Eleven Medicare Advantage Plans Will Exit Market for 2027
Healthcare operators and providers will see reduced plan availability as eleven carriers shift or exit the market.
Updated on Oct. 1, 2026 in Healthcare
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For the 2027 plan year, 11 health plans across the United States will exit the individual Medicare Advantage market. This shift includes seven health system-owned insurers choosing to cease these specific offerings.
Why it matters
The contraction of Medicare Advantage offerings impacts provider reimbursement networks and patient routing, forcing operators to assess which coverage options remain viable for their elderly patient populations.
A total of 11 health plans are exiting the individual Medicare Advantage market, including seven health system-affiliated insurers and three separate Blue Cross Blue Shield plans that are discontinuing coverage.
The players
Molina Healthcare
A multi-state healthcare organization that manages government-sponsored health programs and is shifting its Medicare Advantage strategy to special needs plans.
Horizon Blue Cross Blue Shield of New Jersey
A major regional insurer that is narrowing its Medicare Advantage footprint to special needs plans.
MJHS Health System
A New York-based health system that will limit its Elderplan Medicare Advantage offerings to special needs plans.
Presbyterian Health Plan
An Albuquerque-based integrated healthcare provider that will transition its Medicare Advantage coverage to special needs plans.
Wellmark Blue Cross Blue Shield
A regional health insurance company that is discontinuing its individual Medicare Advantage coverage.
The details
Insurers are narrowing their focus for the 2027 cycle, with several opting to transition their remaining footprint exclusively to special needs plans rather than maintaining broader individual Medicare Advantage coverage. This consolidation changes how health systems interact with their own insurance arms, potentially limiting the direct-billing networks previously available to providers in those coverage areas.
Timeline
The exits will take effect for the 2027 plan year.
The 2026 reporting period established the current baseline for county service areas.
Market Landscape
The exit of these 11 plans follows an established pattern of insurers recalibrating their Medicare Advantage individual market participation rules to align with changing CMS regulatory and financial benchmarks. This shift highlights a broader industry trend toward prioritizing special needs plans over broader individual market offerings.
Operators must immediately review which insurance plans their local patients utilize to identify potential network gaps before the 2027 plan year begins. Revenue cycle teams should monitor for upcoming changes in payer mix and coordinate with patients to ensure continuity of care.
The takeaway
The move toward specialized Medicare plans signals a tightening of insurer margins that providers must prepare for in their upcoming contract negotiations. Monitor upcoming enrollment communications from regional carriers to assess how the loss of these plans will shift local patient volumes.
Further reading
For broader trends in coverage shifts, visit the Healthcare section.
Source note: This article includes information reported by Becker's Hospital Review | Healthcare News & Analysis.
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