For nearly a decade, the yearly odds of a Medicare Advantage member being forced out of a canceled plan barely moved. Researchers tracking national enrollment and plan data from 2018 through 2026 found the forced-disenrollment rate held close to 1% a year for most of that stretch, then climbed to 6.9% in 2025 and reached roughly 10% in 2026, a shift large enough that an event once described as rare now touches close to one member in ten every year.
A Rate That Sat Near 1% for Years, Then Tripled Twice
The finding comes from a research letter published in JAMA by health-policy researchers at the Johns Hopkins Bloomberg School of Public Health, who used national Medicare Advantage enrollment and plan files, including data from the Centers for Medicare and Medicaid Services, to plot forced disenrollment from 2018 through 2026. Annual forced disenrollment rates averaged just over 1% between 2018 and 2024, according to the analysis, a level low enough that most members went years without ever encountering it.
The number began moving in 2025, when it climbed to 6.9%, described by the study’s lead author as a substantial and sudden reversal of a pattern that had held for most of Medicare Advantage’s history. The rate kept climbing into 2026, reaching approximately 10% among enrollees in non-employer HMO and PPO plans, the arrangement that covers more than 80% of Medicare Advantage policyholders nationwide.
The increase tracks a wave of insurer retrenchment rather than a single company’s decision. Multiple large carriers substantially reduced their Medicare Advantage offerings for 2026, citing financial pressures and policy uncertainty, and the researchers note that Medicare Advantage enrollment had grown steadily for more than two decades with few large-scale coverage disruptions before this reversal began.
The scale of that retrenchment is visible in insurers’ own enrollment filings. UnitedHealthcare’s Medicare Advantage rolls fell 9%, from 10.3 million enrollees in October 2025 to just under 9.4 million by February 2026, while Elevance Health’s local and regional plans dropped 14% and Centene’s Medicare Advantage enrollment fell below 1 million members, according to a Healthcare Dive analysis of federal enrollment data. Those declines came as national Medicare Advantage enrollment growth slowed to roughly 3% in 2026, down from annual increases that reached 10% in prior years, even as the program continued covering more than half of all Medicare beneficiaries nationwide.
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The National Number Hides Sharp Local Swings
A national rate near 10% understates what happened in the hardest-hit states. In Vermont, 92.2% of Medicare Advantage members were forced to find new coverage in 2026, essentially the entire state’s Advantage population starting the year with a canceled plan. Twelve states recorded forced-exit rates above 20%, and seven of those states exceeded 40%, meaning the national average of roughly 10% sits far below the experience of millions of enrollees living in a relatively small number of states.
Vermont’s experience shows how a high disenrollment rate can compound into an outright access problem. The state’s Medicare Advantage plan count fell from eight in 2025 to three for 2026 after UnitedHealthcare and Vermont Blue Advantage both exited the market, leaving Humana as the only insurer still selling Advantage coverage there and just 35.68% of Vermont Medicare beneficiaries with access to any Medicare Advantage plan at all. Neighboring New Hampshire lost nineteen of its thirty-eight plans over the same stretch but kept full market access for its Medicare population, showing that a wave of plan cancellations does not automatically strip away access outside a small number of especially hard-hit states.
Rural beneficiaries faced forced exits at roughly twice the rate of members in urban areas, and counties with lower overall Medicare Advantage penetration were more likely to see large-scale plan exits, concentrating the disruption in places that also tend to have fewer replacement options to begin with.
The plans most likely to be dropped share identifiable traits. Beneficiaries enrolled in PPO plans, non-special-needs plans, plans offered by smaller insurance carriers and plans rated below four stars were all more likely to lose coverage than enrollees in HMO, special-needs or higher-rated plans, meaning the disruption fell unevenly even within a single county.
The Letter That Comes With the Bad News
A forced exit is not purely a loss. Federal rule requires a Medicare Advantage organization ending a contract to notify each enrollee by mail at least 90 calendar days before the date on which the nonrenewal is effective, and that same notice opens a Special Enrollment Period along with a guaranteed-issue right to buy a Medigap policy without medical underwriting.
The guaranteed-issue right applies specifically to a member who returns to Original Medicare rather than choosing another Advantage plan, and it runs alongside a Special Enrollment Period stretching from December 8 through the final day of February. Because the protection has a defined start and end date tied to when the old plan’s coverage stops, the same forced exit that ends one policy also puts a fixed clock on the best chance to buy a Medigap policy without a health screening standing in the way.
At a 1% annual rate, relatively few members ever needed to learn how that mechanism worked. At roughly 10%, it now applies to a share of the Medicare Advantage population large enough that skipping the Special Enrollment Period and Medigap details in a plan explainer no longer counts as covering a rare edge case.
The lead researcher, Mark Meiselbach, framed the shift as a signal for people well beyond the affected households: understanding where and for whom these disruptions are occurring is essential for policymakers, regulators and consumer advocates trying to keep pace with a market that has, in the space of two years, gone from stable to genuinely volatile for a meaningful share of its enrollees.
This article was drafted with AI assistance and edited for accuracy.
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