Is Humana discontinuing Medicare Advantage plans?

Editorial team Published on

Humana is dropping select Medicare Advantage plans for the 2027 coverage year, affecting approximately 600,000 members (about 8% of its total Medicare Advantage base).

Why Humana is Pulling Back

  • Profitability Targets: Humana is cutting lower-margin plans—primarily those with star ratings of 3.5 stars or lower—to reach a 3% pretax profit margin by 2028.
  • Rising Costs: Like other major insurers including UnitedHealth Group and Aetna, Humana cites medical costs outpacing government reimbursements.
  • Geographic Reach: Humana's coverage will contract from 85% to just over 80% of U.S. counties, spanning roughly 2,600 counties across 45 states and Washington, D.C.

What Affected Members Should Do

  • Check Mail Notices: Non-renewal and Annual Notices of Change were mailed out around late September and early October 2026. Coverage for discontinued plans officially ends on December 31, 2026.
  • Enrollment Windows: Medicare's Annual Enrollment Period runs from October 15 to December 7, 2026, for coverage starting January 1, 2027. A special enrollment period is also available from December 8, 2026, through February 28, 2027, for those affected by plan cancellations.
  • Avoid Default Risk: Doing nothing means automatic reversion to Original Medicare on January 1, which lacks prescription drug (Part D) and out-of-pocket maximum protections unless separate coverage is secured. Humana hopes to transition about 40% of impacted members into alternative internal plans.

Why is Humana dropping Medicare Advantage plans?

Humana is dropping select Medicare Advantage plans for 2027 to eliminate unprofitable offerings and raise its profit margins amid rising medical costs.

Key Reasons for the Cuts

  • Rising Medical Costs: Higher utilization of healthcare and increasing medical spending by members have strained insurance profit margins.
  • Lower Star Ratings: Declining federal quality star ratings from the Centers for Medicare & Medicaid Services (CMS) have reduced Humana's quality bonus payments, impacting financial returns.
  • Profit Margin Targets: Humana is specifically targeting plans with star ratings of 3.5 or lower in an effort to reach a sustainable pretax profit margin of at least 3% by 2028.

What This Means for Members

  • Affected Enrollees: The cuts will affect roughly 600,000 members (about 8% of Humana's Medicare Advantage base).
  • Plan Adjustments: Humana is still rolling out other 2027 offerings across a slightly narrower geographic footprint.
  • Action Period: Affected members are receiving non-renewal notices and can choose a new plan during Medicare's annual enrollment period from October 15 through December 7.

What is the latest news on Humana Medicare Advantage plans?

Humana announced details on its 2027 Medicare Advantage Plans while simultaneously cutting lower-profitability plans affecting about 600,000 members.

Plan Adjustments and Exits

  • Membership Impact: Roughly 600,000 members are targeted by nonrenewal notices for 2027 as Humana drops 3.5-star or lower lower-profitability plans.
  • Geographic Reach: Humana's 2027 coverage will contract to reach just over 80% of U.S. counties (about 2,600 counties across 45 states and D.C.), down from 85%.
  • Retention Strategy: Humana expects to retain about 40% of affected members internally, leaving around 240,000 to 360,000 individuals needing to select a new insurer or switch to Original Medicare.

2027 Offerings and Benefits

  • Core Benefits: Humana Expands Medicare Advantage Options For 2027 to include $0 or low monthly premiums, $0 in-network routine lab services, and $0 copays for eligible primary care visits and hundreds of prescription drugs.
  • Specialized Care: Expanding Chronic Condition Special Needs Plans (C-SNPs) into Pennsylvania, Utah, and Wisconsin.
  • Supplemental Care: Dental, vision, and hearing coverage remain available across plan offerings.

Important Deadlines

  • Notice of Change: Members facing cancellations or changes should receive their Annual Notice of Change letters in the mail.
  • Open Enrollment: Medicare's annual open enrollment runs from October 15 through December 7, 2026.
  • Special Rights: Involuntary plan terminations trigger a special enrollment period and federal guaranteed-issue rights to buy a Medigap policy without medical underwriting.

What company has the highest rated Medicare Advantage plan?

Kaiser Permanente and Alignment Healthcare rank highest for star ratings, with 100% of their members in plans rated four stars or higher.

