AARP Medicare Advantage from United Health Care is gone

[jskyer]

 Earlier this year, (2025), I signed up for the AARP Medicare Advantage (PPO) Plan from United Healthcare. I had some medical issues that would have made for a financial nightmare had I stuck with plain old Medicare. So far the UHC plan has been a lifesaver in both the quality of care and how much it costs. However, I just received the 2006 issue of the Medicare and You book and that plan is no longer being offered by United Healthcare. Well, it is but only if you live in Santa Barbara, which I don't, and at an increased rate. Since it was a PPO plan, many of my doctors are not in network in the available HMO plans that would fit my needs. Now I'm stuck with negotiating new insurance plans for doctors that are out of network with the HMO plans that will fulfill my needs. My team of doctors have been deeply involved with my case since about March, and it is really an almost impossible idea to start over with new doctors that are in network for any new plan that I select.

In order to find a way to not lose my Advantage coverage, I have been researching the Medicare Continuity of Care policy that guarantees that I can keep my current doctors if Medicare, the new plan, and my team of doctors all agree to the Continuity of Care policies. And even if they all do, the Continuity of Care policy only guarantees that I can take advantage of this for 12 months. 

As most people already know, dealing with Medicare and insurance is a complicated procedure. Now that I'm forced to make a change that involves more than a couple of doctors, and at least two different health insurance providers, and their underlying groups, well... my head hurts at how complicated it has suddenly become. 

I'm posting this info here for the sake of all AARP UHC PPO plan participants as a warning that they better start looking for a new Advantage plan. Soon. It's also a message to AARP that you need to stop promoting this plan, as it no longer exists. 

[jskyer]

UPDATE:

Yes, it's true that UHC is dropping almost all of their PPO Advantage plans. But... After WAY too many hours on the phone and online I have found out a couple of things. And, being stupid, I discovered that none of this information was available to me prior to October 1, when the 2026 Advantage plans were revealed to both the public, the provider support people and online. 

The AARP UHC PPO plan is not the only AARP plan that UHC offers. In fact, according to the person I spoke with today, AARP is involved with most of the UHC Advantage plans. Both PPO and HMO.

I learned that UHC offers two AARP HMO plans that beat the cost of the AARP PPO plan that is now being discontinued. Plus, I learned that pretty much all my PPO selected doctors and specialists are already in the healthcare groups that the HMO plan works with. After 1-1/2 hours on the phone with a UHC support person today, I have learned that, at least for me, the two plans that make the most sense as a replacement for the PPO plans that are being discontinued are...

CA-004P

CA-19

CA-19 offers a $35 discount on Medicare payments but offers a bit less in exchange for what it provides.

I've contacted a couple of other Advantage plan providers and based on my needs and the differences in competing plans, the CA-004P plan makes the most sense to me. 

IMPORTANT! Do your research NOW. Once October 15 rolls around and it becomes time to make changes, the wait time on hold to talk to a support person could be hours. Talk to them NOW and you can get everything set up for the change prior to October 15 and then all you have to do is let them know you're ready to make the move. 

[CBtoo]

As your plan you have now is being discontinued, this gives you what is called guaranteed issue which means you can also switch to a medicare supplement (from any provider, not just the AARP royalty agreement United Health Care ones) without having to deal with passing medical underwriting IF that is something you are interested in doing. If you have a lot of medical issues it may be far cheaper in the end to have a supplement and drug plan rather than pay a high out of pocket on an advantage plan that can add up to far more than the premium and maximum out of pocket with a original medicare, supplement and drug plan. Some drug plans have a zero premium - just be sure, when you look, to put in all your drugs to see the cost - medicare.gov lists your annual drug cost with each drug at up to 5 pharmacies you pick - surprisingly the prices may be different between them even if they are a preferred, in network provider (since the pharmas I picked are close to each other I have my meds spread between them and save about $40/mo doing that - who knew).  

