Why Medicare Advantage Plans Are Bad In Texas

If you live in Texas and have a Medicare Advantage plan, 2026 could bring some big (and frankly unsettling) changes.

This year, we’re seeing something that many of us in the Medicare world have feared for a long time: major insurance companies pulling back on their Advantage plans in a big way.

Between UnitedHealthcare and Humana alone, more than 1.1 million Americans are losing their Medicare Advantage coverage heading into 2026 - and yes, tens of thousands of those people are right here in Texas.

Now, I don’t say that to scare you. I’ve been helping Texans with Medicare for over two decades, and I’ve seen this same story play out before - just never on this scale. My goal here isn’t to push panic; it’s to give you the truth and help you plan ahead.

The reality is that these changes aren’t random or isolated. They’re the result of a system that’s been under pressure for years - rising medical costs, tighter government reimbursements, and networks stretched too thin to serve the growing number of retirees.

And unfortunately, the people caught in the middle are the ones who rely on these plans for their healthcare.

So in this guide, we’re going to break down exactly why Medicare Advantage plans are being dropped, what it means for Texans specifically, and most importantly, what you can do to protect yourself before the next enrollment period rolls around.

If you’ve been hearing confusing headlines or you’re worried your plan might be next, don’t worry - you’re in the right place. Let’s walk through this together, one step at a time.

Here’s the truth - 2026 is shaping up to be one of the biggest shakeups we’ve ever seen in the Medicare Advantage world.

UnitedHealthcare, the nation’s largest Medicare Advantage carrier, just announced it’s cutting plans for roughly 600,000 members nationwide because of poor financial performance and unsustainable claim costs.

Not far behind, Humana confirmed it will be dropping 500,000 members by 2026, citing the same pressures: higher healthcare costs and lower reimbursement from Medicare. And it doesn’t stop there.

Cigna, another major player, exited the Medicare Advantage market entirely in 2024, selling off its plans and leaving thousands of seniors to find replacement coverage on short notice. Even smaller regional carriers are quietly pulling back or narrowing their service areas - a pattern that’s spreading fast.

Now, while those numbers sound national (and they are), Texas is feeling the impact in a big way. With one of the largest Medicare populations in the country - and one of the highest participation rates in Advantage plans - our state is right in the crosshairs of these cutbacks.

Several Texas counties have already seen Advantage plans disappear, and more are expected to lose options as these changes roll out into 2026.

We’re already hearing from clients in places like Dallas, Austin, and Corpus Christi who’ve received letters warning that their plans may not renew next year. For many of them, this isn’t just inconvenient - it’s scary. Imagine opening a letter that says the plan you rely on for your doctors and prescriptions will simply end in a few months.

The 5 Biggest Reasons Medicare Advantage Plans Are Failing Texans

#1. Prior Authorizations = Delayed or Denied Care

If you’ve ever been told your doctor needs to “get approval first,” you already know how frustrating that can be. With Medicare Advantage, this isn’t the exception - it’s the norm.

According to the Kaiser Family Foundation, over 2 million prior authorization requests were denied by Medicare Advantage insurers in a single year, and only about 11% of those denials were ever appealed

That means millions of people - including thousands of Texans - never received the care their doctors initially recommended.

Here’s how this plays out in real life. Imagine you’re recovering from a knee replacement or a stroke. Your doctor recommends physical therapy to help you heal, but before that therapy can even begin, your Medicare Advantage plan requires a prior authorization.

That paperwork has to be submitted, reviewed, and approved before treatment starts. In some cases, that process can take days - or even weeks.

Now, if you live in a major city like Houston, that delay might be a hassle. But if you live in a rural area where specialists are already hard to find, it can mean a serious setback to your recovery. Every day you’re waiting for approval is another day your health is on hold.

That’s the fundamental problem: prior authorizations create barriers between Texans and the care they’ve already earned through Medicare.

And here’s what’s worth knowing - if you had Original Medicare with a Supplement (Medigap) instead, this wouldn’t happen. There are no prior authorizations, no delays, and no waiting for an insurance company to “decide” if you can get care.

If your doctor says it’s medically necessary, it’s covered. Period.

#2. Financial Instability and Carrier Withdrawals

Another major reason Medicare Advantage plans are failing Texans comes down to something very simple: the math doesn’t work anymore.

Both Humana and UnitedHealthcare, two of the largest players in the Medicare Advantage market, are cutting huge portions of their membership going into 2026.

UnitedHealthcare is dropping around 600,000 members nationwide, and Humana is cutting another 500,000. Why? Because the government reimbursements these companies receive no longer cover the rising cost of care.

Hospitals are charging more, outpatient services are busier than ever, and people are using their plans more frequently. When that happens, insurers start losing money - and they react the same way every time: they reduce coverage areas, cut benefits, or drop plans altogether.

It’s become a roller coaster of federal funding. One year, the government reimbursement rate goes up and plans expand. The next year, rates get cut and plans disappear. There’s no consistency, and the people stuck in the middle are the ones depending on those plans for their healthcare.

