Health insurers are reducing or discontinuing Medicare Advantage plan offerings in Vermont and New Hampshire for the 2026 plan year, according to state regulators.
In New Hampshire, Anthem Blue Cross and Blue Shield and Martin’s Point Health Care will no longer offer Medicare Advantage plans.
CVS Health Corp.’s Aetna is withdrawing individual Medicare Advantage plans from most counties and will fully exit the market in seven counties, the New Hampshire Insurance Department said.
Other health insurers in the state have indicated plans to scale back offerings and narrow service areas, impacting approximately 77,000 residents, according to a BestWire report.
Insurance Commissioner DJ Bettencourt (pictured above) said, “While these withdrawals and reductions will create challenges and uncertainty for many Granite Staters, New Hampshire’s market will continue to offer meaningful plan options and strong consumer protections.”
The department has greater insight into these exit plans due to a new law requiring all licensed insurance companies, including health carriers, to notify regulators of intentions to exit product lines, Bettencourt said. He previously noted that shrinking federal payments and tighter regulatory requirements are contributing to these decisions.
The Medicare Advantage landscape is also being shaped by ongoing changes to Medicare Part D. For 2026, the maximum out-of-pocket cap will increase to $2,100, and it will be the first year that federal drug price negotiations for selected high-cost drugs are enforced under the Inflation Reduction Act.
An Anthem spokesperson said the move will allow the company to focus resources on Medicare plans it will continue to offer in New Hampshire. CVS stated that the changes will not affect Aetna’s group Medicare Advantage offerings in the state.
“We remain committed to serving our Group Medicare clients and the needs of their retirees in all the US geographies in which they have retirees,” a CVS spokesperson said.
In Vermont, Vermont Blue Advantage, an affiliate of Blue Cross Blue Shield of Vermont, will end all Medicare Advantage plans at the end of this year, the Vermont Department of Financial Regulations reported. Blue Cross Blue Shield of Vermont will continue to offer Medicare supplement plans in the state.
These changes come as the Medicare Advantage market faces increased scrutiny and regulatory shifts. A federal judge in Texas recently vacated a rule that would have expanded the government’s authority to audit Medicare Advantage plans and recover alleged overpayments.
The rule, finalized in 2023, would have allowed the Centers for Medicare and Medicaid Services (CMS) to extrapolate audit findings across all enrollees, but the court found that affected parties had not been given fair notice of the change.
In another recent development, Humana was ordered to pay more than $32 million in attorneys’ fees after settling a federal False Claims Act case for $90 million. The case involved allegations that Humana deliberately inflated its Medicare Part D bids to secure more favorable contract terms, resulting in substantial overcharges to the government.
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