If you use medicare.gov to check to see what is out there be sure to click on, with each plan, the drugs and pharmacies as they will flag any drug that is not on the formulary (and thus makes the cost really high - thus the total cost is really high). You can check GoodRx, SingleCare, and other coupon plans to see if they offer that drug (and others) cheaper than your insurance. You can then use the coupon instead of your insurance to buy that drug (I am sure you already know this, just posting this for those who do not who are reading this thread). 

For those of you who fail medical underwriting a back door way into guaranteed issue is sign up for an advantage plan being ended the end of 2026 (called "termed" in insurance broker speak; but realize if you already have a supplement and fail medical underwriting and they end up not terming it then you are trapped in the medicare advantage plans). On an insurance forum I am on (I am not and have never been a broker, those forums though are a good source of information) they are talking about plans they are pretty sure will be termed the end of 2026 based on what is going on with commissions (or more accurately lack there of). 

Those of you who use brokers you need to realize that many on that forum I am on they are stating they will not tell clients about any plan (advantage plan, supplement, drug plan) that will not pay commissions in 2026 even if they are the best fit (and of course most agents are not licensed write plans from all insurance companies that offer them due to the hoops they have to jump through and the costs to do so). This means going to medicare.gov to look at the plans available in your area is prudent so that if your agent doesn't tell you about one you know to ask about it.

[larry3rv]

Problem is, HMO do not offer the same level of care and greatly limits the specialists one can see, often resulting in long way to see one of the few specialists covered.

[jskyer]

Update: After spending way too much time online and on the phone over the last day or so I learned that in spite of the fact that Medicare has already delivered the 2026 edition of "Medicare and You", nobody knows what's going on. Insurance companies, medical providers, even Medicare itself has admitted that until October 1, they will all be in the dark about what changes to plans will actually be implemented. I also learned that many plans may have to drop some long term conditions from the plans they offer. Apparently the list of conditions, and treatments, that Medicare will no longer support are part of some of the presidential Executive Orders that have been recently signed. And nobody will know, or will admit to, what those changes are until October 1.

😟

[GailL1]

@jskyer wrote. . . . . After spending way too much time online and on the phone over the last day or so I learned that in spite of the fact that Medicare has already delivered the 2026 edition of "Medicare and You", nobody knows what's going on. Insurance companies, medical providers, even Medicare itself has admitted that until October 1, they will all be in the dark about what changes to plans will actually be implemented

=========================

[ME] There are all kinds of warnings and instructions in the pages of the 2026  “Medicare and You” booklet preceding the listing of the MAPD, SNP or free standing Part D plans which MAY BE in your area - it says specifically to (1) check with the insurer to make sure the plan still exist (2) check the updated plan for the new formulary - 

The AEP does not start until 10/15 and although most insurers have pretty much nailed down all their details in their 2026 plans by late Sept - they actually have until Oct 1 to provide it to beneficiaries either on their website or in the mail - that is IF, the plan is going to continue at all.

That’s why there is an AEP for Medicare Advantage plans and Free Standing Part D plans - so that all the changes that are occurring as a result of a CMS new rule or specific changes to the insurer’s plan design like formularies and networks.  

==============

@jskyer wrote . . . . I also learned that many plans may have to drop some long term conditions from the plans they offer. Apparently the list of conditions, and treatments, that Medicare will no longer support are part of some of the presidential Executive Orders that have been recently signed. And nobody will know, or will admit to, what those changes are until October 1.

==================

[ME] That is a big accusation without any details or back up - care to elaborate what you are talking about because without some factual explanation, you are just spreading misinformation. 

So PLEASE explain what you are talking about here.

