12 Medicare Advantage Carriers Are Exiting in 2027: A Playbook for Orphaned Clients
Twelve payers are leaving Medicare Advantage for 2027. Eight of them are owned fully or partly by health systems..
If your clients are with any of them, they need a new plan. Here's who's going and how we'd handle it.
The BCBS exits
Braven Health: 21 New Jersey counties
Wellmark: 98 Iowa counties and 43 South Dakota counties
BCBS Mississippi/Patrius: 26 Mississippi counties
BCBS North Dakota: 53 North Dakota counties
BCBS Michigan isn't leaving entirely, but it's exiting 65% of its current counties. That's the largest percentage cut of any carrier.
The health system exits
Christus: 36 Texas counties and 8 in New Mexico
Aspirus: 21 Wisconsin counties
Providence: 6 Oregon counties, 6 Washington counties and Orange County, CA
WellSense: 10 New Hampshire counties
Memorial Hermann: 6 Texas counties
Mass Advantage: Worcester County
Sharp: San Diego County
People in health system plans usually picked them for the hospital and the doctors. That makes these moves personal. Expect a lot of "can I keep my doctor?"
One More in New York
iCircle is also out. It ran a D-SNP in 14 New York counties. Those duals need a new home too.
The SNP-Only Carriers
Molina, Horizon BCBS NJ, Elderplan and Presbyterian will stay in MA only through SNPs.
Their non-SNP members need a new plan. Their SNP members may be able to stay, depending on the plan and their eligibility.
What's Staying Stable
Here's the good news. The national carriers are messaging stability for 2027.
Humana says members keep $0 in-network primary care visits and labs, plus dental, vision and hearing coverage. It's adding new $0 in-network routine labs and continuing $0 copays on hundreds of drugs on eligible plans, with $0 or low monthly premiums.
UnitedHealthcare says more than 94% of Medicare eligibles have access to a UHC Medicare plan. About 90% of those with MA access have a $0 premium option. It's offering $0 primary care, preventive care and Tier 1 drug copays for all members.
Elevance is taking a local approach built around community needs and provider relationships. Plan-dependent benefits include dental, vision, hearing, Rx, transportation and OTC. Many plans offer an Everyday Options Allowance.
Wellcare is focused on affordable Rx coverage. It has Spendables for eligible OTC, dental, vision and hearing expenses, plus new Brass and Amber dental options.
Benefits vary by plan and county. Always quote the actual plan in front of you.
The Playbook
Here's how we'd work it.
1. Find them. Pull every client with an exiting payer. Add anyone in BCBS Michigan's exited counties. Add non-SNP members with Molina, Horizon, Elderplan and Presbyterian.
2. Call first. Get to them before the termination letter confuses them. Tell them what's happening in plain words. Calm them down. Set the appointment.
3. Check doctors and drugs. That's the starting point for every move. Especially for health system plan members.
4. Shop MA where MA still works. Where other MA plans remain, compare networks, drug coverage and total cost. The nationals above are a good place to start.
5. Go medsupp and PDP where MA is gone or weak. 181 counties will have no MA plans in 2027. In those counties, and anywhere the remaining MA doesn't fit, a medsupp plus a standalone PDP is the route.
You've got PDP choices. Humana keeps three PDP options focused on budget, generic value or broad formulary. Wellcare has nationwide standalone Part D with two PDPs, Wellcare Classic and Value Script. UHC offers $0 Tier 1 copays at preferred pharmacies on its standalone PDPs.
6. Check the medsupp rules first. Before you quote medsupp, find out whether your client has guaranteed issue rights in their situation and their state. That decides which plans you can realistically offer.
7. Look at SNPs. If the client is dual eligible or has a qualifying chronic condition, a D-SNP or C-SNP may fit better than a standard MAPD.
8. Document everything. Every call, every comparison, every choice. It protects the client and it protects you.
Make it Personal
Orphaned clients didn't choose this. Their plan left them.
Treat it that way. Be patient. Be clear. Don't rush them into the first thing that quotes well..
Get them settled into the right coverage and you've got a client who sticks with you for a long time.
Got clients in exiting plans? We'll help you sort options county by county and get appointed where you need to be. Talk to us at BROCK.
Industry Insight
The immediate challenge is helping orphaned clients find new coverage.
The bigger story is understanding why so many Medicare Advantage carriers are exiting markets in the first place.
As Andrew Saul points out, Medicare Advantage may offer thousands of plans nationally, but enrollment is increasingly concentrated among a smaller number of large organizations. When one of those organizations exits counties, implements service area reductions, or changes strategy, the effects can ripple across entire communities of beneficiaries and agents.
Stay Ahead of the Changes
This year's carrier movements are only part of the story.
If you want more than headlines and carrier announcements, join us throughout the week:
Monday Medicare Market
Join Justin Brock and Andrew Saul live every Monday as they discuss:
2027 Medicare changes
Carrier exits
Service Area Reductions
Industry trends
Tuesday GPS Training
Learn how to identify the right opportunities and naviagte client conversations using Brock's GPS framework. The GPS process focuses on Medicare knowledge, health history, budge discussions, coverage reviews, and retirement conversations.
Wednesday Selling HDG to a SAR
Strategies for helping clients impacted by Service Area Reductions and evaluating High-Deductible Plan G opportunities.
Thursday Product + Carrier Highlights
A deeper dive into carrier opportunities and product positioning.
