1 in 10 Medicare Beneficiaries Face Forced Disenrollment from Medicare Advantage Plans

A landmark study published in Health Affairs by researchers at the Johns Hopkins Bloomberg School of Public Health has found that approximately 1 in 10 Medicare Advantage enrollees -- millions of seniors nationwide -- are facing forced disenrollment as private insurers exit markets they can no longer profitably serve.

The findings confirm what many Medicare beneficiaries have already experienced firsthand: a sharp and accelerating wave of coverage disruptions that is leaving older Americans scrambling to find new plans, often with little time and limited guidance.

The Johns Hopkins study, published in Health Affairs, analyzed Medicare Advantage plan exits across the country and found several alarming patterns:

• Roughly 10% of Medicare Advantage enrollees were affected by plan exits in the years studied -- a figure that has grown significantly as insurer losses have mounted
• Plan exits are not evenly distributed. Rural counties, lower-income markets, and areas with higher rates of chronic illness are being abandoned at disproportionately high rates
• Affected beneficiaries are among the most vulnerable. Those forced out of their plans tend to be older, sicker, and less equipped to navigate the re-enrollment process on their own
• Disruption to care is measurable. Forced disenrollment is associated with changes in provider relationships, medication access, and in some cases, delays in necessary treatment

The researchers called for greater federal oversight of plan exit decisions and stronger protections for beneficiaries caught in the crossfire of insurer market withdrawals.

Medicare Advantage plans are paid a fixed capitated rate by the federal government for each enrollee. When medical costs rise faster than those payments -- as they have sharply since 2022 -- insurers face mounting losses. The response has been predictable: exit the markets where losses are steepest.

Several of the largest Medicare Advantage carriers have announced significant market withdrawals for 2025 and 2026, citing:

• Higher-than-expected utilization following the COVID-19 pandemic
• CMS risk adjustment changes that reduced payments to plans
• Rising costs for outpatient procedures, home health, and specialty care
• Competitive pressure that led to overly generous benefit packages that proved unsustainable

The result is a market in retreat -- and seniors are paying the price.

When your Medicare Advantage plan exits your county or service area, you are not simply inconvenienced. You are automatically returned to Original Medicare (Parts A and B), which means:

• Your extra benefits disappear. Dental, vision, hearing, fitness, and transportation benefits -- common in Medicare Advantage plans -- are not covered by Original Medicare
• Your prescription drug coverage is dropped. Unless you actively enroll in a standalone Part D plan, you will have no drug coverage
• Your provider network resets. Doctors and specialists who accepted your Advantage plan may not accept Original Medicare at the same cost-sharing terms
• You face potential coverage gaps. Original Medicare has no out-of-pocket maximum, meaning a serious illness could cost you tens of thousands of dollars without a supplement

For seniors managing multiple chronic conditions, complex medication regimens, or ongoing specialist relationships, this disruption is not just inconvenient -- it can be genuinely harmful.

Florida has not been spared from this trend. Several counties across the state have seen plan exits in recent years, and the Johns Hopkins research suggests the pattern is likely to continue.

You are at elevated risk if:

1. You are enrolled in a Medicare Advantage plan in a rural or semi-rural Florida county -- these markets are being abandoned first
2. Your plan has a low CMS star rating -- underperforming plans are more likely to be discontinued
3. You received a non-renewal notice from your insurer in the fall -- this is the official signal that your plan is exiting
4. You have not reviewed your Annual Notice of Change (ANOC) -- sent every September, this document lists all changes to your coverage, network, and premiums for the coming year

If you received a non-renewal notice and did not act, you were automatically returned to Original Medicare on January 1. You may still have options -- but time matters.

If your plan exited and you are now on Original Medicare, you qualify for a Special Enrollment Period (SEP). This gives you a limited window -- typically two months from the date your coverage ended -- to:

• Enroll in a new Medicare Advantage plan in your area, if one is available and appropriate for your needs
• Purchase a Medicare Supplement (Medigap) plan to cover the gaps in Original Medicare, including hospital costs, coinsurance, and the 20% that Medicare does not pay
• Enroll in a standalone Part D prescription drug plan to restore your medication coverage

The right choice depends on your health, your doctors, your medications, and your budget. There is no one-size-fits-all answer -- which is exactly why working with an independent broker matters.

When your plan exits, your former insurer has no incentive to find you the best replacement. They will either try to move you to another one of their products -- whether or not it fits -- or simply send you a letter and wish you well.

An independent Medicare broker works differently. I represent 22 carriers, which means I can compare every plan available in your ZIP code side by side: premiums, drug formularies, provider networks, star ratings, and out-of-pocket maximums. My job is to match your doctors, your medications, and your budget to the right plan -- not to push a product that benefits an insurer.

There is no cost to you for this service. Medicare brokers are compensated by the insurance companies, so you receive personalized guidance at no charge.

Whether you were directly affected by a plan exit or simply want to make sure your current coverage is still the best option available, here is what I recommend:

1. Confirm your plan is still active in your county for 2026 -- do not assume nothing has changed
2. Review your Annual Notice of Change -- look for premium increases, formulary changes, or network narrowing
3. Check that your medications are still covered at the same tier and cost-sharing level
4. Schedule a free, no-obligation review with an independent broker -- especially if anything has changed or you are uncertain about your options

The Johns Hopkins research makes clear what many Florida seniors have already experienced: forced disenrollment from Medicare Advantage is not a rare edge case. It is a systemic problem affecting millions of beneficiaries -- and the most vulnerable are hit hardest.

The good news is that you have options, and you do not have to navigate them alone.

Call me at (386) 871-3858 or schedule a free appointment to review your Medicare coverage today. No obligation, no pressure, no cost -- just straightforward guidance from a licensed Florida Medicare broker who knows exactly how to help.

• Meyers, D.J., et al. "Medicare Advantage Plan Exits and Forced Disenrollment." Health Affairs, 2025. Johns Hopkins Bloomberg School of Public Health.
• Centers for Medicare & Medicaid Services (CMS). Medicare Advantage Plan Availability Data, 2024-2026.

William Gray is a licensed Medicare insurance broker based in Daytona Beach, Florida (FL License #W690237), serving clients across all 50 states. He is not affiliated with Medicare, CMS, or any government agency.