1 in 10 Medicare Advantage Enrollees Face Forced Disenrollment in 2026

As many as 2.9 million Medicare Advantage enrollees are being forced to find new plans in 2026 following a sharp rise in insurers exiting markets across the country, according to a new analysis by researchers at the Johns Hopkins Bloomberg School of Public Health.

Medicare Advantage, a private-insurance alternative to traditional Medicare that operates at the county level, had over 34 million enrollees as of 2025. Medicare Advantage covers more than half of eligible Medicare beneficiaries nationwide.

The researchers estimate that approximately 10% of Medicare Advantage policyholders enrolled in non-employer HMO or PPO plans will experience forced disenrollment this year when their current plan exits their county. The majority of Medicare Advantage policyholders—over 80%—are enrolled in these types of plans.

The findings were published online February 18 in a peer-reviewed research letter in JAMA.

In 12 states, more than one in five Medicare Advantage enrollees are losing their plans. In Vermont, 92% of Medicare Advantage enrollees are losing their plan. People losing their plans were more likely to be enrolled in plans offered by small insurance carriers and more likely to be living in rural areas.

“Medicare Advantage has grown substantially over the last decade. During that time, enrollees have rarely been forced to disenroll from their plans if they wanted to keep them,” says lead author Mark Meiselbach, PhD, assistant professor in Health Policy and Management. “What we’re seeing now is a substantial and sudden reversal of that pattern.”

Medicare Advantage enrollment had grown steadily for more than two decades, as plans increasingly offered supplemental benefits, charged low or zero cost premiums, and became available across most of the country. At the same time, the number of plans offered in most counties expanded, with few large-scale disruptions in coverage.

The reversal began last year, when disenrollment rates jumped. Multiple large insurers have now substantially reduced their Medicare Advantage offerings for 2026, citing financial pressures and policy uncertainty.

For their analysis, the researchers used national Medicare Advantage enrollment and plan data from 2017 through 2026, including publicly available files from the Centers for Medicare and Medicaid Services. The researchers plotted trends in forced disenrollment from 2018 through 2026 and compared the characteristics of plans exiting in 2026 to plans that will continue to be offered. The researchers found that annual forced disenrollment rates averaged just over 1% between 2018 and 2024. That rate climbed sharply to 6.9% in 2025 and will reach 10% in 2026—a tenfold increase in just the last two years.

Medicare Advantage enrollees most likely to lose coverage include those enrolled in Preferred Provider Organization (PPO) plans, non–special needs plans, plans offered by smaller insurance carriers, and lower-rated plans (those with fewer than four stars).

Rural counties and counties with lower overall Medicare Advantage penetration are more likely to experience large-scale plan exits.

Losing Medicare Advantage coverage can create disruptions to provider relationships, changes in covered benefits, and increased complexity during the annual enrollment period. For some individuals, particularly those in rural areas, there may be no or very few alternative Medicare Advantage plan options.

At the market level, widespread plan exits may also reduce competition in Medicare Advantage, particularly in regions served by a small number of insurers.

“Millions of beneficiaries will need to actively navigate plan changes in 2026,” Meiselbach says. “Understanding where and for whom these disruptions are occurring is essential for policymakers, regulators, and consumer advocates.”

“Forced Disenrollments Among Medicare Advantage Beneficiaries Following 2026 Plan Exits” was co-authored by Mark K. Meiselbach, Matthew Lavallee, Jianhui Xu, and Dan Polsky.

The research was supported by funding from Arnold Ventures.