Disruptions in Medicare Advantage Coverage in 2026

Imagine learning during open enrollment that your Medicare Advantage plan is exiting the market, forcing you to find new coverage for 2026. In Vermont, a staggering 92% of Medicare Advantage enrollees face exactly this situation. Nationally, 2.9 million beneficiaries, roughly 1 in 10 Medicare Advantage enrollees, have been forced to change their insurance coverage due to their prior plan exiting the market (forced disenrollment). The research letter by Meiselbach and colleagues documents this unprecedented disruption. Between 2018 and 2024, mean forced disenrollment was just 1% annually. After years of stable market participation, forced disenrollment rates surged to 6.9% in 2025 and are expected to reach approximately 10% in 2026.

The authors investigated patterns of forced disenrollment according to plan level, market level, and beneficiary characteristics. Beneficiaries enrolled in preferred provider organization (PPO) plans were more affected than those enrolled in health maintenance organization (HMO) plans. Smaller insurance carriers exited markets at higher rates and collectively accounted for almost half of all forced disenrollments. Beneficiaries living in rural areas experienced forced disenrollment at nearly twice the rate of beneficiaries living in urban areas (28% vs 15%). Across 12 states, at least 20% of Medicare Advantage enrollees lost coverage due to their plan exiting the market. Notably, the authors found no significant differences in forced disenrollment rates by beneficiary income level, health risk scores, or Medicaid eligibility. This suggests that vulnerable populations face the same level of disruption as other beneficiaries.