Grand Junction · When your plan is discontinued
Why Is My Medicare Advantage Plan Going Away for 2027?
Because the company decided not to renew it, and the rule that governs Medicare Advantage lets a company do that "for any reason." The letter does not say why, and it does not have to. But the reasons are not mysterious. They are the same handful of business factors every year, none of them about you, and knowing them takes the sting out of the envelope. Here is what sits behind a non-renewal, how many people it happened to last year, and what the reason does and does not change about what you do next.
The bottom line
- It is the company's decision, made by June. 42 CFR § 422.506 lets an insurer not renew a plan "for any reason," if it tells Medicare by the first Monday in June and tells you at least 90 days ahead.
- It is not about your health. A plan cannot be dropped, limited or conditioned on "any factor that is related to health status." Everyone in the plan got the same letter.
- Five things usually sit behind it: what Medicare pays the plan in your county, the contract's Star Rating, how member health is measured, what care costs, and company strategy.
- It is common. 2.6 million people, 13% of Advantage drug-plan members, were in a plan terminated for 2026, per KFF. That was double the year before.
- The reason changes nothing about your deadlines. October 15 to December 7 for a January 1 start, and the 2027 list for Mesa County is public on October 1.
The letters are in Grand Junction mailboxes now, and the first thing most people ask is not what to do. It is why. They liked the plan. Their doctor was in it. Nothing went wrong. So why is it going away? We have written most of this fall's posts about the what: the first steps, how to tell a discontinuation from a benefit change, what happens if you do nothing. This one is about the why, because people make better decisions when they are not taking it personally.
Mesa County had 41,709 people on Medicare in June 2026, and 17,134 of them, about 41%, were in a Medicare Advantage plan, according to the CMS monthly enrollment file. The 2026 shelf was 16 drug-coverage plans from 5 carriers. How many of each are on the 2027 shelf is public on October 1, and we will not guess before then.
The short answer: it is allowed, and it was decided months ago
The rule is 42 CFR § 422.506, titled "Nonrenewal of contract." Paragraph (a)(1): "An MA organization may elect not to renew its contract with CMS as of the end of the term of the contract for any reason provided it meets the timeframes for doing so." Two timeframes follow. The company must notify "CMS in writing, by the first Monday in June of the year in which the contract would end," which for 2027 was June 1, 2026. And it must notify "Each Medicare enrollee by mail at least 90 calendar days before the date on which the nonrenewal is effective," which CMS's calendar puts at October 2.
So the decision you are reading about in late September was made by the first of June, before this year's Star Ratings, before the 2027 bids were even submitted. The letter also has to come with help: the company must give "a CMS approved written description of alternative MA plan, MA-PD plan, and PDP options available" in your region, or "Place outbound calls to all affected enrollees to ensure beneficiaries know who to contact." One or the other. Nowhere in the section is the company required to tell you why, and in our experience the letters do not.
There is one more paragraph worth knowing. Under (a)(3), if a company does not renew, "CMS may deny an application for a new contract or a service area expansion from the MA organization for 2 years unless there are circumstances that warrant special consideration." A non-renewal is not a one-year pause. Treat the plan as gone.
What it is not
- It is not about you. 42 CFR § 422.110(a) says a plan "may not deny, limit, or condition the coverage or furnishing of benefits ... on the basis of any factor that is related to health status," and lists medical condition, claims experience, receipt of health care, medical history, genetic information, evidence of insurability and disability. The plan ended for every member on the same day. Your knee surgery did not do it.
- It is not Medicare going away. Parts A and B are unchanged. The plan that delivered them is what ends.
- It is not necessarily the company leaving. Insurers usually keep other plans in the same county. The letter tells you which plan is ending, and the October 1 data tells you what the same company still offers here.
- It is not the same as a benefit change. A plan that is renewing with a higher copay sends an Annual Notice of Change, not a non-renewal letter. This post shows how to tell them apart, including the county-drop case that looks like one and is legally the other.
