Humana’s Decision to End Certain Medicare Advantage Plans
Humana plans to discontinue specific Medicare Advantage plans affecting about 600,000 members. This decision will prompt countless seniors to assess their healthcare coverage before 2027. The insurer aims to enhance profitability by discontinuing plans that perform poorly, instead of broad reductions in its overall Medicare Advantage program. Humana’s Chief Financial Officer, Celeste Mellet, stated during a July 29 earnings call that efforts would focus on regaining a substantial portion of this volume, as seen in 2025.
While those affected will maintain their Medicare eligibility, they must select new coverage if their current plans are not renewed. Newsweek sought comments from Humana via email.
Implications of the Plan Changes
As one of the largest Medicare Advantage insurers in the country, Humana’s plan modifications represent a significant change affecting 600,000 members among the largest announced for 2027. Medicare Advantage plans often combine access to healthcare providers, drug coverage, and additional benefits. As a result, plan discontinuations may require beneficiaries to change doctors, adjust drug coverage, or decide between Medicare Advantage and traditional Medicare.
Details and Reasons for the Plan Changes
During the earnings call, Humana indicated that targeted Medicare Advantage exits in 2027 will affect nearly 600,000 enrollees. Company leaders explained that plans targeted were less profitable, aligning with the company’s financial improvement strategies. Drew Powers, founder of Powers Financial Group in Illinois, noted the contrast between Medicare Advantage and original Medicare due to the profit-driven nature of private insurance. This motivation means policyholders may lose their plans if they are not deemed profitable for the insurer.
Humana has suggested that some affected members might continue with the company by enrolling in alternative Humana Medicare Advantage options. The insurer expects to achieve a recapture rate similar to over 40% following previous exits in 2025. This potential transition depends on individual coverage options, which vary by location.
Plan Discontinuation Procedures
When a Medicare Advantage plan is discontinued, beneficiaries do not lose Medicare coverage. Instead, they must select new coverage for the following calendar year. Without selecting another Medicare Advantage plan, individuals typically revert to original Medicare after their current plan expires.
Kevin Thompson, CEO of 9i Capital Group, discussed with Newsweek the industry’s likely consolidation amid plan exits. This could reduce competition and lead to higher prices or restricted plan offerings.
Members should expect formal Plan Non-Renewal Notices, typically arriving in October. These notices detail when coverage ends and inform about the next steps.
Key Enrollment Periods for Affected Members
The main enrollment window, Medicare Open Enrollment, runs from October 15 to December 7 annually. During this period, beneficiaries can change Medicare Advantage plans, return to original Medicare, or adjust prescription coverage. Changes generally take effect on January 1. If a Medicare Advantage plan is not renewed, individuals qualify for a Special Enrollment Period from December 8 to the last day of February.
Next Steps for Affected Members
Humana members affected will need to carefully review plan materials when non-renewal notices arrive. These documents will identify if a current plan is ending and what options are available. Many retirees will choose between enrolling in a new Medicare Advantage plan or reverting to original Medicare, possibly complemented by a Medigap policy and standalone Part D prescription drug coverage.
According to Thompson, Medicare reimbursements are decreasing; as economic considerations drive policy discussions, more plans might exit the market.
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