The expansion of Special Needs Plans – now covering 21% of MA enrollees – offers a counter trend worth monitoring.
14 Health Systems Dropping Medicare Advantage Plans | 2026
Hospitals and health systems continue to sever ties with certain Medicare Advantage plans heading into 2026, citing persistent frustrations with prior authorization denials and slow reimbursement from insurers.
MA now covers more than half of the nation’s older adults, making these contract terminations increasingly consequential for patient access. Becker’s has tracked these decisions since 2023; our 2025 coverage is here.
— Becker’s Hospital Review, Jan. 2, 2026
UnitedHealth Reduced Hospitalizations for Nursing Home Seniors. Now It Faces Wrongful Death Claims
Three nursing home residents died because employees of the American healthcare giant UnitedHealth Group helped delay or deny them critical hospital care, two pending lawsuits and a complaint to state authorities have alleged.
The three cases involve a UnitedHealth partnership initiative that places medical staff from the company’s direct care unit, Optum, inside nursing homes to care for residents insured by the company’s insurance arm.
— The Guardian, Dec. 21, 2025
Humana Received $10.5M in Medicare Advantage Overpayments, OIG Audit Finds
Humana’s Louisiana business received at least $10.5 million in Medicare Advantage overpayments in 2017 and 2018, according to an audit report from HHS’ Office of Inspector General.
The audit, published in December, reviewed high-risk diagnosis codes including acute stroke, acute myocardial infarction, and several cancer categories. The agency found $553,049 in overpayments in its sample of 240 enrollee-years, which it used to estimate the health plan received at least $10.5 million in overpayments during the audit period.
Medical records did not support the submitted diagnosis codes for 218 of the 240 sampled cases.
— Becker’s Payer Issues, Dec. 17, 2025
Zing Health Sues CMS Over Medicare Advantage Contract Termination.
Medicare Advantage insurer Zing Health has filed a new lawsuit against HHS and CMS, alleging the agencies failed to remedy harms caused by its improper termination from the MA program last year.
The insurer filed the complaint Nov. 26 in the U.S. District Court for the District of Columbia. The lawsuit stems from CMS’s 2023 decision to terminate Zing’s Part D contract and impose sanctions barring the plan from marketing or enrolling new members over a period of six months. The termination was based on Zing receiving a 2.5-star rating for three consecutive years, falling below the required three-star threshold. Zing argued it should have received a three-star rating for 2024 under a proper application of CMS’s methodology.
— Becker’s Payer Issues, Dec. 3, 2025
BCBS Massachusetts Loses Medicare Advantage Star Ratings Challenge
Blue Cross and Blue Shield of Massachusetts has lost its legal challenge against CMS over the methodology used to calculate its 2025 Medicare Advantage star ratings.
In a Nov. 3 ruling from the U.S. District Court for the District of Columbia, Judge Trevor McFadden denied BCBSMA’s motion for summary judgment, effectively siding with CMS and closing the case.
— Becker’s Payer Issues, Nov. 5, 2025
Are Special Needs Plans the Backbone of Medicare Advantage?
Special needs plans are far from new, but they continue to hold promise as some insurers step back from Medicare Advantage.
One KFF analysis attributed about half of MA enrollment growth since 2024 to SNPs, with 21% of 2025 MA enrollees in these plans. UnitedHealthcare, Humana, Aetna and Centene have expanded their SNP offerings this open enrollment period, as well.
— Becker’s Payer Issues, Nov. 4, 2025
UnitedHealth Projects 1 Million-member Drop in Medicare Advantage Enrollment
UnitedHealth Group is projecting its Medicare Advantage enrollment will decrease by 1 million people in 2026.
That estimate is up from a 600,000-member decrease it projected in July. UnitedHealthcare CEO Tim Noel said on the company’s Oct. 28 earnings call that their plan for 2026 “reflects a conservative path focused on margin growth.”
— Becker’s Payer Issues, Oct. 29, 2025
Ballad Health Sues UnitedHealth Over Medicare Advantage Practices, Cites Post-Acute Care Denials.
Ballad Health has filed a federal lawsuit against UnitedHealth Group (NYSE: UNH) and its insurance arm, UnitedHealthcare, over Medicare Advantage practices, including practices related to beneficiaries’ post-acute care access.
Johnson City, Tennessee-based Ballad is a nonprofit health system that operates 19 hospitals in Tennessee and Virginia. The organization alleges that the United entities have “systematically abused and manipulated” the Medicare Advantage system, costing Ballad more than $65 million over the last five years.
— Skilled Nursing News, Oct. 22, 2025
40 Health Systems Dropping Medicare Advantage Plans | 2025
Medicare Advantage provides health coverage to more than half of the nation’s older adults, but some hospitals and health systems are opting to end or not renew contracts with some MA plans over administrative challenges. Here’s 40 health systems dropping Medicare Advantage plans:
— Becker’s Hospital Review, Nov. 26, 2025
Medicare Advantage Insurers Still in Retreat as Annual Enrollment Kicks Off.
Medicare Advantage has skyrocketed in popularity over the past decade, reeling in new members with zero-dollar premiums and generous benefits. But the rate of growth has slowed in recent years, and in 2026, there’s a decent chance enrollment will contract for the first time in 20 years.
It’s happening because private Medicare insurers are increasingly paring back both the number of plans they offer and the benefits within those plans. They say the cuts are necessary because members’ care has gotten more expensive. That means that when Medicare’s annual enrollment period starts Wednesday, beneficiaries will face tough choices and, in many cases, fewer of them.
— STAT, Oct. 13, 2025
Medicare Advantage to See Drop in Beneficiaries Next Year—Forecast
Medicare Advantage is set to experience a drop in beneficiaries next year, according to a new forecast by the Centers for Medicare & Medicaid Services.
While more seniors have enrolled in the private version of Medicare known as Medicare Advantage in recent years, enrollment is expected to decrease from 34.9 million in 2025 to 34 million next year.
— Newsweek, Oct. 6, 2025
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