The five things that usually sit behind the decision
A Medicare Advantage plan is a bid. The company tells Medicare what it will charge to cover a member in a given county for a year, Medicare pays a fixed amount per member each month, and the company keeps the difference or eats the loss. Every reason a plan goes away is some version of that arithmetic no longer working for that plan in that county. Here are the parts, with the public sources for each.
| The factor | Who controls it | Where it is written down | What it does to a plan |
|---|---|---|---|
| What Medicare pays the plan in your county | Set by law and CMS, county by county | 42 CFR § 422.258; CY 2027 Rate Announcement | Benchmarks are 95% to 115% of local Original Medicare spending. For 2027 CMS projects a 2.48% average increase. The average hides counties that gained and counties that did not. |
| The contract's Star Rating | Scored by CMS each October | 42 CFR § 422.258(d)(7) | A rating of 4 stars or higher adds 5.0 percentage points to the benchmark. A contract that slips below 4 loses that money for every plan under it, and a plan that no longer pencils out is the one that goes. |
| How Medicare measures how sick members are | CMS risk-adjustment model | CY 2027 Rate Announcement | The 2024 model finished phasing in during 2026 and stays for 2027 so the market has 'more time to adjust.' Diagnoses from unlinked chart reviews stop counting, a 1.53% reduction on average. |
| What care actually costs | Doctors, hospitals, drug makers, members | CY 2027 Rate Announcement growth rate | Payment grows with Original Medicare's per-person cost, 5.33% for 2027. A plan whose own members cost more than that has to cut benefits, raise premiums or stop offering the plan. |
| The company's own strategy | The insurer's board and investors | KFF 2026 Spotlight; Healthcare Dive, July 29, 2026 | KFF's phrase is 'firm-level strategies, and ultimately the insurers' assessment of potential profits.' One carrier told investors it is closing plans 'with lower capital returns' to keep the rest stable. |
Sources: 42 CFR § 422.258; CMS 2027 Rate Announcement fact sheet; KFF 2026 Spotlight; Healthcare Dive, July 29, 2026.
1. What Medicare pays the plan in your county
The payment starts from a benchmark that is set county by county. Section 422.258(d)(5) sorts counties into quartiles by what Original Medicare spends per person there and pays 95%, 100%, 107.5% or 115% of that figure, with the highest percentage going to the lowest-spending counties. Mesa County's benchmark is not Denver's or Montrose's, which is why a company can keep a plan in one county and drop it in the next. For 2027 the Rate Announcement projects payments to plans rising 2.48%, "or over $13 billion," and 4.98% once the expected rise in members' risk scores is included. That is an average. Some counties came out above it and some below, and a plan that was marginal in a below-average county is the kind that does not come back.
2. The contract's Star Rating
Plans are grouped under contracts, and each contract gets a Star Rating from CMS every October. Section 422.258(d)(7) makes a contract with "a quality rating of 4 stars or higher" a "qualifying plan," and for a qualifying plan the county percentage above is increased "by 5.0 percentage points." Five points on a benchmark is real money, and it is money the plan uses to fund the dental, the gym membership and the $0 premium. A contract that drops below 4 stars loses that on every plan under it, and the thinnest plans under that contract are the ones a company stops offering. The Rate Announcement's own table shows the Star Rating changes moving 2027 payments by only 0.03% on average, which tells you the effect is concentrated in particular contracts rather than spread across the market.
3. How Medicare measures how sick members are
Payment is adjusted for each member's diagnoses through a risk model. CMS finished phasing in the 2024 version of that model in 2026 and, for 2027, decided to keep using it rather than the newer one it had proposed, saying continued use "will allow the MA market more time to adjust to the recently completed phase-in." Two changes did go through: diagnoses from audio-only visits and from "unlinked chart review records," diagnoses not tied to an actual patient visit, no longer count. The fact sheet puts the chart-review change at -1.53% on average. A plan whose payment leaned on those records is paid less for the same members in 2027.
4. What care actually costs
Benchmarks grow with Original Medicare's per-person cost, the "effective growth rate," which the Rate Announcement sets at 5.33% for 2027. A plan whose members' hospital stays, specialist visits and prescriptions grow faster than that has three choices: raise the premium, trim benefits, or stop offering the plan. Mesa County's health profile is part of that math. Per CDC PLACES, 26.6% of adults here live with high blood pressure, 29.8% with obesity and 8.1% with diabetes, conditions whose care a plan pays for month after month.
