By Marc Gilman
📞 (800) 927-9326 |
This is Part 2 of a 3-part series on Medicare Advantage market disruption. Part 1 explains the national trend driving these changes. Part 3 covers what may happen in New Hampshire for 2027 and what to do before December 7.
In October 2025, the New Hampshire Insurance Department issued a warning: the state’s Medicare Advantage market was about to change significantly for 2026. Commissioner DJ Bettencourt went further in testimony before the House Commerce and Consumer Affairs Committee: “From what I am observing, the Medicare Advantage market as it exists today is collapsing.”
That warning proved accurate. What happened to New Hampshire’s Medicare Advantage market for 2026 is one of the most significant disruptions in the state’s Medicare history — and understanding it is essential context for what may happen next.
Key Takeaways
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Four carriers have exited New Hampshire’s Medicare Advantage market in the past two years: Harvard Pilgrim, Wellcare (2025), Anthem, and Martin’s Point (2026).
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Aetna exited seven of ten counties for 2026, continuing only in Hillsborough and Rockingham.
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Approximately 77,000 Granite Staters were directly affected by the 2026 changes.
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Carroll County has no standard Medicare Advantage plan available to the general Medicare population in 2026 — the first county in New Hampshire to reach that point.
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Humana is available in nine of ten counties — the most widely available carrier — but is absent from Carroll County.
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WellSense dropped its standard PPO statewide for 2026 except in Hillsborough County, shifting to primarily a Medicaid-integrated plan for dual-eligible members elsewhere.
The Carriers That Left New Hampshire
2025 exits:
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Harvard Pilgrim Health Care — exited all NH Medicare Advantage plans
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Wellcare — exited all NH Medicare Advantage plans
2026 exits:
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Anthem Blue Cross Blue Shield — exited all individual Medicare Advantage plans statewide. In a statement, Anthem said the decision “allows us to focus our resources on the Medicare offerings where we can be most competitive.”
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Martin’s Point Health Care — exited all individual Medicare Advantage plans statewide.
These four departures represent a dramatic reduction in carrier choice for New Hampshire residents in just two enrollment cycles.
What Aetna Did
Aetna’s 2026 retreat was the most geographically specific change — and among the most impactful, given how many NH residents had been enrolled in Aetna plans.
Counties Aetna exited for 2026: Belknap, Carroll, Cheshire, Grafton, Merrimack, Strafford, and Sullivan
Counties where Aetna remains for 2026: Hillsborough and Rockingham only — where it continues to offer its Medicare Elite (HMO-POS) and Medicare Eagle Giveback (PPO) products.
For residents of Belknap, Carroll, Cheshire, Grafton, Merrimack, Strafford, and Sullivan counties who were enrolled in Aetna plans, 2026 required a full plan change. Those who took no action during the 2025 AEP triggered a Special Enrollment Period and had to select replacement coverage.
County-by-County: The 2026 New Hampshire Picture
Hillsborough County and Rockingham County The most plan options in the state. Aetna, UnitedHealthcare, Humana, and WellSense all have a presence. Even here, however, the total number of plan choices is smaller than it was in 2024.
Merrimack County and Strafford County UnitedHealthcare (AARP Medicare Advantage plans), Humana, and WellSense. No Aetna.
Belknap, Cheshire, Grafton, and Sullivan Counties Humana and WellSense only. No Aetna. No UnitedHealthcare community plans (UHC offers nursing home plans but no community Medicare Advantage options in these counties).
Coos County WellSense and Humana only. No Aetna. No UnitedHealthcare. The most rural and geographically isolated county in the state is also now among the most limited in plan choice.
Carroll County No standard Medicare Advantage plan is available to the general Medicare population. WellSense has a presence in Carroll County but only through a Medicaid-integrated HMO for dual-eligible members — people enrolled in both Medicare and Medicaid. For the majority of Medicare enrollees who don’t have Medicaid, there are no Medicare Advantage options in Carroll County for 2026.
What the Carriers That Remained Are Offering
Humana — Available in nine of ten counties (all except Carroll). Humana discontinued one plan in Carroll County and introduced new plan options in Belknap, Carroll, Hillsborough, Merrimack, Rockingham, and Strafford. Despite the expansion announcements, Carroll County ended up without Humana coverage for the standard Medicare population.
WellSense — Statewide presence on paper, but with an important limitation: WellSense discontinued its standard PPO plan in most of the state. It now offers a standard PPO only in Hillsborough County. In the remaining nine counties, WellSense’s primary offering is an HMO plan for members who qualify for both Medicare and Medicaid (a dual-eligible integrated plan). Most Medicare-only enrollees cannot access this plan.
UnitedHealthcare — Offers AARP Medicare Advantage plans in Hillsborough, Merrimack, Rockingham, and Strafford counties. Absent from Coos, Belknap, Carroll, Cheshire, Grafton, and Sullivan for community plans (though nursing home-specific plans are available in some of those counties).
Aetna — Hillsborough and Rockingham only, as described above.
What This Means Practically
77,000 Granite Staters were directly affected by the 2026 changes — meaning their plan was discontinued or significantly altered by carrier exits or benefit restructuring.
For affected residents, the options were:
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Enroll in another Medicare Advantage plan during AEP (October 15–December 7, 2025) or through a Special Enrollment Period
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Return to Original Medicare with or without a Medigap supplement and Part D plan
For residents of Carroll County specifically, the choice became particularly stark: no Medicare Advantage plan is available for the general Medicare population, so the practical options are Original Medicare plus a Medigap supplement and Part D, or a standalone Part D plan — with no Medicare Advantage alternative.
New Hampshire also passed legislation in 2025 requiring insurers to provide advance notice when withdrawing Medicare Advantage plans, giving the Insurance Department greater visibility into carrier decisions. Commissioner Bettencourt acknowledged this was intended to give beneficiaries and regulators more time to prepare — but noted that earlier notice doesn’t change the underlying financial pressures driving the exits.
The Larger Picture
What happened in New Hampshire for 2026 isn’t an anomaly. It’s an accelerated version of a national trend playing out in rural and lower-density markets where building adequate provider networks has always been harder — and where the CMS rate environment now makes those networks harder to sustain financially.
The NH Insurance Department’s count of 77,000 affected enrollees represents a significant portion of the state’s Medicare Advantage population. And those disruptions are happening in a state where the Medicare-age population is growing steadily and where rural residents often have the fewest alternative coverage options.
The next post in this series looks at what may happen in New Hampshire for 2027 — what signals are already visible, what to watch for, and what to do before AEP closes on December 7, 2026.
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📰 Part 1: The National Medicare Advantage Trend · Part 3: What May Happen in New Hampshire for 2027