For Texas retirees, that means a plan that exists today might not be there next year. Some counties could lose entire plan options, and others may see their provider networks shrink as carriers try to control costs.

Beneficiaries often find out through a letter - usually just weeks before the Annual Enrollment Period - that their plan won’t renew for the upcoming year.

It’s not the member’s fault. It’s the structure of Medicare Advantage itself. When funding fluctuates and profit margins tighten, the insurers adjust, and it’s the policyholders who feel the impact.

That financial instability is one of the biggest reasons so many Texans are rethinking whether Medicare Advantage can truly provide the long-term reliability they need.

#3. Shrinking Doctor Networks and Provider Disputes

Another major reason Medicare Advantage plans are becoming such a headache for Texans is what’s happening behind the scenes with hospitals and doctor networks.

Across the country, more and more major health systems are cutting ties with Medicare Advantage carriers because of constant disputes over payments and administrative red tape.

We’ve seen this with systems like BayCare in Florida, Scripps Health in California, and even the Mayo Clinic, which has long warned patients about the limitations of Advantage coverage.

These issues aren’t limited to other states - they’re happening here in Texas, too. Large hospital systems such as Baylor Scott & White, Houston Methodist, and Texas Health Resources have publicly voiced growing frustration with Medicare Advantage’s payment delays and complex approval processes.

When hospitals and doctors can’t get paid on time - or have to fight for weeks to get reimbursed - many decide it’s not worth staying in the network.

And when that happens, it’s the members who get caught in the middle.

Imagine going in for a routine appointment only to find out that your doctor is no longer “in-network” because the contract between the hospital and your plan fell apart. That’s what many Medicare Advantage enrollees face each year - sudden network changes that force them to start over with new providers or pay out-of-pocket to keep seeing the ones they trust.

For Texans who’ve spent years building relationships with their doctors, that can be incredibly disruptive. And because these contract disputes often happen late in the year, patients don’t always know about them until right before their coverage renews - or worse, after it already has.

With Original Medicare and a Medigap plan, this simply isn’t an issue. There are no networks to worry about, no surprise terminations, and no last-minute scrambles to find new doctors. If a provider accepts Medicare, you’re covered - anywhere in the country.

That consistency is a big reason more Texans are moving away from Medicare Advantage and toward the stability of Medicare Supplement plans.

#4. High Out-of-Pocket Costs Despite “$0 Premiums”

One of the biggest selling points you’ll hear about Medicare Advantage plans is that they have a “$0 premium.” And yes, it’s true - many of them don’t charge a monthly premium.

But here’s what often gets overlooked: “$0 premium” doesn’t mean $0 cost.

Every year, Medicare Advantage plans are allowed to set an out-of-pocket maximum, which is the most you could pay for covered services in a year. For 2025, that number can be as high as $9,350.

That means if you have a rough year medically - maybe a surgery, a hospital stay, or ongoing treatments - you could end up paying thousands before the plan’s coverage fully kicks in.

That’s a big surprise for a lot of people. They signed up thinking they were saving money with a $0 premium, only to find themselves writing check after check for copays, coinsurance, and medical bills that add up fast.

Now let’s compare that to Medicare Supplement (Medigap) coverage.

For example, a Plan G in Texas usually costs somewhere between $120 and $180 per month, depending on your age and location. That premium gives you predictable costs and real peace of mind.

Your only annual out-of-pocket expense is the Medicare Part B deductible, which is a few hundred dollars a year - and that’s it. Once that’s met, the plan covers the rest of your Medicare-approved costs.

So while a $0 premium Advantage plan might look appealing on paper, the long-term math usually tells a different story. A Medigap plan costs more up front, but it protects you from the big, unexpected bills that can throw your budget off track later.

In other words: low premiums don’t equal low costs - and with something as important as your health, predictability almost always wins.

#5. Constant Annual Changes and Instability

One thing most Texans don’t realize when they first enroll in a Medicare Advantage plan is that these plans only last 12 months at a time. Every Advantage plan in Texas is a one-year contract - which means nothing is guaranteed beyond the current year.

Each fall, insurance companies decide what they’ll keep, cut, or change for the following year. That can include everything from your copays and deductibles to your prescription coverage and even which doctors or hospitals remain in the network.

In other words, your plan might look great this year - but come January, it could be a completely different story.

That’s why it’s so important to review your plan carefully each October when you receive your Annual Notice of Change (ANOC) in the mail. This document outlines exactly what’s changing for the upcoming year.

Here’s a quick checklist every Texan with a Medicare Advantage plan should go through each fall:

• Is my doctor still in network? Provider networks change frequently, and many Texans don’t find out until it’s too late.
  
• Did my drug tier change? A prescription that was affordable this year could cost much more next year.
  
• Are my out-of-pocket costs increasing? Look for changes to copays, coinsurance, or your plan’s maximum out-of-pocket limit.