[jskyer]

GaiL1 - Thank you for posting that info. I understand all that, and I have started the investigative procedures you describe. In fact, to answer your questions, I understand that while most insurers may have nailed down the details of their 2026 plans, they have not posted any of these into the systems that their customer support teams can access. I have been told, by those customer support teams, that they will not be able to refer to anything beyond 2025 until October 1, when the insurers actually reveal those changes to them. My comment about Medicare, and the related Advantage insurers, being forced to cancel some long term care coverage came to me via the United Healthcare customer service rep I talked to yesterday. I had called them to inquire about the disappearance of my 2025 plan from the 2026 Medicare directory. I wanted to know what my options are going to be come October 15 so that I can organize my coverage. That AARPUHC customer service rep is the one that informed me that some of the long term coverage options provided by all insurers are likely to be cancelled due to  executive order outlining health cost cutting measures. Since this information came to me from what I consider a reliable source, I don't believe I am spreading misinformation. If the information I am posting here is in fact incorrect, I would appreciate it if someone who actually knows a different truth would post it here so I could move forward with confidence that I'm following the right path. Until then, I believe that until October 15, nobody is going to be able to provide the answers I'm looking for. 

[CBtoo]

It's not only that their customers and support teams don't know what is going on with some of the plans, neither do some of the agents as they are complaining some companies haven't released 2026 plan details yet. Agents are upset since they want to see how their current customers are affected before everything is public. And even more oddly, with some plans patients are getting details about changes in the mail that agents haven't yet gotten. It seems like this year's roll out is not as organized as previously and that with some companies for some plans getting updated information is happening later than usual. That causes stress for everyone. 

What might be prudent in your case (and you are likely already doing this) is find out what plans your providers will be accepting in 2026 (if they know) regardless of which company, so that you have that information when you are trying to figure out what to do.

I had to change providers (work insurance) in the middle of cancer when my main system was out of network (so I lost almost all my providers). My new ones were far less informed. Scary thought when you are dealing with serious health issues. I didn't have the choice of changing who provided my insurance like you do because it was work insurance.

Be open to whatever plan(s) your important providers accept. As I learned the hard way some things matter a lot (like who treats you) and if it is an option, choosing by which plan(s) have your providers in network matters fare more than  over a preferred company. Just be sure to check your maximum out of pocket for each plan that will keep your providers.

 Having to switch is a pain, but unfortunately that sometimes is the case. Make sure you check any plans your providers accept for the cost of meds that would fall under D for their costs as that has a separate $2000 maximum out of pocket.

if you resort to asking agents realize that some will not tell you about plans they don't write or don't pay commission and those plans might be the ones that meet your needs the best despite compromises you are having to make. Some will tell you. The problem is you don't know which ones, in advance, do which.

[TRL1111]

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@jskyer wrote:

That AARPUHC customer service rep is the one that informed me that some of the long term coverage options provided by all insurers are likely to be cancelled due to  executive order outlining health cost cutting measures.

---

What specifically were you talking about with the customer service rep?  Medicare generally doesn't cover long-term care.

And I looked at a list of executive orders this year and the word Medicare appears only once, in relation to a hiring freeze.

[GailL1]

@jskyer wrote . . . . to answer your questions, I understand that while most insurers may have nailed down the details of their 2026 plans, they have not posted any of these into the systems that their customer support teams can access. I have been told, by those customer support teams, that they will not be able to refer to anything beyond 2025 until October 1, when the insurers actually reveal those changes to them.

===========================

[ME]  That’s right, it is called proprietary information and even though some agents may know some of the new information, whether by law or by ethics, I do not know which, they have a date - 10/01 - when the new info is then released on the new plans for the following year.  

Everybody with a MA plan or a free-standing Part D plan will receive an ANOC (annual notice of change) around that date - perhaps a bit earlier especially if the plan they are currently on is going to be discontinued.  Once you get the ANOC, the AEP (annual open enrollment period) for MA plans and free-standing Part D plans begins 10/15 thru 12/07 and then beneficiaries will have access to look at all the plans available to them and they can decide what to do for the next year.  The ACA marketplace plans work similar to this except different dates of enrollment.  Employer plans (including government plans) often work the same way if there is more than one plan to choose from -

So now you are ready - so come 10/15 you will be able to make a good decision.  (see my next answer too since it relates).

