By Marc Gilman
📞 (800) 927-9326 |
This is Part 3 of a 3-part series on Medicare Advantage market disruption. Part 1 explains the national trend. Part 2 covers what happened in New Hampshire for 2026.
New Hampshire’s Medicare Advantage market has already lost Anthem, Martin’s Point, Harvard Pilgrim, Wellcare, and most of Aetna’s statewide presence in two years. Carroll County now has no standard Medicare Advantage plan for the general Medicare population.
The question for 2027 is: does it get better, or does the disruption continue?
The signals visible in August 2026 suggest continued turbulence. Here’s what we’re watching, what your rights are if your plan is discontinued, and exactly what you should do before December 7, 2026.
Key Takeaways
-
More exits and benefit changes are expected for 2027. CVS/Aetna has signaled continued margin-over-growth strategy. Humana confirmed 2027 market exits this week. The 2.48% CMS rate increase again falls short of medical cost inflation.
-
Aetna’s 2027 status in Hillsborough and Rockingham is not yet confirmed. The scope of Aetna’s 2027 footprint in New Hampshire will be revealed through ANOC letters by September 30, 2026.
-
Your ANOC letter is the most important piece of mail you’ll receive this fall. Read it when it arrives. Do not set it aside.
-
If your plan is discontinued, you receive a Special Enrollment Period — and potentially a rare guaranteed-issue window to move to a Medigap supplement without medical underwriting.
-
AEP runs October 15 through December 7, 2026. Do not auto-renew without reviewing.
What We’re Watching for 2027
Aetna in Hillsborough and Rockingham counties. After exiting seven counties for 2026, Aetna currently operates only in Hillsborough and Rockingham. The company has explicitly stated it is prioritizing margins over membership growth for 2027. Whether those two remaining New Hampshire counties remain in Aetna’s footprint will be confirmed in ANOC letters by September 30, 2026. If you are currently on an Aetna plan in either county, do not assume continuation.
Humana. Humana confirmed additional 2027 market exits this week (August 2026), with an estimated 600,000 members nationally expected to need to switch plans. Humana’s specific county-level decisions for New Hampshire have not yet been announced. Given Humana’s role as the most widely available carrier in New Hampshire for 2026 — present in nine of ten counties — any Humana exits would represent significant additional disruption.
WellSense. WellSense dropped its standard PPO statewide for 2026 except in Hillsborough. The 2027 plan year may bring further restructuring or possible exit decisions.
UnitedHealthcare. Present in four counties. UHC is also facing medical cost pressures nationally and has trimmed its geographic footprint in prior years.
The 2.48% CMS rate problem. The structural issue — CMS rates not keeping pace with medical cost inflation — has not changed. Until it does, the financial pressure driving market exits persists.
Six Types of Changes to Watch for in Your 2027 Plan
“Benefit changes” can mean very different things. Here is what to look for in your ANOC letter:
1. Complete market exit. Your plan stops operating in your county. You will receive required notice and a Special Enrollment Period. Most disruptive — but also provides guaranteed-issue Medigap rights (see below).
2. Supplemental benefit reductions. Dental allowances, OTC cards, grocery benefits, vision coverage, or gym memberships reduced or eliminated. Your core Medicare coverage continues, but perks may disappear. A lost $75/month grocery card is $900 of real value per year.
3. Premium increases. Previously $0 plans may introduce modest monthly premiums — $20 to $50. Still low compared to Medigap, but a real change for enrollees who built their budget around $0.
4. Network narrowing. Hospitals, specialists, or pharmacies dropped from the network. If your doctors or preferred hospital are removed, costs can increase sharply or care may become unavailable in-network.
5. Prior authorization expansion. Additional procedures or medications require advance approval before coverage kicks in.
6. Formulary changes. Medications may shift to higher-cost tiers or be removed from coverage entirely, requiring an exception process.
Your ANOC Letter: What It Is and What to Do With It
By law, your Medicare Advantage plan must send you an Annual Notice of Change (ANOC) by September 30, 2026. This document details every change to your 2027 plan: premiums, cost sharing, network, formulary, supplemental benefits, and service area.
Read it the day it arrives. Don’t set it aside. Don’t assume it says nothing important because your plan has been fine for several years. Insurers are required to disclose changes in the ANOC — but the changes can be buried in dense document language. What you’re looking for:
-
Is your plan continuing in your county in 2027?
