A wave of Medicare Advantage plan exits pushed roughly 2.9 million enrollees out of their coverage in 2026, a disenrollment rate near 10 percent that Johns Hopkins researchers found was roughly ten times the historical average. In Vermont, about 92 percent of Advantage members were forced to find new coverage, matching the nine-in-ten scale now circulating as insurers finalize which plans survive into 2027. For anyone opening a similar nonrenewal notice this fall, last year’s numbers, and the enrollment rights that came with them, show what a forced switch can mean for premiums, provider access and the choice that follows.
From a 1 Percent Event to 2.9 Million in a Single Year
For most of the last decade, an involuntary Medicare Advantage exit was rare. Researchers at the Johns Hopkins Bloomberg School of Public Health found that forced disenrollment averaged about 1 percent of Medicare Advantage enrollees annually from 2018 through 2024, then jumped to 6.9 percent in 2025 and reached roughly 10 percent, or 2.9 million people, in 2026. The same insurers now sending 2027 nonrenewal letters are working under a federal rule that requires 90 days’ notice before a plan’s coverage ends on December 31, which is why this year’s letters must reach members by October 2, 2026.
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Vermont's 92 Percent and the Insurers Behind the Exodus
The national figure understates how uneven the disruption has been. In seven states, more than 40 percent of Medicare Advantage enrollees were left to find new coverage in 2026, led by Vermont at 92 percent, followed by Idaho, Wyoming, North Dakota, South Dakota, Maryland and New Hampshire; twelve states saw disruption rates above 20 percent, and rural beneficiaries were forced out at roughly twice the rate of members in cities and suburbs. Enrollees of smaller insurance carriers accounted for half of the disruptions nationally, while UnitedHealthcare accounted for nearly 14 percent, Aetna about 8.65 percent and Elevance about 8 percent, after all three reported cost pressures in 2025 and pulled back or reshaped their Advantage markets for 2026. RAND policy researcher Hannah James, writing in an editorial that accompanied the study, said the pattern raises the question of whether the current payment design “adequately aligns plan incentives with beneficiary needs.”
The Enrollment Window a Nonrenewal Letter Opens
A plan’s nonrenewal carries its own timeline. Medicare’s rules give affected members a Special Enrollment Period running from December 8 through the last day of February to move into another Medicare Advantage plan, a stand-alone drug plan, or Original Medicare. Members who choose Original Medicare during that window also gain a federal guaranteed-issue right to buy a Medigap policy without medical underwriting, meaning no application can be denied or priced higher because of a pre-existing condition such as diabetes or a cancer history. That application period begins 60 days before the old Advantage coverage ends and continues for 63 days afterward, and eligible members may choose from Medigap Plans A, B, C, D, F, G, K and L, though eligibility for Plans C and F depends on when someone first qualified for Medicare. The guaranteed-issue right does not follow someone who instead re-enrolls in another Advantage plan, and it cannot be used again once this application period closes.
Two Different Costs to Compare Before Choosing
The decision facing a nonrenewed member splits into two different cost structures, not one automatically cheaper option. A replacement Advantage plan can carry a different provider network, drug formulary and prior-authorization rules than the one it replaces, and its in-network medical out-of-pocket maximum can run as high as $9,250 for 2026. Original Medicare paired with a Medigap Plan G policy spreads costs differently: premiums commonly run $150 to $250 a month, and after a $283 Part B deductible, the policy covers most remaining Part A and Part B cost-sharing, including a $1,736 Part A hospital deductible and daily coinsurance on longer hospital or skilled-nursing stays. Prescription drugs, dental care and other services outside Original Medicare’s coverage remain separate expenses under either path, and an income-related surcharge on Part B and Part D premiums applies under either structure for higher-income households, based on tax return information from two years earlier.
What the Letter Is Worth Keeping
None of this changes what a member does with the notice once it arrives. It still documents the date coverage ends, and for someone who chooses Original Medicare, it is the evidence a Medigap insurer will ask to see when a guaranteed-issue application is filed. The forced-exit rate behind this year’s letters was a 1-percent-a-year rarity for most of the past decade before Johns Hopkins researchers clocked it at roughly 10 percent in 2026; the temporary right the letter unlocks is rarer still, and it closes on its own schedule whether or not it gets used.
What a Forced Switch Leaves Unhandled
A forced plan switch often reopens the cost conversation before it reopens coverage, since a new Advantage plan or a return to Original Medicare can carry a different premium, deductible and drug list. Two programs sit beside that decision that a nonrenewal letter never mentions: Medicare Savings Programs, which can lower Part B costs for those who qualify, and Extra Help, which lowers Part D drug spending. Both remain opt-in, no agency notice invites enrollment, and participation among eligible older households stays low.
It is a 69-page guide covering eleven programs, laying out the 2026 income limits and the phone number to call in every state.
See the full list and the 2026 income limits in The Benefits Checklist.
This report was produced with AI assistance and checked against its sources before publishing.
David M. Keller is a finance writer based in Columbus, Ohio, covering personal finance and consumer-focused economic topics. He earned his degree in journalism from Ohio University and began his career reporting on local business and economic trends for a regional media outlet. Since then, he has contributed to a variety of online publications, focusing on clear, practical coverage of topics such as cost of living, debt, and everyday financial decision-making.