============

@jskyer wrote . . . . My comment about Medicare, and the related Advantage insurers, being forced to cancel some long term care coverage came to me via the United Healthcare customer service rep I talked to yesterday. I had called them to inquire about the disappearance of my 2025 plan from the 2026 Medicare directory. I wanted to know what my options are going to be come October 15 so that I can organize my coverage. That AARPUHC customer service rep is the one that informed me that some of the long term coverage options provided by all insurers are likely to be cancelled due to  executive order outlining health cost cutting measures. Since this information came to me from what I consider a reliable source, I don't believe I am spreading misinformation.

==========================

[ME] Do not consider hearsay as reliable - the term “executive order is definitely not correct”  - as a result of law changes and rules changes by CMS in the MA and free-standing Part D marketplaces - YES but not by executive order.

Changes are occurring in the free-standing Part D program as a result of the Biden Inflation Reduction Act which put MORE financial responsibility on the Part D insurers - both the free standing ones and the one’s within the various MA plans.  Some of the changes were done in 2025 but because it was a bit of a financial shock, the Biden administration built in a cushion effect which some insurers took advantage of - now that cushion is getting reduced by the Trump administration (still not completely removed so the effects will continue into 2027 although in a lesser effect.

The PHE (public health emergency) of Covid did a number on our health care industry - people put off care because they did not want to be exposed.  Plus our government had put in a lot of financial help directly associated with keeping the health care industry intact during the PHE - now all of that is changing - people have began to get back to their regular rhythm of healthcare and the PHE government incentives are being removed - so only NOW is the whole health care industry including ALL health insurance plans getting back to the normal inflation - and it is exploding.  Cost are going thru the roof - all cost are going up for all types of health insurance plans - for employers to ACA plans to Medicare and even Medicaid too.

PLUS for Medicare plans - Medicare Advantage plans in this case, CMS is also putting for some new rules for the insurers to play by - to try to correct some of the errors of the past, so to speak - 

All of this is putting pressures on the insurers to make sure that their plans are adequate per CMS rules in coverage (like network size).  That they develop ways that prior approvals can be done in the fastest possible way (technology) and the items being requested for prior approvals are kept down to as few as possible - it is the insurers right to have the correct documentation from the provider to approve the [whatever] thus this process has to be set up correctly for expediency.  

There are probably even more CMS changes than I can think of while writing this - but it all adds up to insurers redesigning their various  MA plans and the areas where they are in effect.   

One of the big things was that many PPO plans were going away - 

========================

@jskyer wrote . . . . If the information I am posting here is in fact incorrect, I would appreciate it if someone who actually knows a different truth would post it here so I could move forward with confidence that I'm following the right path. Until then, I believe that until October 15, nobody is going to be able to provide the answers I'm looking for. 

===================

[ME]  I have attempted to do this on this AARP Community Medicare and Insurance board as I either read about them on the CMS News Release site or on some other health industry site like KFF.org.

Like here:  AARP Community Medicare & Insurance Board 09/10/2025 - Medicare’s open enrollment period (October 15... 

I think there were other times too -

Here is another, although state specific - Maryland

AARP Medicare & Insurance Board - What Would You Do in This Situation 

And another which involves some new rules made by CMS on MA plans and their risk adjustment models

 AARP Medicare & Insurnce Board - AARP Endorses Bill to Stop Medicare Advantage Upcoding (AARP Articl... 

When you post something that sounds like a fact - maybe it is a good idea to understand it and perhaps post a link along with your comment.

[jskyer]

Very hard to provide a link to go along with what customer service reps for UHC and Medicare are telling me over the phone. If I can't believe what they're telling me then how can I make intelligent decisions. Web site info or not. 

