Why Some Medicare Advantage Enrollees May Need to Switch Plans in 2026
Medicare Advantage has become the most popular form of Medicare coverage, now serving more than half of all eligible beneficiaries. As the program continues to grow, some enrollees may face changes to their coverage from year to year—including the possibility of needing to choose a new plan for 2026. Understanding why these changes happen can help beneficiaries prepare and avoid surprises.
Why Plan Changes Happen
Medicare Advantage plans are offered by private insurance companies and operate at the county level. Each year, insurers can adjust their plan offerings by expanding into new areas, reducing coverage, or exiting certain markets altogether. When a plan is discontinued or no longer available in a specific area, enrollees are required to select new coverage.
While most beneficiaries are able to keep their plans from one year to the next, a small but meaningful share experience plan exits or significant changes during the annual enrollment cycle.
Insurers point to several factors that influence these decisions, including:
- Rising healthcare costs
- Increased use of medical services
- Policy and payment updates from the Centers for Medicare & Medicaid Services (CMS)
Who May Be More Affected
Plan changes do not impact all enrollees equally. Research suggests that coverage disruptions may be more common among:
- Enrollees in certain plan types, such as PPOs
- Members of smaller or regional insurance carriers
- Individuals not enrolled in Special Needs Plans
- Residents of rural areas, where fewer plan options may be available
The level of disruption can also vary widely by state and county, depending on how insurers adjust their local offerings.
Why This Matters
If a Medicare Advantage plan is discontinued or significantly altered, beneficiaries may need to review and compare new options. Changes in coverage can affect:
- Access to preferred doctors and hospitals
- Prescription drug coverage
- Supplemental benefits such as dental, vision, or fitness programs
Because of this, it’s important for enrollees to review their plan details each year during the Medicare Open Enrollment Period to ensure their coverage continues to meet their needs.
Bottom Line
The Medicare Advantage market continues to evolve, and plan availability can change from year to year. While most enrollees will not be required to switch plans, some may need to make new choices for 2026. Staying informed and reviewing options annually can help beneficiaries maintain coverage that fits their healthcare needs and avoid unexpected gaps.
Sources
- Becker’s Payer Issues — 10% of Medicare Advantage enrollees forced to switch plans for 2026[beckerspayer.com]
- Johns Hopkins Bloomberg School of Public Health / JAMA — 1 in 10 Medicare Advantage enrollees face forced disenrollment in 2026[publichealth.jhu.edu], [jamanetwork.com]
- Fierce Healthcare — Forced Medicare Advantage disenrollments rise amid payer plan exits[fiercehealthcare.com]
- American Hospital Association — Nearly 3 million MA beneficiaries forced to find alternative coverage for 2026[aha.org]
Not affiliated with or endorsed by Medicare or any government agency.