Medicare Advantage

Most Medicare Beneficiaries Affected by Plan Terminations in 2025 Have Robust Medicare Advantage Options in 2026, KFF Finds

A new KFF analysis shows that the majority of enrollees losing Medicare Advantage coverage due to plan exits can find comparable or better alternatives for 2026—but they must act during specific enrollment windows.

March 20, 2026·By Senior Health Times Staff·✓ Reviewed April 2026

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Key Takeaways

✓KFF found that most Medicare beneficiaries affected by 2025 plan terminations live in counties where five or more Medicare Advantage plans remain available for 2026.
✓Enrollees whose plans are terminated qualify for a Special Enrollment Period (SEP) that runs from the termination notice date through February 28 of the following year.
✓Average Medicare Advantage premiums for 2026 remain below $30 per month for many zero-premium plans, though out-of-pocket maximums can reach $8,850 for in-network services under CMS rules.
✓Beneficiaries who miss the SEP can still switch during the Medicare Advantage Open Enrollment Period, which runs January 1 through March 31 each year.
✓CMS requires insurers to send termination notices at least 90 days before a plan's end date, giving enrollees time to compare options on Medicare Plan Finder at Medicare.gov.

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The Short Answer

Most Medicare beneficiaries whose Medicare Advantage plans were terminated in 2025 have access to multiple replacement options for 2026, according to a KFF analysis—but enrollees must use the correct enrollment window and compare plans carefully before coverage gaps occur.

What the KFF Analysis Found

KFF, the nonpartisan health policy research organization, examined county-level Medicare Advantage market data following a wave of plan terminations and service-area reductions announced for the 2025 plan year. The analysis found that the overwhelming majority of affected beneficiaries reside in counties where at least five Medicare Advantage plans will be available in 2026. In many urban and suburban markets, that number exceeds a dozen competing options.

The findings matter because plan terminations are not rare events. Insurers routinely exit markets, consolidate product lines, or reduce service areas during the annual bid process governed by the Centers for Medicare & Medicaid Services (CMS). When a plan exits, enrollees do not lose Medicare eligibility—they lose their specific contract and must re-enroll elsewhere.

Why Plans Exit Markets

Medicare Advantage plans operate under contracts with CMS that must be renewed annually. Insurers can choose not to renew a contract, reduce the counties they serve, or consolidate two plans into one. CMS can also terminate a plan for cause—for example, for failing to meet quality standards under the Star Ratings program, which scores plans on a 1-to-5 scale across measures including chronic disease management, member experience, and customer service.

Plans rated below 3 stars for three consecutive years face enhanced scrutiny and potential termination under CMS's Low Enrollment and Chronic Low Performing Plan policies. In recent years, several large national carriers have also voluntarily exited less profitable rural counties, citing reimbursement rates set under the Medicare Advantage benchmark payment system.

What Termination Means for Enrollees

When a Medicare Advantage plan is terminated, CMS requires the insurer to notify affected members at least 90 days before the plan's end date. That notice triggers a Special Enrollment Period (SEP). Under current CMS rules, the SEP for plan terminations allows affected beneficiaries to switch to another Medicare Advantage plan or return to Original Medicare (Parts A and B) at any point from the date of the termination notice through February 28 of the year following the termination.

Enrollees who return to Original Medicare during this SEP also have a guaranteed-issue right to purchase a Medicare Supplement (Medigap) policy in most states, though this right has a limited window and varies by state law. Beneficiaries should contact their State Health Insurance Assistance Program (SHIP) counselor—a free service available in every state—to confirm their Medigap rights before the window closes.

Comparing 2026 Medicare Advantage Options

For 2026, CMS approved Medicare Advantage plans across more than 3,000 counties nationwide. The average plan offers benefits beyond Original Medicare, including prescription drug coverage (Part D), dental, vision, and hearing benefits. However, benefit generosity varies significantly by plan and county.

Key cost benchmarks for 2026 include:

Premiums: Many plans continue to offer $0 monthly premiums, though enrollees still pay the standard Medicare Part B premium, set at $185.00 per month for 2026 for most beneficiaries.
Out-of-pocket maximums: CMS caps the in-network out-of-pocket maximum at $9,350 for 2026 for standard Medicare Advantage plans. Combined in- and out-of-network maximums can be higher.
Deductibles: Part D drug deductibles are capped at $590 for 2026 under CMS rules, though many plans waive this for lower-tier drugs.