One of the big things was that many PPO plans were going away

And that is exactly my situation. My AARP UHC plan is PPO. And it is disappearing in 2026. I have been receiving care for a tumor since the beginning of this year. The doctors that I have been referred to, and involved with, are very engaged in my care, and they may no longer be available to me come 2026. My posting, here, is to raise a flag to this and to seek information on how to go about coordinating my future care without a) losing any of my doctors, and b) not going bankrupt in the process because of care that is potentially no longer available via an acceptable Advantage plan. The only universal answer I have received so far is to give up the quest until October 1 when customer service reps have the latest changes in front of them, and/or, websites are updated to reflect those changes. 

[CBtoo]

What I have found is sometimes you need to call multiple times and then see if the answers match or not. Sometimes when you do that you also get more information that is useful. Been doing that with medical underwriting myself. 5 calls and on each call I got more useful information. Shouldn't be like that but it can be.

The other useful thing is to ask to speak to a supervisor if in calling more than once you get conflicting answers. Generally they know more than who answers the phone initially. 

[GailL1]

@jskyer wrote - Very hard to provide a link to go along with what customer service reps for UHC and Medicare are telling me over the phone. If I can't believe what they're telling me then how can I make intelligent decisions. Web site info or not.

=================

[ME]  Do not rely on hearsay from anybody, - reps are reps  - keep up or look it up yourself or just verify what they tell you - even if it is just to verify that you are understanding what they tell you .  Or at least talk to somebody that at least has some education on any Medicare matter - independent knowledgeable Medicare plan brokers, State SHIP or Dept of Aging Representatives.

CMS.gov News Room - everything they do or what is in the process is shown right here.  

CMS.gov - CONTACT  

Reddit has people that work for CMS and even Social Security as well as novices and independent agents answering questions all day, everyday.  Normally if somebody says something that is wrong, they are called out or down voted. 

Reddit Medicare

Reddit - Social Security 

There are also many a-political news and research sites that will cover various issues - especially the big ones - on health related issues. This is one of my favorites -

KFF.org 

As to your problem in keeping your doctors -

Find another plan that they participate within a network - call their billing office and ask and then verify when the new network listings are posted.  Make sure that it is a plan that you have access to per the 2026 look up when available.

A PPO is a plan that lets a beneficiary choose an out of network doc at a higher price in coverage - how are you using these docs?  As an out of network or as part of the UHC plan of network providers?

OR since your MAPD plan is leaving your area - I bet these docs participate in Traditional Medicare - Look them up on the Medicare.gov site 

Medicare.gov - Find Healthcare providers - Compare Care Near You 

As I explained before, you can easily switch back to Original Medicare AND as a condition of your plan leaving your area, you have a Medigap guaranteed issue special enrollment period to sign up for a Medigap plan of your choice WITHOUT UNDERWRITING.  And in CA, once you have a Medigap plan, you can change your choice once a year around your birthday.  

From:  Medicare.gov

Your plan changes its contract with Medicare

My Medicare Advantage Plan, Medicare drug plan, or Medicare Cost Plan's contract with Medicare isn't...

What can I do?

Switch from your Medicare Advantage Plan, Medicare drug plan, or Medicare Cost Plan to another plan. You’ll be enrolled in Original Medicare if you don’t join another Medicare Advantage Plan before your current plan ends. 

When?

Between December 8 and the last day in February of the following year.

Medicare.gov - Get Ready To Buy - Medigap 

What if I miss my Medigap Open Enrollment Period?

There are certain situations where you may be able to buy a Medigap policy outside of your Medigap Open Enrollment Period. Situations where an insurance company can’t deny you a Medigap policy are called “guaranteed issue rights” or “Medigap protections.”   What are guaranteed issue rights?

Go down and click on the embedded link of:

What are guaranteed issue rights? 

It will open up a window that explains how losing your MAPD plan because they are leaving your area works in this Medigap Period of guaranteed issue Medigap special enrollment.  

Guaranteed issue right situations

The chart describes the most common situations under federal law where you may be able to buy a Medigap policy outside your Medigap Open Enrollment Period, the kind of policy you can buy, and when you can or must apply for it. You may have additional rights under state law.

