Presbyterian Is Leaving Medicare Advantage in 2027 — Here's What That Means for You
If you're one of the roughly 30,000 New Mexicans on a Presbyterian Medicare Advantage plan, you'll need new coverage for 2027. Your 2026 plan doesn't change. But the clock on your next move starts this fall.
In early June 2026, Presbyterian Healthcare Services announced it's discontinuing most of its Medicare Advantage plans starting in 2027. That decision moves about 30,000 New Mexico members off their current plan and into a search for something new. If that's you, take a breath first — nothing happens to your coverage this year.
What actually happened
Presbyterian is keeping its hospitals and clinics running as always. What's going away is most of its Medicare Advantage insurance plans — the Part C plans that bundled your hospital, doctor, and drug coverage onto one Presbyterian card. The company said those plans lost it more than $59 million in 2025, and staying in that market was pulling money away from the care side of the house.
One type of plan is staying: its dual-eligible Special Needs Plan (a D-SNP), for folks who have both Medicare and Medicaid. That covers about 13,000 people. If you're on that one, you're not affected. If you're on a regular Presbyterian Medicare Advantage plan, you are.
Why this is happening — and why it's not just Presbyterian
This isn't a New Mexico problem. It's a national pattern. Hospital systems all over the country jumped into the Medicare Advantage business over the last decade, and a lot of them are now backing out as the math stopped working — rising medical costs, tighter government reimbursement, and the star-rating changes that drive a chunk of plan revenue. Another large system out west announced a similar pullback for 2027 around the same time.
The reason that matters to you: a plan leaving the market isn't a sign you did anything wrong, and it isn't rare anymore. It's worth picking your next plan with both eyes open about whether it's built to stick around.
Your three real options for 2027
When your plan goes away like this, you don't get dropped into a void. A plan termination like this opens a Special Enrollment Period, which gives you extra time to choose. Here are the lanes in front of you.
1. Pick another Medicare Advantage plan
There are other Advantage plans in New Mexico from other carriers. If you like the all-in-one structure — low or $0 premium, drug coverage built in, extras like dental and vision — this keeps you in familiar territory. The thing to check hard this time: is the network actually built around your doctors, and does the plan look financially steady? You don't want to repeat this same scramble in two years.
2. Switch to Original Medicare plus a Medicare Supplement
This is the lane a lot of people in your spot end up looking at, and here's why. A Medicare Supplement (Medigap) has no network. Any doctor or hospital in the country that takes Medicare takes your plan. No carrier can pull a network out from under you, because there is no network. Plan G and Plan N are the most common. You'll pay a monthly premium — more than a $0 Advantage plan — but you're buying stability and the freedom to see anyone. If your doctors are at Presbyterian, UNM, or Lovelace in Albuquerque, a Supplement keeps every one of them with no network to check.
There's a catch worth knowing. Normally, switching into a Supplement later means answering health questions, and you can be turned down. But when your Advantage plan is terminated, you may get a guaranteed-issue right — a window where a Supplement has to take you regardless of health history. That window is one of the most valuable things this situation hands you, and it doesn't stay open forever.
3. Add a standalone drug plan if you go the Supplement route
A Supplement doesn't include prescription drug coverage, so if you go that way you'd pair it with a standalone Part D drug plan. We'd run your actual medication list against the available plans to find the one that covers your drugs for the least money.
Don't guess your way through this one
Bring me your doctors and your prescriptions. I'll lay all three lanes side by side and show you which one fits — including whether your guaranteed-issue window is open.
The timeline that matters
- Now through December 31, 2026: your current Presbyterian plan works exactly as it does today. No action needed.
- Early October 2026: Presbyterian said it will share specific next-step details and dates with members. Watch your mail.
- Fall 2026 (Annual Enrollment, Oct 15 – Dec 7): the main window to choose your 2027 coverage. This is where most people will make the switch.
- Your guaranteed-issue window: because your plan is being terminated, you may have a protected right to buy a Medicare Supplement without health questions. Timing rules are specific — this is the piece worth getting personal advice on early.
You've got time. What you don't want to do is wait until December, get rushed, and pick something that doesn't fit your doctors or your budget.
Presbyterian Medicare Advantage Exit FAQ
Is my Presbyterian Medicare Advantage plan ending right now?
No. Your coverage continues unchanged through December 31, 2026 — same doctors, network, and drug coverage. The discontinuation is for the 2027 plan year.
How many people does this affect?
About 30,000 New Mexico Medicare Advantage members. Presbyterian is keeping its dual-eligible Special Needs Plan (a D-SNP), which serves roughly 13,000 people with both Medicare and Medicaid, so those members are not affected.
Do I have to switch to another Advantage plan?
No. You can choose another Advantage plan, or move to Original Medicare with a Medicare Supplement and a standalone drug plan. The right choice depends on your doctors, your prescriptions, and how much network freedom matters to you.
Can I get a Medicare Supplement without health questions?
Possibly. When an Advantage plan is terminated, members often gain a guaranteed-issue right that lets them buy certain Supplements without medical underwriting. The timing rules are specific, so it's worth confirming your window early rather than late.
Why did Presbyterian drop these plans?
Presbyterian said its Medicare Advantage plans lost more than $59 million in 2025 and that staying in the market would limit its ability to invest in care delivery. It's part of a broader national trend of hospital-owned health plans exiting Medicare Advantage as margins tighten.
What should I do first?
Nothing is required today. Watch for Presbyterian's October notice, and set up a review before the fall enrollment window so you walk in with a plan instead of scrambling at the deadline.
Losing your Presbyterian plan? Let's fix it the right way.
Fifteen minutes, your doctor list, and we'll map your 2027 options together — including the guaranteed-issue window you don't want to miss.
Medicare On Main, a DBA of Kenztara INC. 880 S Main St, Moab UT 84532. 435-260-3200. Brian Penner, NPN 8206556. Licensed in 17 states.
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.