Health systems cite slow reimbursements and administrative burdens as 25 drop Medicare Advantage contracts, raising costs for enrollees.
Twenty-five health systems have terminated or narrowed Medicare Advantage contracts for 2026, disrupting coverage for enrollees. The moves stem from disputes over reimbursement rates, prior-authorization requirements, and administrative burdens, according to industry reports.
Medicare Advantage plans cap out-of-pocket costs at $9,250 for in-network care and $13,900 for PPOs, but exclude Part D drug expenses, which can add up to $2,100 annually. Enrollees losing in-network providers face higher costs or forced plan changes during the annual enrollment period.
Affected beneficiaries are advised to apply for Medigap policies before canceling Medicare Advantage to avoid gaps in supplemental coverage. The trend reflects broader tensions between insurers and providers over payment terms and care management.