This is as good as I can do with this copy paste - just look it up at the link ~

It also says:  Check with your State Insurance Department to see if you can buy a Medigap policy outside of your Medigap Open Enrollment Period. You may have additional rights under state law.

If you are interested in laws specific to California on Medigap coverage (Medicare Supplemental Coverage - special state rules)  this will also help.

California Dept of Insurance.gov - Guide to Medicare Supplement 

California Dept of Insurance - Health coverage - Seniors 

You have tons of options - You have a lot of time to decide what to do within your criteria of keeping your docs and controlling your cost - 

I will be glad to help you find info but i am not in your state and the decision is yours and there are people that can help you - call your state’s SHIP office and get an appointment before they all fill up - you are ahead of the game currently but do not delay.

A good reference is  Medicare.gov - Medicare and You -  

[TRL1111]

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@jskyer wrote:

 Earlier this year, (2025), I signed up for the AARP Medicare Advantage (PPO) Plan from United Healthcare. I had some medical issues that would have made for a financial nightmare had I stuck with plain old Medicare.

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Can you explain why your issues would have made for a financial nightmare with traditional Medicare?  

Usually that's the "best"coverage if paired with a supplement--once you meet your Part B deductible, everything's covered at 100%, and there are no networks to deal with.

[evrytan]

I already see that Medicare advantage cuts many services that were included this year plus is raising the co-payments a lot. So, actually is not going to be any increase. 

[GailL1]

@evrytan 

And some plans are just going away altogether. And some insurers are leaving the marketplace altogether.

Because of many changes that CMS is making to control certain aspects of Medicare Advantage plans

• preapproval methodology and time restrictions to get it done faster
• tighter controls on risk assessments methods
• requirements that networks be adequate per CMS definition 
• (to name a few off the top of my head) - maybe others too

and because

• the insurers share of the cost has increased under the Prescription Drug coverage that is within their plans,
• the discontinuance of some of the extended benefits in regular MAPD plan designs which are now only covered under some of the dual eligible special needs plans

there is definitely a change in plan designs and cost.  

Many PPO MA plans are leaving regional plans and premiums are being recalculated as well as standalone PDP plans.

The most important thing a beneficiary can do during this AEP ( Annual Enrollment period) for PDP and MAPD plans is to review all those that are available to them and pick the best one based on ones needs or depending upon their state rules, determine if going back to Traditional Medicare (with a Medigap plan) might be a better move for them.  

IMPORTANT:  If a MA plan to which a beneficiary is participating leaves your area, and one wants to go back to Traditional Medicare, this cancellation of MA coverage opens up a guaranteed issue special enrollment period for a Medigap plan without underwriting.  

Beneficiaries need to understand their options and many times that involves knowing what the federal and state laws say about Medicare plans.  So if a big move is gonna happen, beneficiaries may want to solicit help from a knowledgeable local Medicare plan broker or a State Health Insurance Plan representative (SHIP).  But act ASAP cause they are all gonna get booked up this year based on all the changes.  

[jskyer]

 The financial nightmare involves the maximum out of pocket expense. Basic Medicare met all my needs for years. It is only recently that my health required some expensive treatments and drugs. Basic Medicare has no out of pocket limits while Advantage plans do. 20% copays on treatments or drugs that are expensive never end with Basic Medicare. Once I have reached an out of pocket maximum with an Advantage plan I no longer have to deal with that 20% copay. In other words, I can no longer afford the Basic Medicare plan that I relied upon for years. 

[CBtoo]

Since your plan is being ended that gives you what is called guaranteed issue, meaning you don't have to pass medical underwriting, to get a supplement to pick up nearly all or most of what Medicare B and A doesn't cover. While you may already know all of this, I am posting it in case someone reading this thread does not.

The benefits offered by each alphabet letter supplement has to have a minimum identical set of benefits (a few companies offer more benefits than the minimum). 

I have:
1) original medicare so pay that premium for B

2) supplement G so pay that premium and I only owe the B deductible and beyond that anything I'd have a copay with is covered and the deductible if you are hospitalized (so medicare A) is covered. 

