600,000 UnitedHealthcare Medicare Advantage members to lose coverage in 2025
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If you rely on a Medicare Advantage plan for your health coverage, you may be facing a major change next year.
UnitedHealthcare, the largest provider of these plans in the US, is set to discontinue certain options that currently serve about 600,000 people.
This move is part of a larger trend in the Medicare Advantage market, as insurers adjust to rising healthcare costs and changes in government payments.
Affected members will still have Medicare coverage but will need to select a new plan for 2025.
Taking time to review your options early can help ensure a smooth transition to your next plan.
Why the cuts are happening
UnitedHealthcare, a division of UnitedHealth Group, serves more than 8 million Medicare Advantage members.
According to Tim Noel, CEO of UnitedHealthcare’s health insurance division, the company is “making significant adjustments to benefits to recover lost margins and keep pace with the cost of care” after experiencing “a notable increase in the use of outpatient services and emergency room visits.”
These shifts, combined with rising medical expenses and recent federal rate cuts, have pressured the insurer to focus on sustainability.
The cuts will largely affect less managed plan types—especially PPOs (Preferred Provider Organizations) that offer broader provider choice but cost more to administer.
Also read: Could you be charged extra for Medicare without realizing it?
Understanding Medicare Advantage
Medicare Advantage, or Medicare Part C, is an alternative to Original Medicare administered by private insurers.
Plans typically combine hospital, medical, and prescription drug coverage, often with extras like dental, vision, and wellness benefits.
By 2024, more than half of all eligible beneficiaries—about 32.8 million people—were enrolled in Medicare Advantage.
The Congressional Budget Office projects that by 2034, nearly two-thirds of Medicare beneficiaries will opt for these private plans.
Also read: Medicare price talks progress quietly as government targets costly prescriptions
What happens if your plan is dropped
If your plan is among those discontinued, UnitedHealthcare will send you a notice this fall.
You’ll qualify for a Special Enrollment Period, allowing you to switch to another Medicare Advantage plan or return to Original Medicare.
While the Annual Enrollment Period runs from October 15 to December 7, affected members will have extra time to make changes.
It’s still smart to start reviewing options early—consider premiums, out-of-pocket maximums, provider networks, and drug formularies before deciding.
Also read: Medicare grocery allowance: Are you missing out on this food benefit?
Ongoing federal investigation
The plan changes come as UnitedHealthcare faces a federal civil fraud investigation into whether it exaggerated patient diagnoses to secure higher Medicare Advantage payments.
The Wall Street Journal has reported that investigators are looking into “billions of dollars in potential overpayments.”
UnitedHealthcare says it is cooperating fully and “stands by the integrity of our risk-adjustment practices.”
Also read: Are you spending too much on Medicare? Here’s how to cut costs in retirement
Broader company challenges
UnitedHealth Group, the nation’s third-largest company by revenue, has also faced recent turbulence.
Its share price has declined more than 15% this year, following a spike in medical costs, a leadership change in its insurance division, and the fatal shooting of an executive.
The company is navigating these issues while managing one of the most popular segments of its business.
Also read: Still confused by Medicare? Let’s clear up 10 common myths seniors should know
The bigger picture
UnitedHealthcare is not alone—other insurers are also reevaluating their Medicare Advantage offerings as more Americans turn 65 and join the program.
Trends to watch include:
Also read: Medicare may soon cover medications for weight loss—here’s what to know about the proposed program
Steps to take now if you’re affected
While losing a health plan can be stressful, it can also be an opportunity to reassess your coverage and find an option that better fits your current needs.
Taking time to review your choices, compare benefits, and confirm your doctors and prescriptions are covered can help ensure a smoother transition.
Staying informed and proactive will make it easier to navigate these changes and maintain the care you rely on.
Read next: Bigger benefits, smaller payoff? Medicare costs may cut into your next Social Security raise
Have you experienced a Medicare Advantage plan change before? Share your experience with the community so others can learn how to navigate these shifts.
UnitedHealthcare, the largest provider of these plans in the US, is set to discontinue certain options that currently serve about 600,000 people.
This move is part of a larger trend in the Medicare Advantage market, as insurers adjust to rising healthcare costs and changes in government payments.
