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Humana Medicare Advantage Exit Could Give 600,000 Members a Rare Medigap Opportunity


Humana Medicare Advantage Exit Could Give 600,000 Members a Rare Medigap Opportunity

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Humana is preparing to exit Medicare Advantage plans, which could affect roughly 600,000 members in 2027. This could also potentially force hundreds of thousands of seniors to choose new coverage. For some, however, losing their current plan could unlock a valuable opportunity to obtain Medigap coverage without medical underwriting.

Humana disclosed the planned exits during its July earnings call as part of an effort to improve the profitability of its Medicare Advantage business. CFO Celeste Mellet said the company intends to prioritize higher-performing plans while trying to move a big portion of affected members into other Humana offerings. Humana previously recaptured just over 40% of members affected by its 2025 exits.

Humana Q2 2026 earnings

The insurer has nearly 7.2 million Medicare Advantage members, which makes the planned exits a massive reshaping of its portfolio. Humana is targeting a sustainable Medicare Advantage margin of at least 3% by 2028.

Humana Stock Falls Before Friday’s Close

Investors are also watching Humana’s turnaround closely. Humana shares dropped 1.81% on Friday, Aug. 28, to close at $385.54, snapping a four-session winning streak. 

Humana stock price over the past 6 months (Source: CoinCodex)

Despite Friday's decline, HUM is still up by more than 105% over the past six months.

Losing a Humana Plan Could Unlock Medigap

Members whose Medicare Advantage plans disappear may receive an important protection that is easy to overlook.

Federal rules generally provide a guaranteed-issue Medigap right when a Medicare Advantage plan leaves Medicare or stops serving a person's area, provided the member switches to Original Medicare. That means a Medigap insurer cannot reject an eligible applicant because of their health or charge more based on medical conditions.

Available plans can include Medigap Plans A, B, C, D, F, G, K and L, depending on eligibility. People who became eligible for Medicare on or after Jan. 1, 2020 generally cannot buy Plans C or F. The federal Medigap window can begin 60 days before Medicare Advantage coverage ends, giving members time to investigate their options.

Affected Humana members therefore should not automatically move into whichever replacement Advantage plan is offered. Doctor networks, drug formularies, copays and out-of-pocket limits could all change.

For some of the roughly 600,000 people affected, an unwanted cancellation notice could ultimately provide something valuable: a rare opportunity to reconsider Medicare Advantage versus Original Medicare and Medigap without their health history standing in the way.

Read the article at Coinpaper

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