments and services. Key changes include:
  ● Plans must honor inpatient approvals through discharge
  ● Faster response times (within 14 business days)
  ● Clearer denial reasons
  ● Expanded appeal rights
• Caps on supplemental “extras”
  The Centers for Medicare and Medicaid Services (CMS) is standardizing and capping supplemental benefits, such as transportation, meals, and grocery cards. Plans must clearly document eligibility based on chronic conditions. While this may lead to fewer perks, it will also result in more consistency across plans.
  

Key takeaways

1. 1. Major Medicare Advantage insurers, such as UnitedHealthcare, Humana, and Aetna, are scaling back their MA plan offerings in certain areas due to financial pressures from rising healthcare costs and regulatory changes.
   2. These changes create uncertainty in the Medicare Advantage landscape, and licensed agents need to understand the underlying reasons to support their clients and provide alternative coverage effectively.
   3. Agents should help clients carefully review their Annual Notice of Change to understand if their current plan is being discontinued or significantly altered and guide them through the transition to appropriate coverage with a personalized approach.