By Marc Gilman
📞 Call (800) 927-9326 or (603) 493-1394 | ✉️
If you’re on a Medicare Advantage plan, there’s a question worth asking before October: Will your plan still exist in 2027, and if it does, will it still offer the same benefits?
For a growing number of beneficiaries — including right here in New Hampshire — the honest answer is no.
Key Takeaways
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CMS finalized a 2.48% average rate increase for Medicare Advantage plans in 2027 — below what many carriers need to sustain current benefit packages, triggering a wave of exits and reductions.
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Major carriers have explicitly signaled a shift from membership growth to margin improvement for 2027, meaning benefit cuts and selective county exits are planned — not speculation.
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New Hampshire has already absorbed more carrier disruption than most states — Anthem and Martin’s Point both exited the NH individual Medicare Advantage market in 2026. Further changes for 2027 are possible.
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If your plan exits your county, you get a Special Enrollment Period and guaranteed issue rights for Medigap — one of the most significant coverage opportunities available. But acting on it requires knowing your options before the letter arrives.
What’s Actually Happening in the Medicare Advantage Market for 2027
Medicare Advantage insurers are paid a fixed monthly rate by CMS for each enrollee — adjusted for age, health status, and geography. The insurer takes on the financial risk of delivering Medicare benefits plus whatever supplemental extras (dental, vision, flex cards, gym memberships) they’ve added to attract enrollees.
This model worked well when CMS rates were rising faster than medical costs. Several factors have now converged to squeeze carrier margins:
Post-pandemic healthcare utilization. Patients who deferred care during COVID-19 are now using significantly more medical services, driving up claims costs across the board.
Risk score accuracy crackdowns. CMS has tightened oversight of how insurers calculate risk scores, reducing some of the favorable revenue adjustments plans had previously relied on.
Rate growth below medical cost inflation. The 2.48% average rate increase for 2027, while nominally positive, hasn’t kept pace with medical cost trends in many markets.
When the math doesn’t work in a given county, carriers have two choices: reduce benefits, or leave. Both are happening heading into 2027.
What’s Already Happened in New Hampshire — and Why It Matters
New Hampshire residents don’t need to take this on faith. We’ve already lived through a version of it.
Heading into 2026, both Anthem and Martin’s Point withdrew from the individual Medicare Advantage market in New Hampshire entirely — leaving thousands of beneficiaries without their existing plan and scrambling for alternatives during last year’s Annual Enrollment Period. Aetna scaled back its NH presence to Hillsborough and Rockingham counties only. The carriers that remained — UnitedHealthcare, Humana, and WellSense — absorbed the displaced membership, but the disruption was real and significant for many families.
What 2026 taught us is that New Hampshire is not insulated from national market forces. When major carriers decide a market isn’t profitable enough to sustain their benefit packages, NH residents feel it directly. And the same pressures driving 2026 disruption are intensifying heading into 2027.
6 Ways Your Medicare Advantage Plan Can Change for 2027
When a Medicare Advantage plan “cuts benefits,” that phrase covers a wide range of changes. Understanding the specific type matters because each requires a different response.
1. Complete Market Exit The plan stops operating in your county entirely. You’ll receive a required CMS notice that your plan will be discontinued and that you have a Special Enrollment Period to select a new plan. This is the most disruptive scenario — but as we’ll discuss below, it also comes with the most options.
2. Reduction of Supplemental Benefits The plan continues operating but eliminates or reduces extras like the grocery flex card allowance, dental benefit amount, OTC allowance, vision coverage, or gym membership. Your core Medicare coverage continues unchanged, but the perks that attracted you to the plan may disappear. A lost $85/month OTC credit is $1,020 per year of real financial impact — not a minor footnote.
3. Premium Increases Many Medicare Advantage plans have offered $0 monthly premiums as a selling point. In 2027, some of these plans are introducing modest monthly premiums — $20–$50/month — to offset costs. While still low compared to Medigap premiums, this breaks the $0 expectation many beneficiaries have built their budget around.
4. Network Narrowing Your plan may cut specific hospitals, specialist practices, or pharmacy chains from its network. If your preferred doctors or hospital are dropped, your costs for out-of-network care can increase significantly — or care may simply be unavailable in-network at any cost.
5. Prior Authorization Expansion Plans may add prior authorization requirements for procedures or medications they previously covered without approval. This doesn’t change what’s covered in theory — it changes how much friction stands between you and accessing care you already receive.
6. Formulary Changes Medications that were on a preferred, lower-cost tier may move to a higher tier or be removed from coverage entirely. A formulary exception process can restore access, but it requires additional steps and isn’t guaranteed.
The Window Most People Miss: Medigap Guaranteed Issue
Here’s the piece that most beneficiaries don’t know — and it may be the most important thing in this post.
