Being Forced Out of a Medicare Advantage Plan Was a 1% Event for Years. In 2026 It Hit 10%. The 2027 Letters Must Arrive by October 2.

Medicare mail has a way of blending into the pile, even when it carries a hard deadline. A plan nonrenewal notice must reach the member by October 2, 2026. When a Medicare Advantage insurer decides not to offer its plan in 2027, federal rules require 90 days’ notice before coverage ends on December 31. The envelope looks routine. The decision it forces is anything but.

For most of the last decade, relatively few members ever received one. Researchers from the Johns Hopkins Bloomberg School of Public Health and Georgetown University reported in JAMA that forced Medicare Advantage disenrollment averaged about 1% annually from 2018 through 2024. The rate jumped to 6.9% in 2025, then reached roughly 10%, or 2.9 million people, in 2026. Among non-special needs plans specifically, the 2026 rate hit 12.4%.

The national figure conceals much sharper local disruption. In Vermont, 92.2% of Advantage members were forced to find new coverage. Twelve states had rates above 20%, and seven exceeded 40%. Rural beneficiaries faced forced exits at roughly twice the rate of urban members.

The pattern is not slowing. For the 2027 plan year, UnitedHealthcare confirmed it is discontinuing plans covering approximately 390,000 members, while Humana announced targeted exits affecting roughly 600,000 enrollees. Aetna and Centene are also pulling back on their Advantage footprints, according to analysts reviewing government data. Together, the two largest confirmed exits alone will send nonrenewal notices to more than one million seniors this October. A letter that was once an outlier has become part of Medicare planning for millions of households, and the 2027 cycle suggests that reality is not changing anytime soon.

The Door the Letter Reopens

A plan nonrenewal creates two separate protections. Medicare provides a Special Enrollment Period (SEP) from December 8 through the final day of February. Members who return to Original Medicare also receive a federal guaranteed-issue right to buy certain Medigap policies without medical underwriting. That means no denial and no higher premium because of diabetes, a cancer history, or another pre-existing condition. For someone who passed the initial six-month Medigap open enrollment window years ago, this may be one of the few remaining moments when health history cannot block access to a supplement.

The application period begins 60 days before the Advantage coverage ends and continues for 63 days afterward. Plans A, B, C, D, F, G, K and L may be available, although eligibility for Plans C and F depends on when the person first became eligible for Medicare. Medigap coverage cannot begin until the Advantage plan ends. One important distinction: this guaranteed-issue protection applies only when the member returns to Original Medicare, not when they select another Advantage plan. Choosing a familiar replacement without first pricing Medigap can let a rare opportunity slip by.

Two Paths, Two Different Risks

One path is another Advantage plan. The additional monthly premium may still be $0, but the provider network, drug formulary, and prior-authorization rules can all change. In 2026, the federal ceiling on a Medicare Advantage plan’s in-network medical out-of-pocket maximum is $9,250. Part D drug spending and some out-of-network care sit outside that ceiling. The other path is Original Medicare paired with Medigap and a standalone Part D plan. The standard $202.90 Part B premium applies under either structure. The additional cost difference comes down to Medigap and Part D premiums.

Plan G premiums commonly run around $150 to $250 a month, though age, location, tobacco use, carrier, and rating method can push the quote outside that range. After the $283 Part B deductible, Plan G covers most Part A and Part B cost-sharing. That protection includes the $1,736 Part A hospital deductible, $434 daily hospital coinsurance for days 61 through 90, and $217 daily skilled-nursing coinsurance for days 21 through 100. Prescription drugs, dental care, and other services Original Medicare does not cover remain separate expenses.

Advantage may cost less during a healthy year. Original Medicare with Plan G tends to deliver more predictable medical spending and broader provider access when serious illness arrives. Neither structure wins automatically. The termination notice matters because it creates a window to compare both options while Medigap underwriting is temporarily off the table.

Income and IRMAA Still Apply

The income-related monthly adjustment amount (IRMAA) applies under either structure. In 2026, it begins above modified adjusted gross income (MAGI) of $109,000 for a single filer or $218,000 for a couple filing jointly. At the first tier, IRMAA adds $81.20 a month to Part B and $14.50 to Part D. At the top tier, the monthly additions reach $487 and $91. MAGI is adjusted gross income plus tax-exempt interest, and Medicare generally uses tax information from two years earlier, meaning a 2024 return determines the 2026 surcharge. These surcharges are one of several premium traps covered in a free Medicare guide.

The Envelope Please

Before enrolling anywhere, three details deserve attention:

1. Save the nonrenewal notice and confirm the coverage end date. The letter may be needed to prove the guaranteed-issue right when applying for Medigap.
2. Price Original Medicare, the available Medigap policies, and Part D together before selecting another Advantage plan. The protected application period begins before the old coverage ends.
3. Compare any replacement plan’s doctors, prescriptions, authorization rules, and annual spending limit. A familiar carrier name does not mean the coverage stayed familiar.

When forced exits were a 1% event, few members had reason to know this rule existed. At 10%, and with another million-plus nonrenewal letters now in the mail for 2027, the October notice is no longer administrative clutter. It is a temporary chance to choose a new coverage structure while health history stays out of the equation.

Editor’s note: This article has been updated to add Georgetown University as a co-author of the JAMA research alongside Johns Hopkins, to include the 12.4% forced disenrollment rate among non-special needs plans in 2026, and to incorporate new reporting that UnitedHealthcare and Humana together sent nonrenewal notices to more than one million Medicare Advantage members for the 2027 plan year, with Aetna and Centene also reducing their Advantage footprints.

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