What Happens If Your Medicare Advantage Plan Leaves Your County

Medicare advantage plan leaves county — and suddenly, millions of beneficiaries face a coverage decision they never expected. For 2025 alone, nearly 1.4 million Medicare Advantage enrollees were forced to find new coverage due to plan terminations. That number represented a 450% increase from the prior year.

Major insurers like UnitedHealthcare and Humana have pulled out of hundreds of counties nationwide. When your plan exits, you don’t lose Medicare. However, you must act within a limited window to avoid gaps in coverage. Understanding your rights, your timeline, and your options can protect both your health and your finances during this transition.

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Why Plans Leave and How Often It Happens

Medicare Advantage insurers reassess their service areas every year. They may exit counties where costs are rising faster than Medicare reimbursement rates. Consolidation, low enrollment, and regulatory changes also drive these decisions. For 2026, UnitedHealthcare exited 225 counties while Humana pulled out of 198. Both dropped from roughly 89% U.S. county coverage to around 80%. These are not small shifts.

When a medicare advantage plan leaves county coverage areas, the insurer must notify affected members at least 90 days before the termination date. For plans ending December 31, CMS requires that notice be dated by October 2. This gives you time to evaluate alternatives during the Annual Enrollment Period or through a Special Enrollment Period. Roughly 98.9% of affected enrollees still had at least one other Medicare Advantage option available in their county, according to KFF analysis.

What Happens When a Medicare Advantage Plan Leaves County Coverage

The moment your insurer confirms it is leaving, a Special Enrollment Period (SEP) activates. This window begins one month before your coverage ends and lasts two full months after the termination date. During this SEP, you can switch to another Medicare Advantage plan in your area. Alternatively, you can return to Original Medicare with Parts A and B.

If you take no action during the SEP, Medicare automatically moves you back to Original Medicare. Your hospital and medical coverage continues. Yet you would lose the bundled benefits that many Advantage plans include — dental, vision, hearing, and prescription drug coverage. To restore drug coverage, you would need a standalone Part D plan.

One critical protection activates when a medicare advantage plan leaves county boundaries. Federal law grants you Medigap guaranteed issue rights. Insurers must sell you a Medicare Supplement policy without denying coverage or charging more based on your health. This window opens 60 days before your plan ends and extends 63 days after. Keep your disenrollment notice as proof of eligibility.

Your Step-by-Step Action Plan

First, confirm the exit date. Check the notice from your insurer or log into your Medicare.gov account. Verify which plans still operate in your ZIP code using the Medicare Plan Finder tool. Compare premiums, provider networks, drug formularies, and star ratings carefully. A replacement Advantage plan may look similar but carry different cost-sharing rules.

Second, contact your local SHIP office. The State Health Insurance Assistance Program provides free, unbiased counseling with no sales agenda. SHIP counselors frequently discover that an insurer’s auto-assigned replacement plan is not the best fit. They help you compare all options — including Original Medicare plus a Medigap supplement. Every state has a SHIP office, and you can also reach them by calling 1-800-MEDICARE.

Third, consider whether Original Medicare plus Medigap makes sense long-term. If a medicare advantage plan leaves county coverage in your area repeatedly, switching to Original Medicare with a supplement policy offers stability. Medigap plans are standardized by letter (Plan G and Plan N are the most popular). They travel with you anywhere in the country. In contrast, Advantage plans can change networks, benefits, and service areas annually. For beneficiaries who value predictability, this combination often provides greater peace of mind.

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Frequently Asked Questions

Will I lose my Medicare coverage if my Medicare Advantage plan leaves my county?

No. You never lose Medicare itself. If your medicare advantage plan leaves county coverage and you take no action, you automatically return to Original Medicare Parts A and B. However, you would need to separately enroll in a Part D drug plan to maintain prescription coverage.

Can I be denied a Medigap policy after my plan exits?

No. Federal guaranteed issue rights protect you when your Advantage plan terminates or leaves your service area. Insurers cannot deny you coverage, charge higher premiums based on health conditions, or impose pre-existing condition waiting periods. Typically, this protection window lasts 63 days after your coverage ends. Companies like Mutual of Omaha, Aetna, and Cigna all must honor these rights.

How do I find out which Medicare Advantage plans are still available in my area?

Visit the Medicare Plan Finder at Medicare.gov and enter your ZIP code. As a result, you will see every Advantage plan, Part D plan, and Medigap policy available in your county. For personalized help, contact your state’s SHIP program or call 1-800-MEDICARE (1-800-633-4227).

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Content last reviewed June 2026. If you notice any outdated information, please contact us.

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