UCare is exiting the Medicare Advantage Marketplace in 2026

[GailL1]

One of the most popular (non-profit) Medicare Advantage plan insurers in  Minnesota and Wisconsin is exiting the MAPD marketplace in 2026. 

Modern Healthcare.com 09/04/2025 - Ucare to Exit Medicare Advantage in 2026

I do not have full access to this publisher so this is just the highlights to give a heads up so that you can look up more info if it involves your plan

Synopsis: UCare will exit the Medicare Advantage market in 2026, the company announced Thursday, citing financial challenges in the business. As of Aug. 1, the nonprofit carrier had 186,700 Medicare Advantage members across Minnesota and Wisconsin, up 31.3% from the same period last year, according to data from the Centers for Medicare and Medicaid Services. Overall, the company is one of Minnesota’s largest health insurers, with 600,000 total enrollees. It is the state’s second-largest Medicare Advantage carrier, trailing Blue Cross and Blue Shield of Minnesota, which has 242,500 members. (Tepper, 9/4)

[GailL1]

Adding new (local) media coverage of Ucare leaving the MA marketplace in Minnesota.

CBS News - 10/22.2022 - UCare, other carriers dropping Medicare Advantage Plans, leaving nearly 200K... 

I am sure many of those in Wisconsin are saying the same thing.

NOPE - a Medigap plan is not gonna fill this void - they like Ucare - a nonprofit physicians group that formed together as a MAPD plan but financially, they could not make it in survival.  An insurance plan has to be well founded in making it work with the beneficiaries enrolled, the premiums and plan design and the size of their network - including what they pay the providers.  When any of these things get out of kilter, something has to change.  But it was the benefits design and the premiums that people like this plan - so if it changes, the appeal also would go -

It will be interesting to see how this year pans out in the Medicare field.  How many Medicare Advantage plans are we loosing?  How many Medigap plans are gonna break the bank?  

We will always have the Medicare Advantage plans that serve the dual eligible, we may always have those that serve underserved communities and are testing some waiver benefit design.  

Until we are ready to do something about the actual source of the problem, I think things will get worse, not better.  What is the source of the problems - health care cost !  

Would you be willing to help in controlling health care cost for the betterment of all of Medicare?

[GailL1]

@CBtoo 

Ucare was only in a couple of states - Wisconsin and Minnesota.

As I understand, this was a physician owned non-profit company - 

This is sad - because it was one of the best in this area and had a greater market share than many of the others. It helped many who chose to go this route because of their finances and health needs - especially many who were on Medicare because of a disability and who are under 65 years of age.  

Specifically, they stated their financial problems were created by 

significant financial challenges, specifically citing the difficulty of sustaining the business because of rising healthcare costs, increased member utilization, and declining federal reimbursements.  The company's leadership stated that market dynamics and plan designs have made it increasingly difficult for provider-owned health plans to remain sustainable.

From Beckers: UCare reported an operating loss of $504 million in 2024, amid rising costs in its MA and Medicaid businesses.  

Yes, I do see this as happening more and more - and it is something that CMS does not want to happen because it creates problems for Medicare - the Traditional program because many may not be able to afford a Medigap plan to cover their part of the cost that Medicare does not cover.  So most likely we will have an increase in Medicare’s Bad Debt.

Medicare bad debt is the uncollectible cost-sharing amount (deductibles and coinsurance) for services provided to Medicare beneficiaries. To be considered "allowable" and potentially reimbursed, a provider must prove they made reasonable collection efforts, the debt is uncollectible, and there is no likelihood of future recovery. Since the ACA was passed, this reimbursement has gone lower and lower to the point that it is now almost nothing especially with the collection expense that the provider has to exert just to get it to reimbursement eligibility.