Humana and UnitedHealthcare drop Medicare Advantage plans for nearly 1 million

Humana told CBS it regularly reviews its Medicare offerings "to ensure we can continue providing affordable, coordinated care," and that most affected members are being offered another plan. Humana's chief financial officer, Celeste Mellet, told investors in July that the 600,000 is roughly 8% of its 7.2 million Medicare Advantage members and that the company hopes to "recapture a significant portion" of them.

UnitedHealthcare, which had about 7.6 million Medicare Advantage members at the end of the third quarter, confirmed the 390,000 figure through a spokesperson and said those members will have access to another of its plans. The company has pointed to higher medical costs and heavier use of care. Its Medicare president, Bobby Hunter, said on an Oct. 13 call that the cuts were focused on PPO plans.

It's an industry-wide pullback, not just two companies. Bloomberg reported that at least 1 million seniors are being forced to switch, with CVS's Aetna and Centene also shrinking. Healthcare Dive's review of CMS data found Centene offering about 3,000 fewer plans and exiting 344 counties, CVS exiting 103 counties, UnitedHealthcare 63 and Elevance 56. Medicare Market Insights, counting plan terminations and service-area cuts together, estimates about 3.16 million enrollees, roughly 11%, are losing their current plan for 2027.

Benefits are getting thinner even for people who keep their plans. Leerink analyst Whit Mayo, cited by Healthcare Dive, estimates the average maximum out-of-pocket limit is rising about 10% and Part D drug deductibles about 30%, while average premiums rise about 1%. For UnitedHealthcare plans he estimates out-of-pocket limits up 11% and premiums up 9%; for Humana, out-of-pocket limits up 8% and premiums up 1%.

Two readings — the strongest case from CMS: The agency says the market is stable. It projects the average Medicare Advantage premium falling from $14.37 a month to $12.00 in 2027, says more than 99% of beneficiaries have at least one plan and 97% have 10 or more, and estimates about 8 in 10 can stay in their current plan at the same or lower premium. "By slashing handouts to big insurance companies, CMS is keeping premiums stable," Administrator Dr. Mehmet Oz said.

Two readings — the strongest case from analysts and insurers: The companies say rising costs and usage force them to cut unprofitable plans, and Wall Street largely agrees the shake-up is real. "We think this does point to most [MA companies] trimming their footprints and creating disruption in 2027," J.P. Morgan's Lisa Gill wrote. Healthcare Dive notes CMS's average-premium figure includes special-needs plans, which can understate changes in ordinary plans, and insurers' own projections point to total enrollment slipping to about 34 million.

What to do if your plan is ending: Your plan must send a notice. You can choose a new Medicare Advantage plan or return to traditional Medicare during open enrollment through Dec. 7. Under CMS rules, people whose plan isn't renewed also get a special enrollment period from Dec. 8 through the end of February; a switch made in December takes effect Jan. 1, in January on Feb. 1, and in February on March 1. People leaving a non-renewed plan for traditional Medicare can generally buy a Medigap supplement on a guaranteed-issue basis. Medicare's help line, 1-800-MEDICARE, is open 24 hours a day.

What's still unknown: How many of the affected members will accept the replacement plans insurers are offering, how many will move to traditional Medicare, and whether the cuts become an issue in the midterm campaigns. Final 2027 enrollment won't be clear until early next year.

Member counts come from the companies' own statements and earnings calls as reported by CBS News, Fortune and Healthcare Brew. Plan and county counts come from CMS landscape data as analyzed by Healthcare Dive and Medicare Market Insights, which count terminations differently, so their totals don't match. Check your own plan's Annual Notice of Change or call 1-800-MEDICARE before choosing.