Aetna, under CVS Health, will discontinue nearly 90 Medicare Advantage plans across 34 states starting in 2026—a strategic shift in response to rising medical costs and shrinking margins. Most affected plans are PPOs, and this action reflects a broader trend in the healthcare industry toward profitability over expansion.AJMC+5Chain Drug Review+5risehealth.org+5
Why This Change Is Happening
Medicare Advantage has long been a profitable venture for insurers, but that’s changing. Rising government scrutiny, declining reimbursement rates, and higher medical costs are squeezing margins. Insurers are now retrenching, with Aetna opting to cull underperforming plans to protect overall profitability.The Wall Street JournalReutersrisehealth.org
Who May Be Affected?
Existing members enrolled in one of the affected PPO plans across the 34 impacted states.
Individuals seeing changing network limitations, reduced benefits, or plan discontinuations.
Anyone enrolled in Advantage plans through brokers—note that commissions for certain plans will be eliminated starting September 1, 2025.The Wall Street Journal+9Chain Drug Review+9AJMC+9
How to Know if Your Plan Is Affected
Look for your Annual Notice of Change (ANOC), which typically arrives in fall. This will confirm if your plan will continue in 2026 and outline any changes or offer alternatives if your current plan is being dropped.
Your Options if Your Plan Is Ending
Select a new Medicare Advantage plan available in your area for 2026.
Return to Original Medicare (A & B) and optionally add Part D or a Medigap policy for comprehensive coverage.
Be sure to evaluate your healthcare needs and provider preferences—especially if you receive services from PPO networks.
Important Deadlines to Keep in Mind
Annual Enrollment Period (AEP): October 15 – December 7
During this window, you can switch plans or move to Original Medicare. Coverage changes take effect January 1.Special Enrollment Period (SEP): If your plan is discontinued, you’ll typically be granted a SEP to enroll without penalty.
What to Do Next
Gather details about your prescriptions, doctors, and preferred hospitals.
Compare plans side-by-side to weigh premiums, provider networks, and out-of-pocket costs.
Book a free consultation with one of our licensed agents to help you choose wisely and avoid gaps.
Your Next Step
At MedicareFor65.com, we’re ready to help you navigate these changes:
Quick Help: Click the phone icon to speak with an agent in under 60 seconds.
Schedule a Session: Book your free, no-obligation consultation here: medicarefor65.com/calendar.
We’re here to make sure you stay covered—with confidence and peace of mind.
Citations:
Aetna to close nearly 90 Medicare Advantage plans across 34 states in 2026.Connie Healthaetnacvshealth.comConnie Health+6Chain Drug Review+6risehealth.org+6
Industry trend: insurers like Humana and CVS Health scaling back expansions and focusing on margins.The Wall Street Journal+1
CVS is repricing half of group-based Advantage plans for 2026 to reflect cost pressures.americanhealthlaw.org+4