Affected members will still have Medicare coverage but will need to select a new plan for 2025.
Taking time to review your options early can help ensure a smooth transition to your next plan.
Some UnitedHealthcare members will need to select a new Medicare Advantage plan for 2025. Image Source: YouTube / CBS Evening News.
Why the cuts are happening
UnitedHealthcare, a division of UnitedHealth Group, serves more than 8 million Medicare Advantage members.
According to Tim Noel, CEO of UnitedHealthcare’s health insurance division, the company is “making significant adjustments to benefits to recover lost margins and keep pace with the cost of care” after experiencing “a notable increase in the use of outpatient services and emergency room visits.”
These shifts, combined with rising medical expenses and recent federal rate cuts, have pressured the insurer to focus on sustainability.
The cuts will largely affect less managed plan types—especially PPOs (Preferred Provider Organizations) that offer broader provider choice but cost more to administer.
Also read: Could you be charged extra for Medicare without realizing it?
Understanding Medicare Advantage
Medicare Advantage, or Medicare Part C, is an alternative to Original Medicare administered by private insurers.
Plans typically combine hospital, medical, and prescription drug coverage, often with extras like dental, vision, and wellness benefits.
By 2024, more than half of all eligible beneficiaries—about 32.8 million people—were enrolled in Medicare Advantage.
The Congressional Budget Office projects that by 2034, nearly two-thirds of Medicare beneficiaries will opt for these private plans.
Also read: Medicare price talks progress quietly as government targets costly prescriptions
What happens if your plan is dropped
If your plan is among those discontinued, UnitedHealthcare will send you a notice this fall.
You’ll qualify for a Special Enrollment Period, allowing you to switch to another Medicare Advantage plan or return to Original Medicare.
While the Annual Enrollment Period runs from October 15 to December 7, affected members will have extra time to make changes.
It’s still smart to start reviewing options early—consider premiums, out-of-pocket maximums, provider networks, and drug formularies before deciding.
Also read: Medicare grocery allowance: Are you missing out on this food benefit?
Ongoing federal investigation
The plan changes come as UnitedHealthcare faces a federal civil fraud investigation into whether it exaggerated patient diagnoses to secure higher Medicare Advantage payments.
The Wall Street Journal has reported that investigators are looking into “billions of dollars in potential overpayments.”
UnitedHealthcare says it is cooperating fully and “stands by the integrity of our risk-adjustment practices.”
Also read: Are you spending too much on Medicare? Here’s how to cut costs in retirement
Broader company challenges
UnitedHealth Group, the nation’s third-largest company by revenue, has also faced recent turbulence.
Its share price has declined more than 15% this year, following a spike in medical costs, a leadership change in its insurance division, and the fatal shooting of an executive.
The company is navigating these issues while managing one of the most popular segments of its business.
Also read: Still confused by Medicare? Let’s clear up 10 common myths seniors should know
The bigger picture
UnitedHealthcare is not alone—other insurers are also reevaluating their Medicare Advantage offerings as more Americans turn 65 and join the program.
Trends to watch include:
- Narrower provider networks to control costs.
- Scaling back supplemental perks like dental and vision.
- Greater regulatory scrutiny as Medicare Advantage spending grows.
Also read: Medicare may soon cover medications for weight loss—here’s what to know about the proposed program
Steps to take now if you’re affected
- Check your mail for the official UnitedHealthcare notice.
- Review available plans using Medicare’s Plan Finder tool or by speaking with a licensed insurance agent.
- Call your providers to confirm which plans they accept.
- Verify medication coverage under any plan you’re considering.
While losing a health plan can be stressful, it can also be an opportunity to reassess your coverage and find an option that better fits your current needs.
Taking time to review your choices, compare benefits, and confirm your doctors and prescriptions are covered can help ensure a smoother transition.
Staying informed and proactive will make it easier to navigate these changes and maintain the care you rely on.
Read next: Bigger benefits, smaller payoff? Medicare costs may cut into your next Social Security raise
Have you experienced a Medicare Advantage plan change before? Share your experience with the community so others can learn how to navigate these shifts.
