From the MSM - Med. Adv. Enrollment expected to fall in 2026 as Unprofitable Plans are Dropped

[GailL1]

CNBC 09/29/2025 - Medicare Advantage enrollment expected to fall in 2026 as insurers cut back on unp... 

Yep,with all the changes that CMS is imposing on them now, some plans are just not profitable any longer.

Many PPO plans are going away, I think because there is now a Network Adequacy imposed - Networks are also supposed to be posted online on Medicare.gov with the plan for beneficiary’s review before committing to a 2026 plan.  Now they can still change during the year since this is done by contract date with the provider but at least a beneficiary can see what it is during the AEP (Annual Enrollment Period).

I have already covered the Value Based Design Insurance (VBDI)  Policies that are going away in 2026.  They were just too expensive to continue.  For those who are in the Special Needs category or can be, many of the extra benefits that were available in the VBDI will be offered in the Special Needs Plans.

MAPD (Medicare Advantage with Prescription Drug Coverage) plans still remain but there are perhaps higher deductibles and out of pocket cost in the 2026 plan designs - so check this when you are making your selection for 2026.

Read the CNBC article 

CMS is also making rules which the MA insurer have to follow on risk assessment - the new procedure requires that any added diagnosis has to be in the providers documentation so there are checks and balances being put into place before a beneficiary is labeled as a higher risk and the plans are paid more for their care like they do in the traditional program.  

CMS is also getting together a routine so that any prior approvals needed in MA plans or Trad. Medicare will be done expediently and accurately.  They will only have a certain number of days to approve or deny.  They will ask for help from the providers but also have some access to Medical records so that it doesn’t slow down the providers.  Also the prior approvals will be limited to just a few Diagnosises and Procedures - in most cases.

Remember that if your MA plan is cancelled in your area, or your insurer stops their MA participation or all of their Medicare plans,  this open up a special enrollment period for you to go back to Traditional Medicare and get a Supplemental plan (Medigap)  WITHOUT Underwriting - if that is what you want to do.

Again, Read the article, Read what comes to you about your MAPD plan and your Free Standing Part D plan for 2026 and please do not forget to sign up for the plan that best serves your needs during the Annual Enrollment Period for MAPD, MA and Part D plans - October 15 - December 7.  

[CBtoo]

One advantage of having your advantage plan dropped is if you wanted to go back to supplements and fail medical underwriting (meaning you can't switch unless you live in one of the states that allows you to switch once a year or fall under one of the other limited opportunities that allow you switch - there are several). Then you can switch without having to pass medical underwriting (called guaranteed issue).