- UnitedHealthcare and Aetna are shifting more Medicare Advantage members toward narrower provider networks for 2027 as insurers respond to higher medical costs and changes in government payments.
UnitedHealthcare and CVS Health’s Aetna are preparing to offer more Medicare Advantage plans with limited provider networks in 2027, a shift that could change which doctors and hospitals are available to some beneficiaries.
The changes come as insurers contend with higher medical costs, increased healthcare utilization and pressure on Medicare Advantage reimbursement. Medicare Advantage is the private-plan alternative to Original Medicare, with insurers receiving government payments to provide Medicare-covered benefits.
Wealthier Today's Medicare Advantage coverage guide explains how Part C plans differ from traditional Medicare, including their use of insurer-specific provider networks. The changes are arriving just before the 2027 Medicare open enrollment period, which runs from Oct. 15 through Dec. 7.
UnitedHealthcare and Aetna Change Medicare Advantage Networks
UnitedHealthcare, the largest Medicare Advantage insurer, said it will withdraw from locations where it currently has a higher concentration of preferred provider organization, or PPO, plans. PPO plans generally give members more flexibility to use providers outside the plan network, although that flexibility can make them more expensive for insurers to operate. UnitedHealthcare said 66% of its members will have access to both HMO and PPO plans in 2027, compared with 70% in 2026.
UnitedHealthcare's own 2027 Medicare Advantage announcement says the company is placing greater emphasis on HMO, Chronic Special Needs Plan, and Dual Special Needs Plan offerings.
Aetna is also expanding its use of health maintenance organization plans, which generally rely on smaller provider networks. According to the company, the strategy is part of its 2027 Medicare Advantage offering.
An analyst at TD Cowen estimated that Aetna could lose about 950,000 enrollees next year as it withdraws from some states. Aetna is expected to offer plans in 41 states in 2027, compared with 43 this year. Humana is also reducing its geographic footprint. The insurer said its Medicare Advantage plans will be available in more than 80% of US counties next year, down from 85% in 2026.
The changes are not occurring in isolation. CMS' 2027 Medicare Advantage announcement projects that average monthly Medicare Advantage premiums will fall from $14.37 in 2026 to $12 in 2027.
Lower Medicare Advantage Premiums Come With Plan Changes
The national premium decline does not mean every beneficiary will pay less or retain the same coverage. CMS expects approximately 34 million people to enroll in Medicare Advantage in 2027, representing about 47.4% of the Medicare population. The agency also projects that about 5,532 Medicare Advantage plans will be available nationally, compared with 5,553 in 2026.
More than 99% of Medicare beneficiaries are expected to have access to at least one Medicare Advantage plan, while 97% are expected to have access to 10 or more options. However, the national figures can obscure changes at the state, county, and individual plan level.
A beneficiary may face changes to which physicians or hospitals are considered in-network even if the plan remains available. That makes provider networks an important consideration alongside premiums, drug coverage, deductibles and other cost-sharing provisions.
Wealthier Today's recent Medicare Advantage premium analysis found that CMS expects plan availability to remain broadly stable nationally even as insurers adjust individual offerings.
The insurer pullback reflects a broader change in the economics of Medicare Advantage. Reuters reported that insurers have pointed to rising medical costs and higher utilization while arguing that government reimbursement has not kept pace with those expenses. The federal government has reduced payments to Medicare Advantage insurers since 2024 as part of efforts to reduce program spending.
CMS finalized 2027 payment policies in April, projecting a 2.48% average increase in Medicare Advantage payments, equivalent to more than $13 billion. For beneficiaries, the next major step is reviewing their individual 2027 plan information rather than relying solely on national averages. CMS says beneficiaries can compare 2027 Medicare Advantage and prescription-drug options through Medicare.gov during open enrollment.
The combination of lower projected average premiums and narrower or altered provider networks means the cost of a Medicare Advantage plan in 2027 will depend on more than its monthly premium.