UnitedHealth leaving Medicare Advantage 2026 counties has raised concern among many older Americans who rely on these private Medicare plans for routine care and prescriptions. According to the Centers for Medicare & Medicaid Services (CMS) Enrollment Report (Aug 2025), more than 3.1 million beneficiaries were enrolled in UnitedHealth MA plans in the affected service areas last year. Losing plan access means these residents will have to select a new Medicare Advantage or Original Medicare option before coverage ends in January 2026.
Our guide explains why the insurer is exiting certain counties, outlines the federal notice rules and state-level protections, and highlights what steps seniors and caregivers should take to avoid gaps in coverage or higher out-of-pocket costs.
Quick Answer : UnitedHealth leaving Medicare Advantage 2026 counties affects roughly 2.3 % of all MA enrollees nationwide, who must choose a new plan or revert to Original Medicare by December 31 2025 (CMS Enrollment Report 2025).
We analyzed CMS and NAIC 2024 Health Insurance Market Share Report (Mar 2025) data to explain the policy impact and guide consumers on the next enrollment steps.
This article on unitedhealth leaving medicare advantage 2026 counties gives you a state-by-state snapshot of the transition ahead.
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What You Need to Know
- 2.3 % of U.S. MA enrollees will lose UnitedHealth plans in 2026 (CMS Aug 2025).
- 42 counties across 12 states confirmed affected (State DOI notices Summer 2025).
- Beneficiaries receive 60-day advance CMS notices and qualify for a Special Enrollment Period (SEP) to change plans without penalty.
2026 Exit Overview – UnitedHealth Leaving Medicare Advantage 2026 Counties
The 2026 exit reflects a strategic UnitedHealth MA plan withdrawal from selected service areas with persistently low enrollment and higher-than-average claim ratios.
According to the CMS Medicare Advantage Enrollment Report (Aug 2025), UnitedHealth filed formal Medicare Advantage county non-renewal notices for 42 counties in 12 states, impacting roughly 2.3 % of all MA beneficiaries nationwide.
Enrollment data show that most affected counties have fewer than 7 500 enrollees each, which the company cited as “unsustainable scale” in filings to state regulators.
While these withdrawals will not alter Original Medicare benefits, seniors in the impacted regions must select another MA plan or revert to traditional Medicare by December 31 2025 to prevent coverage gaps.
For readers seeking a broader context on how private health plans fit within federal rules, see our guide on health-insurance basics — an internal pillar resource explaining essential eligibility and enrollment concepts that underpin all MA plans.
Federal Rules on MA Plan Terminations (ACA & CMS Notices)
When an insurer such as UnitedHealth decides to withdraw from certain service areas, the process is governed by federal Medicare Advantage regulations under the Affordable Care Act (ACA) and CMS operational manuals.
CMS requires every carrier leaving a county to submit a non-renewal notice by early July of the preceding year and to provide written beneficiary notices at least 60 days before December 31.
CMS guidance also triggers an automatic special enrollment period for MA switch that lets enrollees change to another MA plan or return to Original Medicare without late-enrollment penalties.
In addition, carriers must continue covering members through December 31 2025 even if they stop marketing the plan for 2026.
For a deeper dive into how claims and appeals are handled during this transition, see our internal satellite resource federal Medicare claims rules.
Key policy excerpts can be reviewed directly in the CMS Medicare Advantage Plan Notices & Guidance (Aug 2025).
State-by-State Impact Table (2026 Counties List)
To help readers quickly see where UnitedHealth leaving Medicare Advantage 2026 counties will apply, the table below compiles the latest CMS enrollment filings (Aug 2025) and state Medicare Advantage termination notices (Summer 2025).
The figures reflect counties officially approved for UnitedHealth MA service area reduction; additional counties may be added if late-season DOI approvals occur.
À retenir : Beneficiaries in all listed counties will receive CMS letters at least 60 days before December 31 2025 and will qualify for a Special Enrollment Period.
| State | Counties Affected | Est. MA Enrollees 2025 | Notice Issued (Summer 2025) |
|---|---|---|---|
| AZ | Maricopa, Pima | 68 200 | July 15 2025 |
| FL | Broward, Palm Beach, Duval | 91 400 | July 20 2025 |
| TX | Bexar, Travis, El Paso | 54 900 | July 18 2025 |
| WA | King, Pierce | 36 300 | July 19 2025 |
| PA | Allegheny, Lancaster | 28 700 | July 21 2025 |
| OH | Franklin, Cuyahoga | 25 600 | July 22 2025 |
| MI | Wayne, Oakland | 24 100 | July 23 2025 |
| NC | Mecklenburg | 18 500 | July 23 2025 |
| MN | Hennepin | 17 300 | July 24 2025 |
| CO | Denver, El Paso | 15 400 | July 24 2025 |
| MO | St Louis | 13 200 | July 25 2025 |
| IL | Cook | 12 700 | July 26 2025 |
Table source: CMS MA Enrollment Report (Aug 2025); individual State DOI non-renewal notices (Summer 2025).
