In the News: The New York Times on Rising Instability in Medicare Advantage, and the Seniors Paying the Price

As Medicare Advantage open enrollment gets underway, a front-page New York Times story documents what many seniors are already finding in their mailboxes: plans are disappearing, choices are shrinking, and costs are going up.

Millions of Seniors Forced to Switch Plans

According to an estimate from health technology firm Duos cited by the Times, roughly five million Medicare Advantage beneficiaries will have to switch plans for 2027 because their current coverage has been discontinued or is no longer offered in their county. Analysts told the Times this year’s disruption will likely exceed last year’s, which was already a record.

Rural Seniors Hit Hardest

The effects are hardest in rural America. Citing KFF data, the Times reports that 187 counties will have no Medicare Advantage plan at all in 2027, up from 118 this year. In Minnesota’s Crow Wing County, a local broker told the Times she is advising about 1,000 clients that they will need to move to traditional Medicare, buy a Medigap policy costing around $330 a month, and add a separate Part D drug plan. Those are costs many seniors on fixed incomes cannot easily absorb.

That matches what Better Medicare Alliance’s ongoing analysis with Avalere Health shows. Rural states that already had few options are losing a large share of them: Wyoming is down a third of its plans and Montana nearly as much. Nationwide, there will be 170 fewer plans available to most beneficiaries in 2027.

Higher Costs for Beneficiaries

Seniors who keep their coverage are also feeling the strain. The Times reports that supplemental benefits like dental care are being reduced. Meanwhile, an analysis by Avalere on behalf of BMA finds that the median out-of-pocket limit for general-enrollment plans will reach $6,600 in 2027. That is a 32% increase since 2024, and the limit is rising in 48 states and D.C.

The story is told through beneficiaries like Mick and Ann Kalber of Pahoa, Hawaii. Mick Kalber has a history of cancer and depends on a feeding tube, and the couple recently learned their Medicare Advantage plan is being discontinued. Asked whether they can afford higher premiums, Ann Kalber said: “No — but we can’t afford not to.”

Funding and Stability Make the Difference

BMA’s Senior Vice President of Public Affairs, Rebecca Buck, said this outcome is not inevitable:

“This doesn’t have to be the new normal, and it shouldn’t be. It all starts by fully funding Medicare Advantage and good stable policymaking.”

There is evidence for that. After CMS finalized a stronger 2027 payment update than it first proposed, average premiums fell. That shows what better funding can do. But there is more work to do to make up for years of underfunding and policy changes in Medicare Advantage — and seniors are absorbing the difference through plan exits and higher out-of-pocket costs.

More than 35 million Americans rely on Medicare Advantage. They deserve a program that is funded to meet their needs and policy they can count on from one year to the next.

Read the full story in The New York Times

Read more on Avalere’s initial analysis