5. The company's own strategy
KFF looked at the counties insurers left for 2026 and found they "do not completely, or in many cases, largely overlap," which "suggest[s] a combination of factors are at play, including local market characteristics, cost pressures, shifts in firm-level strategies, and ultimately the insurers' assessment of potential profits." That last phrase is the honest one. A public company answers to investors. On its July 29, 2026 earnings call, Humana said it "is shuttering plans with lower capital returns to ensure it can keep benefits stable and retain members in plans that generate higher profits," per Healthcare Dive. Roughly 600,000 members, about 8% of its 7.2 million, and it expects to bring about 40% of them back into other plans it offers. That is one company being unusually plain about a decision every company makes. It is not a mark against the care you received.
Got the letter and want to know what is still on the Mesa County shelf?
Bring it to our Grand Junction office, or call. Starting October 1 we can show you every 2027 plan in the county, which of your doctors and prescriptions each one covers, and the Original Medicare and Medigap door beside them. Free, and nothing to sign until you decide. We do not offer every plan available in your area.
Book a coverage review →How common this is
All four from KFF, Medicare Advantage 2026 Spotlight, which uses the CMS landscape files. KFF's 2027 analysis will follow the October 1 release.
The same report counted the two largest carriers' county moves for 2026: "UnitedHealthcare is exiting 225 counties, while entering 14 new counties and Humana is exiting 198 counties, while entering five new counties." Four smaller companies left the market entirely, and "Two of the firms cited financial challenges." None of that is Mesa County data. It is the national weather, and the point of showing it is that a discontinued plan in Grand Junction is not a local failure. It is an ordinary event in a market that reshuffles every fall.
Does the reason change what you should do?
Mostly no, and that is the useful conclusion. Whatever the reason, the calendar is the same: October 15 to December 7 to pick a 2027 plan that starts January 1, a Special Enrollment Period from December 8 through the end of February for people in a discontinued plan, and a guaranteed-issue window for certain Medigap plans in Colorado. Those are covered in the post on changing plans after December 7 and the Medigap post. The reason your plan ended does not extend, shorten or move any of them.
Where the reason does matter is in reading the October 1 list. If the company kept its other plans in Mesa County, your doctors are probably still in that company's network and the move can be short. If the company left the county, the county-drop rules in the discontinued-or-changing post apply and every network has to be checked from scratch. And if the reason was a Star Rating slide, that is a fair thing to weigh when you look at that company's remaining plans, alongside the network check and the drug check that decide most of these choices in the end.
What I would do
Read the letter once for the facts: the plan name, the date it ends, and whether it says the plan is not being offered or the county is no longer in the service area. Then put the why down. It was decided in June by people who have never met you, on numbers you cannot change.
On October 1, look at the 2027 list for Mesa County with your doctor list and prescription list in hand, and compare the plans that are left against Original Medicare with a Medigap policy and a drug plan, which is the door the guaranteed-issue right opens for you this one time. Make the decision by December 7 so it starts January 1. And if you want a second set of eyes, we do this every October, from our Grand Junction office or by phone anywhere on the Western Slope.
How we know all this: the Medicare On Main Data Desk frames every article with public data — here, 42 CFR §§ 422.506, 422.110 and 422.258, quoted as published on Cornell LII; the CMS fact sheet on the CY 2027 Medicare Advantage and Part D Rate Announcement of April 6, 2026; KFF's Medicare Advantage 2026 Spotlight for plan terminations, plan counts and county exits; Healthcare Dive's July 29, 2026 report of Humana's earnings call; the CMS Medicare Monthly Enrollment file for Mesa County; the CMS CY 2026 landscape file for the Mesa County plan count; and CDC PLACES for Mesa County health prevalence. No 2027 plan, premium, carrier or Star Rating for Mesa County is stated here; that information becomes public on October 1. Medicare On Main is a licensed independent insurance agency. We do not offer every plan available in your area. Any information we provide is limited to the plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. Not connected with or endorsed by the U.S. government or the federal Medicare program. Carrier decisions are described from public statements; nothing here is a judgment of any company or plan.
Frequently asked questions
Why is my Medicare Advantage plan being discontinued?
