Goodsurance
ES

Carriers & the market

At Least 25 Health Systems Have Dropped Medicare Advantage Contracts in 2026 as Open Enrollment Nears

From Mayo Clinic to Ohio State's medical center, a growing list of hospital systems has exited Medicare Advantage networks this year, citing prior authorization denials, payment disputes, and algorithm-driven claim rejections.

By the Goodsurance editorial teamJuly 31, 2026

A running tracker compiled by Becker's Hospital Review shows at least 25 major health systems terminated or declined to renew Medicare Advantage contracts in 2026, a number that climbed steadily through midyear. Named institutions include Mayo Clinic, which went out of network with most UnitedHealthcare and Humana Medicare Advantage plans at the start of 2026, and Ohio State University Wexner Medical Center, scheduled to leave Humana's network October 1, 2026.

Hospitals and health systems most often cite three pressures behind these departures: prior authorization denials that delay or block patient care, slow or disputed reimbursement from plans, and the administrative burden of algorithm-driven claims review that hospitals say generates inappropriate rejections. The trend follows a similar pattern from 2025, when approximately 40 health systems exited Medicare Advantage contracts.

25 major health systems have dropped Medicare Advantage contracts in 2026. Check your hospital's network status at medicare.gov before October 15.

For Medicare Advantage enrollees, a hospital's departure from their plan network can raise the cost of care substantially. Out-of-network facility charges count differently toward a member's annual out-of-pocket limit, and the effective ceiling for out-of-network care in many PPO plans is considerably higher than the in-network maximum.

With the Medicare Annual Enrollment Period opening October 15 and running through December 7, 2026, checking network status before that window opens is an important step. Medicare's Plan Finder tool at medicare.gov lets beneficiaries confirm whether their doctor, hospital, or specialist is in-network for any given plan. Members who find a preferred provider has left their current plan can use open enrollment to switch to one that still includes it.

In plain words

At least 25 big hospital systems stopped taking certain Medicare Advantage plans in 2026. That list includes Mayo Clinic and Ohio State University's medical center.

Hospitals say plans pay slowly and deny too many claims. When a hospital leaves your plan's network, you may pay much more for care there.

Open enrollment runs October 15 to December 7. Before then, go to medicare.gov and use Plan Finder to check if your doctor or hospital is still in your plan's network. If not, you can switch during open enrollment.

Source: Becker's Hospital Review
Read at the source →

More news

Other stories on what is moving in Medicare.

Carriers & the market

CVS Health Plans to Split Into Two Companies, Keeping Aetna and Caremark Together

The corporate parent of one of the largest Medicare Advantage insurers announced it will separate its insurance and pharmacy benefits arm from its retail drugstores by 2028, reversing roughly a decade of vertical integration.

November 5, 2026

Carriers & the market

Fairview Health Services Sued UnitedHealthcare for Listing It as In-Network in 2027 Medicare Advantage Plans After Exiting the Contract

A Minneapolis health system says UnitedHealthcare's open enrollment materials pointed current members to a provider directory that still included Fairview even after the system ended its contract. The case raises questions about directory accuracy during the annual enrollment window.

November 4, 2026

Carriers & the market

NewYork-Presbyterian and UnitedHealthcare Reach Another Extension, Keeping Medicare Advantage In Network Through November 30

The October 31 deadline passed without a permanent deal, but both sides agreed to extend in-network coverage one more month. With open enrollment running through December 7, New York-area beneficiaries who use NYP should watch whether a permanent agreement lands before year-end.

October 30, 2026

Carriers & the market

CVS Health Becomes Fifth Insurer to Sue CMS Over 2027 Medicare Advantage Star Ratings

CVS Health filed a federal lawsuit Monday challenging the methodology behind its 2027 Medicare Advantage star ratings, joining at least four other insurers in court after CMS released quality scores on October 8.

October 29, 2026

Carriers & the market

Centene Says WellCare's Medicare Business Will Break Even in 2026, a Year Ahead of Schedule

Third-quarter results showed lower-than-expected medical costs in Medicare Advantage and Part D, pulling Centene's recovery target forward by a full year as Medicare open enrollment continues.

October 28, 2026

Carriers & the market

Centene Becomes Third Insurer to Sue CMS Over Its 2027 Medicare Advantage Star Ratings

Centene filed a federal lawsuit October 22 arguing that CMS applied 17 measures a court already struck down to every plan except the company that won in court, depressing its 2027 scores.

October 27, 2026