Beneficiaries can compare all available plans using the Medicare Plan Finder tool at Medicare.gov, which allows side-by-side cost and benefit comparisons based on a user's specific zip code and prescription drug list.

Enrollment Windows You Need to Know

Missing an enrollment deadline is one of the most common and costly mistakes Medicare beneficiaries make. Here are the windows that apply to people affected by plan terminations:

Special Enrollment Period (SEP) for Plan Terminations Runs from the date of the termination notice through February 28 of the following year. This is the primary window for affected enrollees.

Medicare Advantage Open Enrollment Period (OEP) Runs January 1 through March 31 each year. Any Medicare Advantage enrollee—not just those affected by terminations—can switch to a different Medicare Advantage plan or return to Original Medicare during this period. Changes take effect the first day of the following month.

Annual Enrollment Period (AEP) Runs October 15 through December 7 each year. This is the main window for all Medicare beneficiaries to review and change their coverage for the upcoming year. Changes made during AEP take effect January 1.

What Beneficiaries Should Do Now

If you received a termination notice, the first step is to read it carefully and note the plan's last date of coverage. Then use Medicare Plan Finder at Medicare.gov to search for 2026 plans in your zip code. Filter by your current doctors and preferred pharmacy to check network status, and enter your prescription drugs to estimate total annual costs—not just monthly premiums.

If you need help, call 1-800-MEDICARE (1-800-633-4227), available 24 hours a day, seven days a week, or contact your local SHIP counselor through the SHIP National Technical Assistance Center.

Sources - Medicare.gov — Medicare Plan Finder and enrollment period information - CMS.gov — Medicare Advantage contract and termination rules, 2026 cost benchmarks - KFF.org — Analysis of Medicare Advantage plan availability following 2025 terminations

Last reviewed: April 2026

Sources & Further Reading

Frequently Asked Questions

What happens to my coverage if my Medicare Advantage plan is terminated?

Your Medicare eligibility is not affected. CMS requires your insurer to notify you at least 90 days before the termination date, which triggers a Special Enrollment Period. You can switch to another Medicare Advantage plan or return to Original Medicare. If you take no action, CMS will automatically enroll you in Original Medicare Parts A and B so you are not left without coverage.

How long do I have to find a new plan after my Medicare Advantage plan is terminated?

You have a Special Enrollment Period that begins on the date of your termination notice and runs through February 28 of the year following the termination. You can also use the Medicare Advantage Open Enrollment Period, which runs January 1 through March 31 each year, to make a change. Acting promptly after receiving your notice gives you the most time to compare options carefully.

Will I be able to get a Medigap policy if my Medicare Advantage plan is terminated?

In most states, a plan termination triggers a guaranteed-issue right to purchase a Medicare Supplement (Medigap) policy, meaning insurers cannot deny you coverage or charge higher premiums based on health status. This right has a limited window, typically 63 days from the loss of coverage. State rules vary, so contact your State Health Insurance Assistance Program (SHIP) counselor promptly to confirm your specific rights.

How many Medicare Advantage plans are available in 2026?

CMS approved Medicare Advantage plans across more than 3,000 counties for 2026. The KFF analysis found that most beneficiaries affected by 2025 plan terminations live in counties with at least five competing plans available for 2026. Urban and suburban markets typically offer more than a dozen options. Use the Medicare Plan Finder at Medicare.gov to see exactly which plans are available in your zip code.

What is the Medicare Advantage out-of-pocket maximum for 2026?

For 2026, CMS set the in-network out-of-pocket maximum for standard Medicare Advantage plans at $9,350. Plans may set lower limits, and some Special Needs Plans (SNPs) have different caps. Once you reach your plan's out-of-pocket maximum in a calendar year, the plan covers 100 percent of covered in-network services for the remainder of that year. Always verify the specific limit in your plan's Evidence of Coverage document.

Where can I get free help comparing Medicare Advantage plans?

Every state has a State Health Insurance Assistance Program (SHIP) that provides free, unbiased counseling from trained volunteers. You can also call 1-800-MEDICARE (1-800-633-4227) around the clock. The Medicare Plan Finder tool at Medicare.gov allows you to compare plans by premium, out-of-pocket costs, drug coverage, and provider networks. None of these resources are affiliated with insurance companies or receive commissions.

Editorial Standards

This article was written by the Senior Health Times editorial team and is intended for informational purposes only. It does not constitute financial, legal, or medical advice. Coverage details and costs vary by plan, carrier, and state. Always verify information with official sources including Medicare.gov and your state insurance commissioner.

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