Because the company that runs it decided not to renew that plan's contract with Medicare for 2027, and federal rules let it do that "for any reason" as long as it tells Medicare by the first Monday in June and tells you at least 90 days before the plan ends. The letter does not have to give a reason and usually does not. Behind the decision are ordinary business factors: what Medicare pays the plan in your county, the contract's Star Rating, how the plan's members' costs compare with that payment, and the company's own strategy. It is not about you or your health.
Are Medicare Advantage plans going away in 2027?
No. Medicare Advantage as a program is not ending, and neither is Original Medicare. Individual plans are. In 2026, according to KFF, 2.6 million people, 13% of members in Advantage drug plans, were in a plan that was terminated, up from 1.3 million the year before, and the total number of plans fell 9% to 3,373. The average beneficiary still had 32 plans to choose from. The 2027 list for Mesa County becomes public on October 1.
Does my plan have to tell me why it is ending?
No. The regulation requires the plan to notify you by mail at least 90 days before the non-renewal takes effect and to give you information about your alternatives, either a written description of other plans in your area or an outbound phone call. It does not require an explanation. If your letter says only that the plan will not be offered in 2027, that is a complete letter.
What happens if my Medicare Advantage plan is discontinued?
You keep Medicare. If you do nothing, you return to Original Medicare on January 1 with no drug coverage and no Medigap policy, which is the expensive default. You can pick another Advantage plan from October 15 to December 7 for a January 1 start, you get a Special Enrollment Period from December 8 through the end of February, and you have a guaranteed-issue right to certain Medigap plans in Colorado. Our earlier posts walk through each of those doors.
Is Humana leaving Medicare Advantage in 2027?
Not the program. On July 29, 2026, Humana told investors it would exit plans covering roughly 600,000 members, about 8% of its 7.2 million Advantage members, and that it expects to bring about 40% of them back into other plans it offers. Which plans and which counties become public with the October 1 data. Our July post on Humana's announcement has the Mesa County numbers as of 2026. Other companies make the same kind of decisions every year; the frame is "the plan is being discontinued," not who to blame.
Can the same plan come back next year?
Usually not soon. When an insurer does not renew, the rule says CMS "may deny an application for a new contract or a service area expansion" from that company for 2 years, unless there are circumstances that warrant special consideration. The company may keep offering its other plans in your county, and it may re-enter later, but the plan you had should be treated as gone for planning purposes.
Sources
- 42 CFR § 422.506 — Nonrenewal of contract (Cornell LII) — "for any reason"; CMS notice by the first Monday in June; enrollee notice at least 90 calendar days before; alternatives description or outbound calls; the 2-year bar.
- 42 CFR § 422.110 — Discrimination against beneficiaries prohibited (Cornell LII) — no denial, limit or condition "on the basis of any factor that is related to health status."
- 42 CFR § 422.258 — Calculation of benchmarks (Cornell LII) — (d)(5) the 95 / 100 / 107.5 / 115 percent county quartiles; (d)(7) the 5.0-point increase for 4-star-or-higher plans.
- CMS — 2027 Medicare Advantage and Part D Rate Announcement fact sheet (April 6, 2026) — 2.48% / 4.98%; effective growth rate 5.33%; Star Ratings -0.03%; unlinked chart reviews -1.53%; the 2024 risk model kept for 2027.
- KFF — Medicare Advantage 2026 Spotlight: A First Look at Plan Offerings (December 9, 2025) — 2.6 million / 13% in terminated plans; 1.3 million in 2025; 3,373 plans, down 9%; 32 average choices; county exits; "firm-level strategies."
- Healthcare Dive — Humana to exit more Medicare Advantage plans in 2027 (July 29, 2026) — "shuttering plans with lower capital returns"; 600,000 members, 8% of 7.2 million; 40% expected to return to other plans.
- CMS Medicare Monthly Enrollment (data.cms.gov) — Mesa County, CO, June 2026 — 41,709 beneficiaries, 17,134 in Medicare Advantage.
- CMS — Medicare Advantage / Part D contract and enrollment data and plan landscape files — the CY 2026 file behind the 16-plan, 5-carrier Mesa County count; the CY 2027 file is published October 1.
- CDC PLACES: Local Data for Better Health, County 2023 — Mesa County high blood pressure, obesity and diabetes prevalence.