Top-Rated National Companies

  • Kaiser Permanente: Achieves top marks with 100% of members in 4+ star plans, though its availability is limited to select states.
  • Alignment Healthcare: Also ties at 100% for members in highly rated plans, but operates in a smaller number of states.
  • Aetna Medicare: Leads among major national carriers with wide availability, having over 81% of members in plans rated 4 stars or higher.
  • UnitedHealthcare: Follows closely, with 78% of its members in 4+ star plans and the largest nationwide provider network.

Ratings vary significantly by location, and specific plan performance depends heavily on your local county and ZIP code. You can check specific plan quality using the Official Medicare Plan Finder.

What companies are discontinuing Medicare Advantage plans?

Major national and regional health insurers are scaling back or discontinuing specific Medicare Advantage plans for the 2027 plan year due to rising medical costs, increased healthcare utilization, and tighter profit margins.

Major National Insurers Cutting Plans

  • Humana: The second-largest Medicare Advantage insurer is culling roughly 2,400 plans, cutting coverage that affects approximately 600,000 members.
  • UnitedHealthcare: The nation's largest provider is eliminating about 690 individual plans, impacting nearly 390,000 members through targeted exits and reduced offerings.
  • CVS Health (Aetna): Shrinking its footprint and shifting toward more limited provider networks.
  • Centene: Paring back thousands of unique plan options across multiple regional markets.
  • Molina Healthcare: Exiting the individual Medicare Advantage market to focus strictly on Dual Eligible Special Needs Plans.
  • Clear Spring Health: Exiting the Medicare Advantage market entirely across its Colorado, Georgia, and Illinois footprints.

Regional and Health System-Owned Exits

As part of a broader restructuring of Medicare offerings, roughly a dozen parent companies and health system-affiliated insurers are completely exiting the Medicare Advantage market or dropping specific regional operations for 2027:

  • Blue Cross and Blue Shield of Minnesota: Overhauling and discontinuing most current plans at the end of 2026.
  • HealthPartners: Discontinuing select plans and leaving seven Minnesota counties.
  • Other regional exits include Providence Health Plan, Aspirus Health Plan, Christus Health Plan, Mass Advantage, Elderplan, and WellSense Health Plan. In addition, select Blue Cross plans in states like Wellmark, Mississippi, and North Dakota are dropping coverage.

Humana Just Cancelled 600,000 Medicare Plans: Are You Next?

9 related questions found

Are seniors going to lose their Medicare Advantage plans?

Yes, more than one million seniors will lose or face major changes to their Medicare Advantage plans for 2027 as major insurance companies scale back their footprint.

Why Plans Are Being Cut

According to an analysis by Healthcare Dive, insurers are reducing plan options to deal with high medical spending and rising care costs.

  • Humana is dropping plans that cover about 600,000 members.
  • UnitedHealth Group is discontinuing plans affecting roughly 390,000 members.
  • Other major providers, including CVS Health’s Aetna and Centene, are also reducing their plan offerings.
  • However, as noted by POLITICO, federal regulators maintain that the overall market remains broad, even as specific counties and options are trimmed. Additional details on these market retreats can be found via Yahoo Finance.

What You Should Do

  • Watch your mail: Affected members receive non-renewal notices or an Annual Notice of Change (ANOC) from their insurer.
  • Mark the dates: Medicare open enrollment runs from October 15 to December 7, 2026.
  • Check your options: You can pick a new Medicare Advantage plan or switch back to Original Medicare.

Which Humana Medicare Advantage plan is best?

The "best" Humana Medicare Advantage plan depends entirely on your specific location, medical needs, and budget, as plan availability and costs vary by county. However, according to evaluations by NerdWallet, Humana ranks as a top major provider for overall value, low or $0 monthly premiums, and strong extra benefits.

Key Humana Plan Options

  • HMO Plans: Best if you want lower monthly premiums and a primary care doctor to coordinate your care, though you must stay within Humana’s local network.
  • PPO Plans (HumanaChoice): Best if you want the flexibility to see out-of-network doctors without a referral, though they usually carry higher monthly costs.
  • Special Needs Plans (SNPs): Best if you have specific chronic conditions or qualify for both Medicare and Medicaid, offering tailored benefits and coordinated care.
  • Giveback Plans: Select Humana plans offer a Part B "giveback" benefit that helps lower or cover a portion of your standard Medicare Part B premium.

Public Sentiment and Considerations

  • Most users on Reddit agree that while Medicare Advantage plans like Humana offer attractive zero-dollar premiums and extra perks (like dental and vision), private insurer networks and pre-authorization rules can sometimes lead to denied or delayed care.

