Medicare Plan Terminations Hit 4.3 Million as Part D Market Shrinks

Approximately 4.3 million Medicare beneficiaries will have their plans terminated at the end of 2026—including 3.1 million Medicare Advantage (MA) prescription drug plan (MA-PD) enrollees and 1.2 million stand-alone prescription drug plan (PDP) enrollees—according to a recent analysis from KFF.¹

KFF’s count includes enrollees in plans leaving specific counties, not just plans ending entirely, and is based on June 2026 enrollment.

Share of Stand-Alone PDP Enrollees Facing Termination Doubles

Among PDP enrollees, about 1.2 million will have their plans terminated by the end of the year, equating to 6% of all PDP enrollees—double the share affected last year (3%).¹ Most of these enrollees (81%, or 950,000) are in CVS Health's SilverScript Choice PDP, which is being terminated in 13 PDP regions, and another 190,000 (16%) are in Health Care Service Corporation's HealthSpring Extra Rx, which is being terminated in 16 regions.¹

Last year's PDP exits and reductions were attributed to the Inflation Reduction Act's Part D redesign, which shifted more liability for high-cost enrollees onto plans and to insurers leaning more on MA-PDs, which tend to be more lucrative.^2,3 For 2027, KFF links uncertainty about PDP premiums and plan availability to the administration's decision to end the Part D Premium Stabilization Demonstration, a temporary program that subsidized stand-alone plan premiums, 1 year early.^1,3 The average Medicare beneficiary will have 9 PDPs to choose from in 2027, down from 11 in 2026.¹

Despite the reduction, Centene, a major PDP sponsor still in the market, reported PDP membership growth in its third-quarter (Q3) earnings, although it discontinued 1 of its 3 Wellcare PDP options for 2026.^2,5 Centene's PDP membership increased 12.2%, from 7,972,500 as of September 30, 2025, to 8,947,200 as of September 30, 2026. The company credited premium yield and membership growth in its PDP business as part of what drove its Q3 premium and service revenues, which totaled $45.1 billion.⁵

Medicare Advantage Terminations Concentrated Among 4 Insurers

The 2.8 million individual MA-PD enrollees whose plans are being terminated account for 14% of all enrollees in MA-PDs available for general enrollment; an additional 300,000 are in special needs plans (SNPs).¹ Four parent organizations account for half of the enrollees losing their individual MA-PD plan: Humana, Inc. (19%, or 530,000 enrollees), UnitedHealth Group (13%, or 367,000 enrollees), CVS Health Corporation (9%, or 254,000 enrollees), and Aware Integrated, Inc., which sold Blue Cross–branded plans in Minnesota (9%, or 249,000 enrollees).¹

Neither Centene nor Elevance Health was among the 4 parent organizations KFF identified, but both reported year-over-year declines in Medicare membership in the third quarter. These results reflect the 2026 plan year, not the 2027 terminations. Centene’s Medicare membership, which includes MA, Medicare Supplement, and integrated plans, fell about 6% compared with Q3 2025.⁵ Elevance’s MA membership fell 15.5%, to about 1.9 million from 2.2 million, even as its operating revenue rose $0.4 billion on higher premium yields, CarelonRx product revenue, and service fees.⁶

Coverage Options for Enrollees in Terminated or Consolidated Plans

MA-PD enrollees whose plans are being terminated must enroll in another MA plan, if one is available in their area, or they will be switched automatically to traditional Medicare.¹ They also qualify for a special enrollment period for Medigap with guaranteed issue rights, meaning they cannot be denied a Medigap policy or charged more due to a preexisting condition. Medigap is supplemental coverage that helps pay out-of-pocket costs not covered by traditional Medicare.¹

PDP enrollees whose plans are being terminated will need to choose either a new stand-alone PDP or switch to an MA-PD if they want continued coverage under Medicare Part D.¹

Another group of Medicare beneficiaries will be affected by these changes without having their plan terminated. Approximately 1.4 million MA enrollees are in a plan that will be consolidated with another plan offered by the same insurer, and they will be moved automatically to that plan. This includes 500,000 MA enrollees in plans available for general enrollment and about 900,000 in SNPs.¹ Many of the SNP consolidations stem from a new requirement that, starting in January 2027, insurers that offer a dual eligible special needs plan (D-SNP) and an affiliated Medicaid managed care plan in the same county may generally offer only 1 D-SNP for full-benefit dual-eligible individuals.¹

These beneficiaries can choose a different MA plan during open enrollment. However, if they switch to traditional Medicare, they would not have federal guaranteed issue rights if they also chose to purchase a Medigap policy.¹ KFF notes this is less consequential for dual-eligible individuals because state Medicaid programs cover their Medicare premiums and, in many cases, cost sharing.¹

The average beneficiary will have 9 PDPs to choose from in 2027, down from 11 in 2026, though Centene, which remains in the market, reported PDP membership growth.

References

1. Biniek JF, Freed M, Ochieng N, Cubanski J. More than 4 million Medicare beneficiaries will have their Medicare Advantage or stand-alone prescription drug plan terminated at the end of 2026. KFF. October 27, 2026. Accessed October 27, 2026. https://www.kff.org/medicare/more-than-4-million-medicare-beneficiaries-will-have-their-medicare-advantage-or-stand-alone-prescription-drug-plan-terminated-at-the-end-of-2026/

2. Cubanski J. Medicare Part D premiums are decreasing for many stand-alone drug plans in a number of states in 2026. KFF. October 7, 2025. Accessed October 27, 2026. https://www.kff.org/medicare/medicare-part-d-premiums-are-decreasing-for-many-stand-alone-drug-plans-in-a-number-of-states-in-2026/

3. Minemyer P. Stable premiums, plan exits: a look at the current state of Medicare Part D. Fierce Healthcare. October 7, 2025. Accessed October 27, 2026. https://www.fiercehealthcare.com/payers/stable-premiums-plan-exits-look-current-state-medicare-part-d

4. The Trump administration is reducing enhanced support for the Part D stand-alone drug plan market. KFF. July 28, 2025. Accessed October 27, 2026. https://www.kff.org/quick-insights/the-trump-administration-is-reducing-enhanced-support-for-the-part-d-stand-alone-drug-plan-market/

5. Centene Corporation reports third quarter 2026 results. News release. Centene Corporation. October 27, 2026. Accessed October 27, 2026. https://investors.centene.com/2026-10-27-CENTENE-CORPORATION-REPORTS-THIRD-QUARTER-2026-RESULTS

6. Elevance Health reports third quarter 2026 results; raises full-year guidance. News release. Elevance Health. October 21, 2026. Accessed October 27, 2026. https://www.sec.gov/Archives/edgar/data/1156039/000115603926000068/a3q2026elvearningsrelease.htm