If Your Medicare Advantage Ends
What to Know If Your Medicare Advantage Plan Is Going Away
As we approach the new year, many Medicare beneficiaries are facing an unexpected challenge: their Medicare Advantage (MA) plans are being discontinued. If you’ve received a letter from your insurer or heard about changes in your area, you’re not alone. Here’s what’s happening, why it’s happening, and—most importantly—what your options are.
Why Are Medicare Advantage Plans Being Discontinued?
Several major insurers—including Aetna, Humana, UnitedHealthcare, and UCare—are scaling back or exiting the Medicare Advantage market in certain areas. The reasons behind these changes include:
- Reduced Government Reimbursements: The Centers for Medicare & Medicaid Services (CMS) adjusted benchmark rates for 2025, which some insurers say don’t fully cover the cost of care.
- Rising Healthcare Costs: Seniors are using more healthcare services than anticipated, increasing costs for insurers.
- Regulatory Changes: New rules around prior authorizations and supplemental benefits are making it harder for insurers to manage costs.
- Market Consolidation: Some insurers are merging or simplifying their plan offerings to focus on more profitable regions.
In Minnesota alone, nearly 200,000 seniors are affected by UCare and other carriers pulling out of the market.
What Happens When a Plan Is Discontinued?
If your MA plan is ending, your insurer is required to notify you by early October. You’ll continue to have coverage through December 31, 2025. After that, you’ll need to choose a new plan to avoid a gap in coverage.
You’ll have two key opportunities to make a change:
- Fall Open Enrollment (Oct 15 – Dec 7): You can switch to another MA plan or return to Original Medicare with or without a Part D drug plan.
- Special Enrollment Period (Dec 8 – Feb 28): If your plan is discontinued, you qualify for a Special Enrollment Period (SEP) to make changes without penalty.
If you have not chosen a plan by December 31st for a January 1st start date, you will have Original Medicare. You will not have a plan to supplement the Original Medicare, and you will no longer have prescription coverage.
What Are Your Options?
Here’s what you can do if your plan is discontinued:
- Switch to Another Medicare Advantage Plan
If other MA plans are available in your area, you can enroll in one that fits your needs. Be sure to compare:
- Premiums and out-of-pocket costs
- Provider networks
- Prescription drug coverage
- Extra benefits (dental, vision, hearing, etc.)
- Return to Original Medicare
You can go back to Original Medicare (Parts A and B), which allows you to see any provider that accepts Medicare. If you choose this route, consider:
- Medigap (Supplement) Plans: These help cover out-of-pocket costs. If your MA plan is discontinued, you may qualify for a Medigap plan without medical underwriting (meaning you can’t be denied for pre-existing conditions).
- Part D Prescription Drug Plan: If your MA plan included drug coverage, you’ll need to enroll in a standalone Part D plan to maintain that coverage.
- Seek Help from a Licensed Medicare Advisor
Navigating these changes can be overwhelming. Many local agencies and brokers offer free consultations to help you understand your options and enroll in a new plan that meets your needs and budget.
Final Thoughts
While losing your Medicare Advantage plan can be unsettling, it’s important to remember that you have options and time to make a thoughtful decision. Review your Annual Notice of Change, explore your choices during open enrollment, and don’t hesitate to ask for help.
If you’re unsure where to start, visit https://www.medicare.gov or contact your local State Health Insurance Assistance Program (SHIP) for personalized guidance.
References
[1] www.gohealth.com
[2] smartmatch.com
[5] www.cbsnews.com