Humana Ends Certain Medicare Advantage Plans, Affecting 600,000 Members

Humana plans to discontinue certain Medicare Advantage plans by 2027, impacting around 600,000 members. This decision, shared during the company’s July 29 earnings call, aims to boost profitability by discontinuing lower-performing plans.

CFO Celeste Mellet mentioned that the company plans to regain a substantial portion of the affected members, similar to their actions in 2025. Although beneficiaries will retain their Medicare eligibility, if their plan is not renewed, they must select new coverage. Newsweek contacted Humana via email for additional comments.

Impact on Medicare Advantage Members

Humana ranks among the largest insurers in the nation offering Medicare Advantage plans. The 600,000-strong member base affected marks one of the most extensive plan changes anticipated for 2027.

Medicare Advantage plans often provide retirees a combination of doctor appointments, prescription drug coverage, and other benefits. Consequently, plan termination might necessitate changing healthcare providers, reviewing prescription drug coverage, or considering original Medicare.

Reasons for the Change

During the earnings call, executives noted their strategy would primarily target less profitable plans to enhance financial health. Drew Powers from Powers Financial Group highlighted that Medicare Advantage, run by for-profit insurers, operates to achieve profitability. Hence, policyholders may face plan discontinuation if profitability criteria are not met.

Humana indicated that certain affected members could explore other Medicare Advantage plans within the company. With a 40% recapture rate after previous plan exits in 2025, Humana anticipates retaining a large segment of these members, although options will vary by location.

Steps After Plan Discontinuation

Beneficiaries whose plans are discontinued will need to select new coverage for the approaching year. If they do not choose another plan, they will return to original Medicare. Kevin Thompson of 9i Capital Group stated that reduced competition within the industry could lead to price hikes or fewer plan options.

Members will receive Plan Non-Renewal Notices in October, detailing when their coverage will cease and guiding them on the next steps.

Enrollment and Decision Points

The Medicare Open Enrollment period runs from October 15 to December 7, allowing beneficiaries to change plans or adjust prescription drug coverage. These changes begin on January 1. If a plan is not renewed, a Special Enrollment Period runs from December 8 to the end of February.

Affected members should examine their options upon receiving non-renewal notices, determining whether to continue with a Medicare Advantage plan or revert to original Medicare, potentially coupled with a Medigap policy and standalone Part D drug plan.