-
Are premiums changing?
-
Are your doctors still in-network?
-
Is your formulary changing for medications you take?
-
Are any supplemental benefits being reduced?
If you don’t receive your ANOC by October 10, call your plan’s member services number directly and ask for the 2027 plan details.
Don’t rely on mail alone. When AEP opens October 15, 2026, go to medicare.gov/plan-compare and enter your zip code, current doctors, and medications to see all available 2027 plans in your county. This is the fastest way to verify your plan’s continued availability and compare alternatives.
If Your Plan Is Discontinued: The Guaranteed-Issue Window
If your Medicare Advantage plan exits your county for 2027, federal law gives you a Special Enrollment Period to select a replacement — typically through February 28, 2027.
Do not wait for this SEP to act. If you can, make your decision during AEP (October 15–December 7), when you have the full range of options and the most time to compare carefully.
The guaranteed-issue opportunity. There is one additional right that most affected enrollees don’t know about: if your Medicare Advantage plan is discontinued, you have guaranteed-issue rights for Medigap plans during your SEP. This means a Medigap insurer cannot deny you coverage or charge more because of your health history — even if you are well outside your original six-month Medigap Open Enrollment Period.
For people who are past that initial window and have health conditions that would otherwise make Medigap underwriting difficult or impossible, a plan exit may be one of the only remaining opportunities to move to a Medigap supplement without the insurer reviewing your medical history. This is a significant right that many people let pass without realizing its value.
If your plan is discontinued and you’re considering moving to Original Medicare with Medigap — call us before the window closes. We can help you understand which Medigap plans are available in New Hampshire and what they would cost in your specific situation.
Your Coverage Options for 2027
If your current plan changes significantly or is discontinued, here’s a clear comparison of your primary options:
Estimated costs based on 2026 figures. Medigap costs vary by age, health history (outside guaranteed-issue windows), and carrier.
Original Medicare with a Medigap plan is the option most resistant to Medicare Advantage market disruption. It is accepted by any Medicare-participating provider anywhere in the country. There are no network boundaries, no county service areas, no annual risk that your plan is discontinued. For New Hampshire residents who have been disrupted by two consecutive years of carrier exits, it may be worth a serious look — particularly if a plan exit provides a guaranteed-issue window.
What to Do Right Now: Your AEP Checklist
Now (August–September):
-
Locate your current plan card and note your carrier, plan name, and county
-
Mark your calendar: ANOC letter due by September 30 / AEP opens October 15 / AEP closes December 7
When your ANOC arrives (late September):
-
Read it completely — note any premium, network, benefit, or service area changes
-
If your plan is exiting your county, contact us immediately about your options, including the Medigap guaranteed-issue window
When AEP opens (October 15):
-
Go to medicare.gov/plan-compare, enter your zip code, doctors, and medications
-
Compare every plan available in your county — not just plans from your current carrier
-
Verify that your current doctors and pharmacy are in-network under any plan you’re considering
-
Verify that your medications are on the 2027 formulary at an acceptable tier
Do not auto-renew without reviewing. If you take no action during AEP, your current plan auto-renews — or if your plan was discontinued, CMS may assign you to a default plan. Neither outcome is guaranteed to be right for your situation.
Call us. If you’re in any New Hampshire county and want to understand what’s available for 2027 — whether Medicare Advantage plans, Medigap, or Original Medicare with Part D — we represent multiple carriers and can show you what’s actually available in your specific county. Plan reviews are always free and there is never any obligation.
The Bottom Line
Two things are true simultaneously: we don’t yet know exactly which plans will exist in New Hampshire for 2027, and the signals strongly suggest continued disruption. The structural problem — CMS rates that don’t keep pace with medical cost inflation — has not resolved. Major carriers have stated publicly they are prioritizing margins over growth heading into 2027.
The safest posture for New Hampshire Medicare beneficiaries is to treat this AEP as a fresh review, not a formality. Read your ANOC. Compare your options. Don’t assume your plan is safe because it was fine last year.
AEP opens October 15, 2026. It closes December 7, 2026.
📞 (800) 927-9326 | ✉️ | gilmanagency.com
Book a free plan review at calendly.com/marcgilman
📰 Part 1: The National Medicare Advantage Trend · Part 2: What Happened in New Hampshire for 2026