3) medicare D (for drugs) so have those costs (which change each year and vary between D plans depending on their formulary, how they choose to price drugs and what they choose to have as copays at each tier in their formulary). The maximum out of pocket now is the same, with the same rules, for medicare advantage drug coverage and medicare D coverage.

Add up to see if the premiums, deductibles, etc. for original medicare are more or are less than what you'd have to pay with an advantage plan. BUT pick your supplement carefully because you can't change that (well other than go back to an advantage plan as they have no medical underwriting requirements or if you live in one of the states that allows you do do that annually - see further below for more information on that) in the future unless you pass medical underwriting or that company no longer offers your supplement. ALSO ask what the premiums will be if you were 90 as some plans will be charging a ton more when you are older.

Supplement plans use what are called risk pools: Age attained up (so everyone the same age is one risk pool so premiums rise more as you are older since as people age they tend to have more medical issues as you age), Age signed up (so your risk pool has people of different ages, but typically in a 5 or 6 year age range since people sign up at different ages if they are still working), and Community based (everyone is in the same risk pool so these tend to have the lowest costs when you are older - BUT you are usually given a discount when you are younger and so have 2 increases a year - the anniversary of when you signed up and then the "usual" once a year increase).

IF you live in one of the states that have "birthday rules" or you can change once a year rules, then you can change without any medical underwriting. The costs of supplements in those states tend to be a bit higher as when people are well they tend to sign up for advantage plans and then when they are sicker switch to supplements as then they become cheaper. As the supplement pool then is "sicker" in those states the rates tend to be higher.

[GailL1]

@jskyer 

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@jskyer wrote:

 The financial nightmare involves the maximum out of pocket expense. Basic Medicare met all my needs for years. It is only recently that my health required some expensive treatments and drugs. Basic Medicare has no out of pocket limits while Advantage plans do. 20% copays on treatments or drugs that are expensive never end with Basic Medicare. Once I have reached an out of pocket maximum with an Advantage plan I no longer have to deal with that 20% copay. In other words, I can no longer afford the Basic Medicare plan that I relied upon for years. 

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What’s the difference in being in a Medicare Advantage plan and paying up to that maximum out of pocket and having a Medigap plan that picks up what Traditional Medicare does not pay - all of it or some of it depending on the Medigap plan.  

The point is mute if your docs don’t take traditional Medicare but I bet they do - 

California is a state where there is a birthday rules when you can change Medigap plans ever year around your birthday - so if your docs accept traditional Medicare especially if they accept it as assignment - you have it made big time.

Medicare.gov - how doctors accept or don’t accept Traditional Medicare. 

[TRL1111]

Not very many people choose to have only traditional Medicare with no financial protection for the unlimited 20% coinsurance they face. Actually, according to KFF, it's 10% of people on traditional Medicare--the rest have their 20% coinsurance covered by something like a supplement or employer plan or Medicaid.

As an experiment, I'm looking at AARP/UHC's Medicare plans for Santa Barbara, and see one Advantage plan, and it's a PPO. The out-of-pocket maximum is $6,700 in-network, and $10,100 combined in- and out-of-network, with a monthly premium of $76.

AARP/UHC doesn't offer a high-deductible G, but other companies do. For a 75-year-old non-smoking man in Santa Barbara, the premiums for a high-deductible G range from $53 to $91, with one outlier at $116. And the deductible is $2,875, after which the member pays nothing. This out-of-pocket maximum is important for people with a lot of medical expenses, and vitally important for people with cancer because Part B drugs (e.g. chemotherapy) are covered with coinsurance and not copays.

And the high-deductible plan is attractive for people without a lot of medical expenses because the premium is so low.

When Advantage plan out-of-pocket maximums are in the many thousands of dollars, high-deductible G plans are a viable alternative because their out-of-pocket maximum is $2,875, with a low monthly premium. Not ever $0 like some Advantage plans, but if you're looking at the big picture and potential financial exposure, that $0 may not be such a great deal.

