4 insurers exiting Medicare Advantage markets

 In recent years, a handful of insurers have left the Medicare Advantage market, and others have scaled back.

Medical costs and federal cost-containment efforts have affected MA’s financial viability, and ongoing tensions around how star ratings are calculated — and, thus, which plans secure bonus payments — have complicated matters. And amid prior authorization denials and reimbursement issues, some hospitals have also moved away from accepting certain plans, especially from large carriers.

A study published in JAMA found that 10% of MA enrollees had to disenroll from their plan heading into 2026 as they faced insurer exits. Still, nearly all MA beneficiaries who needed to switch plans had at least one other option for 2026, according to KFF.

Now, more than halfway into 2026, the pattern of insurer exits and anticipated pullbacks persists. Carriers submitted their 2027 bids in June after CMS finalized a 2.48% average rate increase in April. More than 100 industry and provider groups had argued the rate change was too low to prevent further plan losses.

Here are four insurers that are exiting MA markets:

1. Humana will exit MA plans covering 600,000 members in 2027. Just like in 2025, the company said it aims “to recapture a significant portion of that volume.”

2. Clear Spring Health fully departed the MA market June 1, discontinuing its Illinois, Georgia, and Colorado businesses. The payer had more than 12,000 members enrolled in MA as of April, according to CMS.

3. Due to underperformance, Molina Healthcare will no longer offer its MA Part D product in 2027. The company is focusing exclusively on its dual-eligible line.

4. Albuquerque, N.M.-based Presbyterian Health Plan will discontinue most MA plans in 2027, affecting about 30,000 members.

https://www.beckershospitalreview.com/finance/4-insurers-exiting-medicare-advantage-markets/