Humana to exit Medicare Advantage plans affecting 600,000 members

Humana is planning to exit certain Medicare Advantage plans in 2027, a move expected to affect approximately 600,000 members. The company disclosed this strategy during its July earnings call as part of an effort to improve profitability and target a sustainable Medicare Advantage margin of at least 3% by 2028. CFO Celeste Mellet stated that the insurer intends to prioritize higher-performing plans while attempting to transition a significant portion of affected members into other Humana offerings.

For affected individuals, the loss of a Medicare Advantage plan may trigger specific federal protections. Under federal rules, if a Medicare Advantage plan leaves the market or stops serving a specific area, eligible members may receive a guaranteed-issue right to purchase Medigap coverage through Original Medicare. This protection allows individuals to obtain Medigap policies without undergoing medical underwriting, meaning insurers cannot reject applicants based on health status or charge higher premiums due to pre-existing medical conditions.

Non-renewal notices for coverage ending December 31 are expected to be dated around October 2, providing members time to evaluate options before the Medicare annual enrollment period begins on October 15.