Since your Advantage plan is terminating, you have guaranteed-issue rights to a supplement, and if were in your shoes I'd seriously consider a high-deductible G. It could be your only chance to switch back to traditional Medicare. And with California's birthday rule, you can switch to a different high-deductible G every year without medical underwriting. You can't switch to a G or an N, because your new plan has to have equal or lesser benefits that your current plan, but you can price-shop high-deductible Gs.

For what it's worth, insurance agents' commission on supplements is based on the premium, and the commission on a $50/month high-deductible Plan G is not going to be very high, and certainly far lower than a regular Plan G, which is already lower than the fixed commission on Advantage plans. So I would suspect they won't push them very hard. And they could be a hard sell, because people are scared of the high deductible/out-of-pocket maximum, without thinking about the possibly even higher out-of-pocket maximum with an Advantage plan.

[CBtoo]

And actually a non-high deductible G would likely cost less in the long run as premiums plus the medicare B deductible would likely be less than hitting the max with a PPO or other medicare advantage plan. Of course you'd need to add D for meds to that, but both D on an advantage plan and D separately both have a $2000 maximum out of pocket. The key for buying D if you are getting a supplement is put in all the drugs that Medicare B does not cover (for example chemo is covered by B but often a pill cancer drug is covered by D - check with your provider and B and D plans with this). Do the math and see what is cheaper. I haven't checked recently but it used to be if you turned in a receipt for a prescription drug you used a coupon for then your cost is also credited to your deductible/out of pocket limits. 

And what has already been said, anyone in any state who accepts original medicare will see you and it is covered the same regardless of where you get care (provided they accept original medicare). Advantage plans have far more limits with that (eg limited networks). I'd bet that since your providers have accepted advantage plans that they all would accept original medicare. To protect yourself financially though you need a supplement. You are lucky you live in a state where you can change once a year without having to pass medical underwriting, BE SURE you don't forget to sign up for Medicare D (drugs) if you switch to original medicare though.

Good luck.

[GailL1]

@CBtoo wrote . . . . The key for buying D if you are getting a supplement is put in all the drugs that Medicare B does not cover (for example chemo is covered by B but anti-nausea drugs are covered by D). Do the math and see what is cheaper. 

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That depends on how the Anti-nausea med is given - sometimes it is given before the IV chemo and in IV form - that would still be Part B - but if taken in pill form, most usually Part D although some oral cancer drugs are covered under Part B if in combo with IV chemo.  

[CBtoo]

They can find out from their provider/D plan if stuff done in office is billed to B vs D. 

[GailL1]

Yes, this is going to be a year of change,  especially for PPO MAPD plans. This isn’t just UHC that is making this decision to pull from some PPO plan areas.  It is industry wide and insurers will be making their individual decisions as to where they are offering MAPD plans and what type.  It has always been this way - that’s why there is the AEP every year.

ANNAUL Open Enrollment (AEP) for 2026 plans begin on October 15 and goes to December 07.  

Medicare.gov - Explore Your Medicare Options 

You can change Medicare Advantage plans - once the new 2026 plan designs have been uploaded into the Medicare  database sometimes around the 1st part of October, you can see what plans by whatever company are available to you in your zip code and then check their network and their drug formulary to see if any of them fit well for your needs and sign up for the one that does.

OR since your MAPD plan is going away, this also opens up a Medigap special enrollment period (SEP) for you if you want to go back to original Medicare with a Medigap plan.  You might also have another option. to get a Medigap plan if you want to go back to original Medicare.  If it has been less than 6-months since you picked up Medicare Part B - you maybe still in your Initial Enrollment Period and the switch from a MAPD plan to original Medicare with a Medigap plan without underwriting is still available to you. 

I have to run now - but you do have options and time to make the decision.  Just like other insurance, Medicare MAPD plans can change and there is never a once and done in this marketplace - you can change based on your needs and what plans are available,