25 Health Systems Drop Medicare Advantage Contracts in 2026, Impacting Enrollees
In 2026, at least 25 health systems have terminated or narrowed their contracts with Medicare Advantage (MA) plans. This shift is leaving many enrollees without access to previously covered providers and the cost protections they expected from MA coverage. Hospitals are citing slow reimbursement rates, payment disputes, prior-authorization requirements, and administrative burdens as key reasons for exiting these agreements. The loss of in-network care can significantly increase out-of-pocket costs for patients. The 2026 federal maximum allowable out-of-pocket limit is $9,250 for in-network MA plans and up to $13,900 for PPOs—though neither includes Part D drug expenses, which could add an additional $2,100 annually. Patients who thought they had a financial safety net may now face unexpected costs if their providers leave the network. Enrollees are advised to carefully consider switching back to Original Medicare and purchasing Medigap coverage before canceling MA plans. However, this transition is not without risks—Medigap applications can be denied based on health status or state-specific rules.
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Topics: health systems exit contracts Medicare Advantage provider access loss retiree financial planning