A letter arrives in summer saying your hospital system is leaving your Medicare Advantage plan at the end of September. Your cardiology practice, oncology team, and primary care doctor all practice there. Your plan card remains active, but access to those physicians does not. You have roughly two months to figure out what comes next.
This situation is becoming more common. According to Becker's Hospital Review, at least 25 U.S. health systems dropped Medicare Advantage contracts in 2026. Mayo Clinic exited most UnitedHealthcare and Humana plans on January 1, and regional hospital systems have followed with their own termination dates. This risk belongs to Medicare Advantage exclusively. Original Medicare does not use a private plan's provider network, and Medigap supplements follow Original Medicare's coverage rules, so neither faces the same disruption.
When a hospital exits your plan's network, your out-of-pocket costs often spike. The average in-network out-of-pocket limit for Medicare Advantage in 2026 is $5,421. For PPO plans, the average combined limit for both in-network and out-of-network care is $9,825, nearly double. HMO members receiving routine care outside the network may owe the full bill.
Federal rules require insurers to notify you when a contracted provider leaves, typically 30 to 45 days in advance. The notice must explain how to request continuing care. But this does not automatically grant you a 90-day extension with that departing doctor. The federal 90-day protection applies only when you enroll in a new Medicare Advantage plan after starting a course of treatment. A provider leaving your current plan is different. The No Surprises Act's protections do not extend to Medicare Advantage.
One federal rule does matter: if your remaining network cannot meet your medical needs, the plan must arrange medically necessary care outside its network at in-network cost sharing. This argument works better for specialized oncology care than for keeping a familiar primary doctor.
A provider departure does not automatically create a Special Enrollment Period allowing you to switch plans. CMS may authorize one if it determines a network change is significant, but the notice letter alone does not open the door. You should contact 1-800-MEDICARE to ask whether you qualify. Otherwise, your next reliable switching window is the Annual Enrollment Period from October 15 through December 7, with new coverage starting January 1.
If you switch to Original Medicare, you can then buy Medigap supplemental coverage. After the federal six-month Medigap enrollment window closes, most states allow insurers to medically underwrite new applications. Leaving Medicare Advantage because a hospital exited the network does not, by itself, grant you a federal Medigap guarantee-issue right, meaning insurers may deny coverage or charge more based on your health.
When a hospital termination notice arrives, take three written steps. First, request continued care from your current plan, listing every active treatment, prior authorization, scheduled procedure, and specialist involved. Ask for a written decision on what the plan will cover, at what cost, and through what date. Second, contact 1-800-MEDICARE to ask about switching rights and whether a Special Enrollment Period applies. Third, if considering Original Medicare and Medigap, price plans and obtain written underwriting approval before dropping your current Advantage plan. Coordinate all effective dates for Medicare, Medigap, and Part D carefully.
The contract between the hospital and insurer can end with a notice. Rebuilding your care relationship happens one doctor at a time, on your timeline and dime.
Source: https://www.yahoo.com/news/us/articles/another-hospital-system-just-went-153018828.html