Maine Insurers Reduce Medicare Advantage Plans Amid Cost Pressures

At least four insurance companies are reducing their Medicare Advantage plan offerings in Maine, reflecting broader trends of cost pressures and regulatory changes affecting the program. Both **Anthem** and **Aetna** have confirmed cutbacks, while **UnitedHealthcare** is pulling one of its plans, and **Martin’s Point Health** is discontinuing at least one plan.

The decisions come as costs rise and federal funding for Medicare faces reductions. **Aetna**’s changes will impact approximately **1,400** members in Maine, while **UnitedHealthcare** will affect about **100** individuals with its plan withdrawal. The precise number of Mainers impacted by these changes remains unclear, as does the extent of reductions across various counties.

Details on Medicare Advantage Changes

Medicare Advantage plans, which are private insurance options approved by the federal government, typically cover the same services as traditional Medicare but with added benefits like vision, dental, and prescription drug coverage. These plans generally operate through a specific network of providers. The current adjustments by insurers follow a national trend, where many companies have cut back their offerings due to rising operational costs and increased usage of healthcare services.

According to the **Maine Bureau of Insurance**, state officials are investigating the specific changes being made by insurers. **Bob Carey**, superintendent of the bureau, noted that there is no centralized source of information regarding the presence of these plans in Maine, partly due to federal regulations. He confirmed awareness of several plans exiting certain counties.

In 2022, over **212,000** Mainers were enrolled in private Medicare Advantage plans, as reported by **KFF**. Nationwide, about half of those eligible for Medicare, including individuals aged **65** and older as well as younger people with disabilities, are enrolled in Advantage plans.

Insurers Detail Their Decisions

**Anthem Blue Cross and Blue Shield** announced its plan reductions for **March 2026**, but did not specify how many Mainers would lose their coverage. The company also intends to exit New Hampshire entirely next year. The company has faced scrutiny for its decision-making, particularly as it reduces options in a market already strained by cost challenges.

**UnitedHealthcare** is also making significant changes, stating that the adjustments are part of a strategy to ensure long-term affordability and stability. Earlier this month, the company revealed it would stop offering Advantage plans in **109** counties nationwide due to rising costs and operational complexities.

**Martin’s Point Generations Advantage** is discontinuing at least one of its plans, but details on the rationale behind this decision remain sparse. The company continues to list other plans available in Maine for the upcoming year.

Health experts have raised concerns about the sustainability of Medicare Advantage plans. **Jeff Austin**, vice president of government affairs and communications at the **Maine Hospital Association**, has pointed out that while these plans are marketed as affordable, they often result in lower reimbursements for healthcare providers. He stated that Advantage plans typically reimburse providers at **20** percent below the cost of services compared to traditional Medicare, which reimburses at **10** percent below.

Options for Affected Members

Members whose plans are being discontinued will be notified by their insurers. This communication is crucial, as it allows them to select a new plan without undergoing medical underwriting. Affected individuals can transfer to another Advantage plan or enroll in a **Medicare Supplement** (Medigap) plan. While Supplement plans do not offer additional benefits, they allow members to see any provider that accepts Medicare, regardless of network constraints.

Requests for comments from other Maine insurers and consumer advocacy groups went unanswered. Questions directed to the Department of Health and Human Services were referred to the insurance bureau, highlighting the fragmented nature of information regarding these changes.

As Maine navigates these insurance adjustments, the state will continue to monitor the situation and its impact on residents relying on Medicare Advantage plans.