If your Medicare Advantage plan exits your county, you receive a Special Enrollment Period that gives you the right to switch plans outside the normal Annual Enrollment Period window. But more importantly, that exit triggers guaranteed issue rights for Medigap.
In most states — including New Hampshire — if you want to switch from Medicare Advantage to Original Medicare with a Medigap supplement outside of your initial enrollment window, insurers can legally deny you coverage or charge significantly higher premiums based on your health history. Guaranteed issue removes that restriction entirely. You can move to Original Medicare with a Medigap plan — nationwide provider access, no networks, no prior authorization, more predictable costs — at standard rates regardless of your current health conditions.
If a plan exit gives you a guaranteed issue window, it may be your best opportunity to make this move. But acting on it requires knowing what Medigap looks like, understanding the plan options available in New Hampshire, and being ready to move quickly when the letter arrives. That preparation happens before October — not during a scramble in November.
How to Find Out If Your Plan Is Affected
CMS requires Medicare Advantage plans to notify affected members of material benefit changes. Here’s what to watch for:
Annual Notice of Change (ANOC). Your plan must send you this document by September 30 each year, detailing all changes taking effect January 1. Read it carefully — don’t let it sit unopened on a counter. This is the document that tells you exactly what’s changing in your specific plan.
Call your plan directly. Call the member services number on your plan card and ask directly: Is this plan available in my county in 2027? What changes are being made to benefits, network, and premiums? You don’t need to wait for the mail.
Check Medicare.gov Plan Finder. Updated with 2027 plan data before Annual Enrollment opens October 15. Enter your zip code to see all available plans and compare benefits side by side.
Call a local agent. This is the option that gives you the most context, not just the raw data. A local independent agent who knows the NH market can tell you not just what’s in the ANOC, but what it means for your specific doctors, medications, and situation — and what alternatives actually exist in your county.
What If Your Plan Is Cutting Benefits But Not Exiting?
A plan exit triggers guaranteed issue rights for Medigap. A benefit reduction doesn’t — but it still deserves a response.
If your plan trims its OTC benefit, raises its premium, or narrows its network, the right question is: does this plan still make sense compared to what else is available? Annual Enrollment is your window to make that comparison and switch if the math no longer works in your favor.
Calculate the actual dollar impact of the benefit change. Compare competing Medicare Advantage plans available in your county on Medicare.gov. Confirm your current doctors and preferred pharmacy remain in-network under any plan you’re considering. And if the plan exits are significant enough in your area, take a serious look at whether Original Medicare plus Medigap is now a better fit — even without the guaranteed issue trigger.
Frequently Asked Questions
Will my Medicare Advantage plan definitely change for 2027? Not necessarily — but the market conditions heading into 2027 make benefit changes, premium increases, and network adjustments more likely than in recent years. The 2027 Medicare Advantage landscape is the most turbulent it’s been in years. The only way to know what’s changing in your specific plan is to review your Annual Notice of Change when it arrives in late September, or to call your plan or a local agent before that.
What happens if my Medicare Advantage plan exits New Hampshire? You’ll receive a notice from CMS and have a Special Enrollment Period to select a new plan. Critically, you’ll also have guaranteed issue rights for Medigap — meaning you can move to Original Medicare plus a Medigap supplement without medical underwriting. This window closes, so acting on it requires understanding your options before the notice arrives.
Is Aetna leaving New Hampshire for 2027? As of 2026, Aetna had already scaled back to Hillsborough and Rockingham counties only in New Hampshire. Whether they make further changes for 2027 will be officially disclosed through plan filings and beneficiary notices before and during the Annual Enrollment Period (October 15–December 7, 2026). If you’re on an Aetna plan, watch for your Annual Notice of Change in late September.
How do I know if my doctors are still in-network for 2027? Your plan’s provider directory on its member website will be updated for 2027 before Annual Enrollment opens. You can also call your doctor’s office directly and ask whether they’re still participating in your specific plan for the coming year.
Serving Bedford and All of Hillsborough County
Gilman Agency helps Medicare beneficiaries throughout Hillsborough County understand their coverage options — including Bedford, Manchester, Nashua, Merrimack, Goffstown, Amherst, Milford, Hudson, Hollis, Litchfield, Pelham, Brookline, New Boston, Weare, Antrim, Bennington, Deering, Francestown, Greenfield, Greenville, Hancock, Hillsborough, Lyndeborough, Mason, Mont Vernon, New Ipswich, Peterborough, Sharon, Temple, Wilton, and Windsor.
If you want to understand what the 2027 Medicare Advantage changes mean for your specific plan and situation, a review with Gilman Agency is always free.
📞 (800) 927-9326 or (603) 493-1394 | ✉️
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