List of Insurers Tightening Their Medicare Advantage Networks Next Year - Newsweek

Medicare Advantage enrollees may have fewer choices of doctors and hospitals in 2027 as several major insurers are tightening their provider networks.

Health insurers are facing growing healthcare spending as well as higher prescription drug costs.

Lower government reimbursement rates for Medicare Advantage plans and smaller Medicare Advantage premiums in 2027 will likely mean that even as seniors see lower monthly costs, they’ll have less flexibility in choice of provider.

“For years, Med Advantage sales pitch was hard to resist. No premiums in many plans, plus dental, vision, hearing, fitness benefits and other goodies. Those benefits are real, but they were never free,” Michael Ryan, a finance expert and the founder of MichaelRyanMoney.com, told Newsweek.

“They have to fit inside the economics of the plan. And when medical costs and utilization rise, something eventually has to give.”

The Medicare Advantage program now covers about 34 million Americans and is now the more popular form of Medicare coverage for many seniors and people with disabilities.

But, according to Reuters, enrollment is expected to decline about 6 percent in 2027 based on insurer filings.

For beneficiaries, that means lower premiums and supplemental benefits may be on the way, but they’ll also have more restricted access to doctors and hospitals.

Major Medicare Advantage insurers UnitedHealthcare, Aetna and Humana have already announced changes to narrow provider networks or reduce the number of plans available in certain areas next year.

UnitedHealthcare, the nation's largest Medicare Advantage insurer, said it will scale back offerings in areas where it has a higher concentration of Preferred Provider Organization (PPO) plans. PPOs generally allow members to receive care outside their network, though often at a higher cost.

"We can't ignore the realities facing the healthcare system," UnitedHealthcare President Bobby Hunter said last week. "Funding pressures, rising medical costs, rising drug costs, and increased utilization are affecting every part of healthcare."

The insurer said 66 percent of its members will have access to both Health Maintenance Organization (HMO) and PPO options in 2027, down from 70 percent in 2026.

“The people most vulnerable to these changes are beneficiaries with established relationships with major hospital systems or other providers who may no longer be in-network, as keeping the same insurance card doesn’t necessarily mean keeping the same doctors,” Alex Beene, a financial literacy instructor at the University of Tennessee at Martin, told Newsweek.

CVS Health-owned Aetna is expanding its HMO offerings, which generally rely on smaller networks of healthcare providers and can be less expensive for insurers to operate.

The company is also reducing its geographic footprint. Next year, Aetna plans to offer Medicare Advantage coverage in 41 states, down from 43 states in 2026. That translates to roughly 950,000 fewer Aetna enrollees next year, according to Reuters.

“This reflects a larger shift in Medicare Advantage from insurers competing primarily for enrollment growth toward managing profitability as medical and prescription drug costs rise,” Beene said. “For beneficiaries, the number on the monthly premium matters, but the doctors, hospitals, drugs and out-of-pocket costs behind that number may matter significantly more.”

Humana is also reducing the reach of its Medicare Advantage offerings. The insurer said its plans will be available in more than 80 percent of U.S. counties in 2027, down from 85 percent in 2026.

“The most impacted will likely be rural communities at large, as they may be forced to travel longer distances to see an in-network provider. In many cases, those providers may reside in larger cities that are hours away,” Kevin Thompson, the CEO of 9i Capital Group and the host of the 9innings podcast, told Newsweek.

Insurers have repeatedly warned investors that Medicare Advantage costs have risen sharply over the past several years as seniors use more medical services and overall healthcare expenses increase.

Government reimbursement rates are an especially precarious issue, as insurers say they have not adequately kept pace with rising medical costs and how frequently seniors use certain services.

Due to this, many insurers are emphasizing HMO plans, which can be less expensive to administer because they rely on narrower networks of contracted providers.

“The people I'd worry about most are seniors who use the system the most. Like someone in cancer treatment, a retiree seeing several specialists, or someone who chose a PPO specifically for flexibility,” Ryan said. “A $0 premium isn't much of a bargain if your oncologist or hospital suddenly isn't in the network.”

The network changes do not necessarily mean beneficiaries will lose coverage. However, they could find that certain physicians, specialists or hospitals are no longer in-network under a chosen plan.

“As the government continues to reduce reimbursements, insurance companies will look for other ways to make up those costs as medical expenses continue to rise faster than reimbursements,” Thompson said. “Thus, you could foresee a reduction in the quality of care, certain doctors no longer being in network, and seniors having access to a smaller pool of doctors they may not be familiar with.”

Beneficiaries who want to keep seeing specific providers may need to carefully review their plan options during Medicare's annual open enrollment period, which runs from October 15 through December 7.

CMS said last month that average Medicare Advantage premiums are expected to fall to about $12 per month in 2027 from $14.37 in 2026.

The agency has also said more than 99 percent of Medicare beneficiaries should still have at least one Medicare Advantage plan available, while roughly 97 percent will have access to at least 10 plan choices.

“Seniors shouldn’t assume a lower Medicare Advantage premium means their coverage is becoming more affordable in 2027, but rather that some of the country’s largest insurers are controlling rising costs by narrowing provider networks and emphasizing HMOs over more flexible PPO plans,” Beene said.

Insurers will release more detailed plan information ahead of the Medicare open enrollment period.

Experts say Medicare Advantage members should generally review their Annual Notice of Change each year rather than automatically renewing their existing plan, especially when insurers announce network changes.

“You could see your doctor of 30 years quickly move out of your network, forcing you to rely on new doctors and build entirely new relationships,” Thompson said. “For seniors who have spent decades establishing trust with their physicians, that is not a small change.”

Newsweek’s reporters and editors used Martyn, our AI assistant, to produce this story. Learn more about Martyn here.

Contact Newsweek editors on this story: Jason Lemon and Gray R. Thomas