What are the changes to Humana's Medicare Advantage plans in 2026?

Humana's 2026 Medicare Advantage plans focus on benefit stability, expanded chronic condition support, and broader geographic availability across 46 states and Washington, D.C.

Key 2026 Plan Updates and Changes

  • Stable Benefits for Most: Over 80% of Humana Medicare Advantage members remain in plans featuring stable, consistent benefits, including $0 routine preventive and diagnostic screenings (such as mammograms and colonoscopies).
  • New Kidney and End-Stage Renal Support: Humana is introducing specialized benefits for members with End-Stage Renal Disease or chronic kidney conditions on specific non-special needs plans in North Carolina, Oklahoma, Texas, and Virginia. This includes $0 or low in-network dialysis copays and coordinated transportation.
  • Special Needs Plans (SNP) Expansion: Dual-eligible Special Needs Plans (D-SNPs) are expanding into Illinois, while Chronic Condition Special Needs Plans (C-SNPs) are expanding into Idaho, Maine, and New Jersey. New plan options also roll out across 177 new counties.
  • Standard Core Extras: All 2026 plans continue to bundle routine dental, vision, and hearing coverage, alongside $0 in-network primary care provider (PCP) visits and preventive vaccines on many plans.
  • Group Plan Separation: Certain group plans (such as the State Health Plan Humana Group Medicare Advantage PPO) split medical and prescription coverage into two separate cards and administrative paths, with a pharmacy maximum out-of-pocket adjustment to $2,100.
  • Future Plan Reductions: Note that Humana announced upcoming Medicare Advantage plan exits set to affect roughly 600,000 members moving into 2027 as part of a profitability adjustment, making it especially important to review current annual notices of change.

Which is better, UnitedHealthcare or Humana for Medicare?

Neither UnitedHealthcare nor Humana is universally better, as the right choice depends entirely on your local zip code, specific medical needs, and budget.

UnitedHealthcare Overview

  • Network: Features a massive national provider network, often co-branded with AARP.
  • Ratings: Generally earns higher quality ratings from the Centers for Medicare & Medicaid Services (CMS).
  • App/Tools: Offers robust health and reward programs with highly rated mobile apps.
  • Downside: Customer satisfaction scores can lag behind competitors in certain regions.

Humana Overview

  • Cost: Widely praised for low monthly premiums, competitive drug costs, and popular wellness perks like SilverSneakers.
  • Focus: Specializes heavily in government-sponsored healthcare and preventive care.
  • Downside: Overall CMS quality ratings are sometimes lower than UnitedHealthcare's.

Key Factors to Compare

  • Availability: Plan options, costs, and availability change drastically by county.
  • Doctors: Check if your specific doctors and local hospitals accept the exact plan network.
  • Prescriptions: Verify whether your specific medications are covered under the plan's formulary.

Is it better to have straight Medicare or a Medicare Advantage plan?

Neither option is universally "better"; Original Medicare (straight Medicare) and Medicare Advantage suit different health needs, budgets, and preferences.

To decide which is right for you, compare how each option handles key factors:

Original Medicare (Parts A and B)

  • Doctor Choice: You can see any doctor or go to any hospital in the U.S. that accepts Medicare. You do not need referrals to see specialists.
  • Approvals: You rarely need prior authorization or permission from an insurance company for tests or treatments.
  • Costs: It does not have an annual out-of-pocket maximum unless you buy a separate Medigap (Medicare Supplement) policy.
  • Extras: It does not cover prescription drugs (you need a separate Part D plan) or routine dental, vision, and hearing.

Medicare Advantage (Part C)

  • All-in-One Bundles: These private plans combine Part A, Part B, and usually Part D (prescription drugs), often with low or zero monthly premiums.
  • Extra Benefits: They frequently include routine dental, vision, hearing, and gym memberships.
  • Financial Protection: They include a mandatory annual out-of-pocket spending cap (capped at $9,250 for in-network care).
  • Restrictions: You are usually limited to local provider networks (like HMOs or PPOs), and you may need referrals or prior authorization for care.

Which Should You Choose?

  • Choose Original Medicare (with Medigap) if you travel often within the U.S., want the freedom to see any specialist without a referral, and prefer predictable medical bills with fewer coverage denials.
  • Choose Medicare Advantage if you want lower monthly premiums, extra perks like dental or vision care, and a hard cap on your yearly out-of-pocket costs, and you are comfortable using a specific local network of doctors.

You can compare specific local options using the official Medicare Plan Finder.