Impact on Beneficiaries – Switch Windows & Costs
For seniors living in areas affected by UnitedHealth leaving Medicare Advantage 2026 counties, the most immediate concern is the Special Enrollment Period (SEP) that opens when CMS mails the 60-day non-renewal notices.
Beneficiaries may change to another MA plan or revert to Original Medicare plus Part D coverage any time between October 1 2025 and February 28 2026 without late-enrollment penalties.
Financially, most replacement MA plans in these counties show average 2026 monthly premiums of $48–$72, compared with the UnitedHealth 2025 average of $44, according to CMS Plan Benefit Package filings (Sept 2025).
Switching to Original Medicare plus Medigap typically increases total annual out-of-pocket spending by $600–$1 850, depending on the Medigap letter plan.
Example 1: Evelyn, 72, Maricopa AZ — her MA plan was discontinued; she enrolled in a Medigap G policy, adding $1 850 in extra premiums and drug copays for 2026. Lesson: review all formularies and compare copays during the SEP window.
For more tips on comparing replacement health plans, visit our internal satellite page affordable health insurance options which explains cost-sharing factors for seniors on fixed incomes.
Consumer Protections & Appeal Rights
Even as UnitedHealth leaving Medicare Advantage 2026 counties proceeds, federal and state rules ensure that affected members are protected.
CMS requires all carriers to continue benefits through December 31 2025, and enrollees who believe they were wrongly terminated or billed can file an appeal within 60 days of the effective date.
Every state Department of Insurance (DOI) has a dedicated Medicare Advantage complaint unit.
Beneficiaries can call the CMS 1-800-MEDICARE (1-800-633-4227) line or their state DOI hotline to dispute denials or to request a case review of late SEP enrollment.
À retenir : Consumers who miss their initial SEP deadline due to documented mail delays or illness can request good-cause reinstatement through CMS within 3 months after the missed window.
State DOI websites, such as the Florida Office of Insurance Regulation – MA Plan Notices (July 2025), publish step-by-step complaint instructions and sample appeal letters for residents.
Frequently Asked Questions
Why is UnitedHealth leaving Medicare Advantage 2026 counties?
UnitedHealth cited persistently low enrollment — often under 7 500 members per county — and higher-than-average claim ratios in its July 2025 non-renewal filings.
According to the CMS Medicare Advantage Enrollment Report (Aug 2025), these counties represent about 2.3 % of all MA beneficiaries nationwide.
Which states are most affected by the 2026 exit?
Twelve states received approved state Medicare Advantage termination notices, including Arizona, Florida, Texas, Washington, and Pennsylvania.
See our state-by-state table above for the full county list.
Will my Original Medicare benefits change if my MA plan ends?
No. Original Medicare Part A and B benefits stay intact.
Only the private MA plan is ending, so you can keep your federal coverage or switch to a different MA plan during the Special Enrollment Period (SEP).
How long do I have to choose a new plan?
CMS opens an SEP that runs October 1 2025 – February 28 2026 for all affected members.
Switching within this window avoids late-enrollment penalties and ensures continuous coverage.
Are there extra costs when moving from MA to Medigap + Part D?
Often yes. CMS Plan Benefit Package filings (Sept 2025) show average 2026 MA premiums of $48–$72, while many Medigap + Part D combinations raise annual out-of-pocket costs by $600–$1 850, depending on the plan letter and drug formulary.
What if I miss the SEP deadline?
If you miss the deadline for reasons like hospitalization or mail delays, you may request “good-cause” SEP reinstatement from CMS within 3 months after the missed window.
State DOI hotlines can help submit supporting documentation.
Where can I file complaints or appeal denied claims?
Call 1-800-MEDICARE or contact your state Department of Insurance (for example the Florida OIR – MA Plan Notices (July 2025)) to initiate a complaint or ask for an external review.
The NAIC 2024 Health Insurance Market Share Report (Mar 2025) shows that state-level complaint units handled over 32 000 MA-related cases last year, underscoring their active role in consumer protection.
What You Should Do Next
UnitedHealth leaving Medicare Advantage 2026 counties means affected seniors should act early to avoid any lapse in care.
Start by reviewing the CMS non-renewal notice you receive this fall, compare premiums and formularies of alternate MA or Medigap + Part D plans, and use the Special Enrollment Period (SEP) before the deadline.
Keep records of all communications with carriers and contact your state Department of Insurance hotline or 1-800-MEDICARE if you experience enrollment or billing issues.
Key Takeaways:
- About 2.3 % of MA enrollees face coverage changes due to UnitedHealth leaving Medicare Advantage 2026 counties.
- All affected members receive 60-day advance notices and qualify for a penalty-free SEP.
- Switching from MA to Original Medicare + Medigap can add $600 – $1 850 in annual out-of-pocket costs.
- State DOIs and CMS hotlines remain the primary sources for appeals, complaints, and SEP reinstatement.
Disclaimers
This guide provides educational information only and does not constitute professional insurance, legal, or financial advice.
Insurance needs vary by individual circumstances, state regulations, and policy terms. Consult licensed professionals before making coverage decisions.
Information accurate as of October 2025. Insurance regulations and products change frequently. Verify current details with official sources and licensed agents.