UnitedHealthcare will fully exit Medicare Advantage plans in 16 US markets for the 2026 plan year the company confirmed.
The move, which will affect about 180,000 policyholders, has been described as part of a broader Medicare Advantage pullback previously announced, which is expected to impact 600,000 policyholders nationwide. About one third of those affected will be in markets where the insurer is withdrawing completely.
Most of the reductions will involve preferred provider organization (PPO) plans, which the company said underperform health maintenance organization (HMO) plans in terms of outcomes and affordability.
UnitedHealthcare said it is shifting resources into HMOs, citing their ability to help primary care providers coordinate treatment, manage chronic conditions, and prioritize preventive services.
“Member costs for medical care and prescription drugs, including specialist visits and prescription drug deductibles, are lower on our HMOs and they’ll offer more coverage for extras like over-the-counter credit and comprehensive dental,” a UnitedHealthcare spokesperson said in an email, BestWire reported.
Despite the exits, UnitedHealthcare said it will continue offering plans to 94% of Medicare-eligible Americans, maintaining its position as the nation’s largest Medicare Advantage carrier. The company said most enrollees will still have access to $0 premium Medicare Advantage plans.
“We’re modernizing our offerings in response to rising health care costs while preserving what matters most to our members. From $0 copays to enabling access to high-quality care, we’re helping people live healthier lives with confidence and support,” Bobby Hunter, chief executive officer of UnitedHealthcare Government Programs, said in a statement.
The insurer said its 2026 strategy includes expanding access to HMO plans, which will be available to 92% of eligible enrollees, along with increasing access to dual and chronic special needs plans and other tailored products.
In 2025, UnitedHealth has faced escalating financial and regulatory pressures. According to Associated Press, the company cut its 2025 earnings forecast after care usage among Medicare Advantage enrollees spiked—roughly doubling expectations in the first quarter, according to its public disclosures.
Earlier, the US Department of Justice opened a civil fraud investigation into UnitedHealthcare’s Medicare billing practices, centering on whether the company inflated diagnoses to raise payments from CMS, according to a report from The Guardian.
Further scrutiny comes from long-standing critiques of “upcoding” in Medicare Advantage, in which insurers may document more or more severe medical conditions than those observed in original Medicare, The Minnesota Star Tribune reported. Some industry observers project that 2025 overpayments related to such practices may cost taxpayers tens of billions.
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