At least four Medicare Advantage insurers have now confirmed they are pulling back from parts of the market for the 2027 plan year, and industry trackers expect that list to keep growing before enrollment season arrives. The retreats take different shapes — a full state-by-state withdrawal here, a single discontinued product line there — but the driver behind each one is the same: medical costs are climbing faster than what the federal government pays insurers to cover older Americans. For anyone enrolled in Medicare Advantage, checking whether a plan’s insurer is on the retreating list is no longer optional homework.
Four insurers, four different ways of shrinking
Becker’s Payer Issues has been tracking the 2027 exits as they’re announced, and as of early August the list includes four confirmed retreats. Humana will exit plans covering roughly 600,000 members. Clear Spring Health fully departed the Medicare Advantage market on June 1, discontinuing its Illinois, Georgia, and Colorado businesses after enrolling more than 12,000 members as of April. Molina Healthcare will stop offering its Medicare Advantage Part D product in 2027, narrowing its focus to dual-eligible coverage instead. And Albuquerque-based Presbyterian Health Plan will discontinue most of its Medicare Advantage plans in 2027, a move affecting about 30,000 members and triggering layoffs of roughly 150 workers. No single company is driving the pattern — the retreat is showing up across insurers of very different sizes.
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The rate gap forcing insurers to choose between markets
The Centers for Medicare and Medicaid Services finalized an average 2.48% Medicare Advantage payment increase for 2027, a rate more than 100 industry and provider groups argued was too small to keep plans from losing money as enrollee medical spending keeps rising. Faced with that gap, insurers submitted their 2027 bids in June and are now choosing between eating the losses, thinning benefits everywhere, or exiting the markets where they cannot offer competitive coverage profitably. That third option is what’s showing up in the announcements from Humana, Clear Spring Health, Molina, and Presbyterian — each company effectively deciding it would rather leave a region or product line than keep losing money in it.
The 2.48% headline rate is only part of the squeeze. CMS’s separate risk-adjustment model, known as V28, finished a three-year phase-in with the 2026 payment year — the formula that converts an enrollee’s diagnoses into a payment score shifted from a 67%/33% blend of the old and new models in 2024, to 33%/67% in 2025, to 100% V28 in 2026, a change CMS itself projected would cut industry-wide risk scores and, with them, billions of dollars in Medicare Trust Fund payments to plans. Insurers building their 2027 bids this summer were absorbing that fully phased-in cut on top of the thin base-rate increase, which is part of why the same companies exiting markets have also been trimming supplemental benefits like dental, vision, and over-the-counter allowances for the members they keep.
A newly finalized CMS rule adds a second pressure point
Beyond the payment math, CMS finalized a separate 2027 Medicare Advantage and Part D rule on April 2, 2026, effective June 1 and applying to coverage beginning in 2027, that reworks how plans earn their Star Ratings — the same ratings that determine which plans qualify for bonus payments. The rule strips 11 measures CMS characterized as administrative or too uniform to matter to enrollees, adds a new depression-screening measure, and drops a health-equity bonus factor the prior administration had planned to phase in starting with 2027 ratings, keeping the older “historical reward factor” formula instead. CMS estimates the Star Ratings changes alone will move $18.6 billion through the Medicare Trust Fund between 2027 and 2036 — about 0.21% of total Medicare Advantage payments — money that shifts unevenly toward plans that already score well and away from lower-rated ones. A plan losing bonus dollars to a ratings recalibration, on top of a compressed base rate and a fully phased-in risk model, has one more reason to conclude a market isn’t worth defending going into 2027.
One in ten Medicare Advantage members already had to switch once
This is not a new pattern for the program. A study published in JAMA found that 10% of Medicare Advantage enrollees had to disenroll from their plan heading into 2026 because their insurer exited the market. The good news buried in that number: research from KFF found that nearly all Medicare Advantage beneficiaries whose plans were cut still had at least one other Medicare Advantage option available where they lived for 2026. The 2027 wave is expected to follow the same shape — real disruption for a meaningful share of enrollees, but rarely a total loss of Medicare Advantage access in a given county.
Who tends to gain when the national carriers pull back
The exits are reshuffling market share as much as they’re shrinking it. During the last annual enrollment period, UnitedHealthcare’s Medicare Advantage membership fell about 9% and Elevance Health’s fell 14%, while smaller, regional insurers posted record enrollment gains by comparison. Health-system-owned plans, which typically operate in a narrower geographic footprint with tighter cost control over their own hospitals and doctors, have positioned themselves as a landing spot for members whose national-carrier plan disappears. That doesn’t guarantee a smooth transition — a regional plan may not include a member’s existing specialists — but it means the retreat of the big four carriers isn’t simply shrinking the number of choices available everywhere.
Checking a plan’s status before the letter arrives
Members won’t get official confirmation of which specific plans are gone until insurers publish their 2027 offerings this fall, ahead of Medicare’s Open Enrollment period, which runs October 15 through December 7 with changes taking effect January 1. Anyone currently enrolled with Humana, Clear Spring Health, Molina, or Presbyterian has a specific reason to watch the mail closely this fall rather than assuming a renewal notice will show up automatically — and anyone with a different insurer should treat the pattern as a reminder that plan continuity is never guaranteed a year in advance.
This article was researched and drafted with the assistance of AI and reviewed by The Financial Wire editorial team.
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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.