It’s a lot to keep track of - and that’s one of the biggest frustrations we hear from clients. You shouldn’t have to re-evaluate your entire healthcare plan every single year just to make sure your doctors, medications, and budget still fit.

With Original Medicare and a Supplement plan, you don’t. The coverage stays consistent year after year. No surprises, no moving parts, and no scrambling every fall to figure out what’s changing.

For many Texans, that kind of stability is worth every penny of peace of mind.

The Safer Path for Texans: Medigap Stability

After seeing everything that’s happening with Medicare Advantage - the dropped plans, shrinking networks, and rising out-of-pocket costs - it’s easy to understand why so many Texans are looking for a more stable option.

That’s where Medicare Supplement (Medigap) coverage comes in.

Unlike Medicare Advantage, Medigap plans don’t change every year. They’re federally standardized, which means a Plan G or Plan N offers the same coverage no matter which company you buy it from.

Once you’re enrolled, your coverage is guaranteed renewable for life - as long as you keep paying your premium, your plan can’t be canceled or reduced.

And here’s another key difference: there are no networks. You can see any doctor or hospital nationwide that accepts Medicare, whether you’re in Dallas, Amarillo, or visiting family in another state. There are no prior authorizations, no referral hoops, and no worrying about which medical groups are in or out of network next year.

Most importantly, Medigap plans aren’t being dropped or restructured like the Advantage plans we’ve seen disappear across the country. Carriers like UnitedHealthcare and Humana are dropping hundreds of thousands of Advantage members nationwide in 2026 - but their Medicare Supplement plans remain steady, year after year.

If you’re one of the Texans losing your Advantage coverage, there’s also some good news. You qualify for what’s called a Guaranteed Issue Right - a special enrollment window that lets you switch to a Medigap plan without medical underwriting.

That means no health questions, no denials, and no rate increases based on your medical history.

It’s a rare opportunity to move into permanent, reliable coverage that won’t change underneath you.

For Texans looking for strong, long-term stability, some of the top Medigap carriers to consider include:

• Blue Cross Blue Shield of Texas (Texas Blue) – dependable statewide coverage and a strong reputation for service.
  
• Mutual of Omaha – known for consistent pricing and steady rate history.
  
• Cigna – competitive rates with added household discounts.
  
• Aetna – a popular option for comprehensive coverage and easy plan administration.
  

All of these companies offer Plan G, Plan N, and in some cases High-Deductible Plan G, giving you predictable, nationwide protection without the annual headaches that come with Advantage plans.

If stability, flexibility, and peace of mind are what you’re after - Medigap is the path that gets you there.

Our Favorite Plans and Why They Work

Once you’ve decided to move away from the uncertainty of Medicare Advantage, the next question is usually, “Okay, which Medicare Supplement plan should I choose?”

The good news is that Medigap plans are standardized - meaning the benefits for each plan letter (like G, N, or High Deductible G) are exactly the same no matter which insurance company you buy from.

What really matters is finding the plan that fits your lifestyle, budget, and comfort level with out-of-pocket costs.

After helping thousands of Texans compare these options, here are the three plans we recommend most often - and why they work so well here in Texas.

Plan G: The Most Comprehensive Coverage

Plan G is hands-down the most popular Medigap plan in Texas right now, and for good reason. It covers all Medicare-approved costs except for your small annual Part B deductible (which is just a few hundred dollars a year).

After that deductible, you’re covered 100% for the rest of the year - no copays, no coinsurance, no surprise bills.

Why it works for Texans:

• It’s ideal for people who want maximum coverage and predictability.
  
• Works great for those who travel or split time between cities - because you can see any doctor in the country who accepts Medicare.
  
• It’s also the easiest plan to understand: you pay your premium and your Part B deductible, and that’s it.
  

For many of our clients, Plan G offers the perfect balance between peace of mind and value.

Plan N: A Smart Choice for Healthy Texans

Plan N offers many of the same benefits as Plan G but comes with a lower monthly premium.

The trade-off? You’ll pay a small copay when visiting the doctor (up to $20) or the emergency room (up to $50 if you aren’t admitted).

It doesn’t cover “Part B excess charges,” but those are rare in Texas.

Why it works for Texans:

• It’s great for healthy retirees who don’t visit the doctor frequently and want to save a bit each month.
  
• The small copays are easy to plan for and still offer far better predictability than Advantage plans.
  
• Many Texas carriers price Plan N very competitively, especially for non-smokers and couples who qualify for household discounts.
  

Plan N strikes a nice middle ground - you get solid coverage and a lower premium without giving up network freedom.

High Deductible Plan G: Protection on a Budget

High Deductible Plan G (often called HDG) has the same benefits as regular Plan G but with a higher deductible - $2,870 before full coverage begins (the exact number changes slightly each year).

The trade-off is that the monthly premium is often half the cost of a standard Plan G.

Why it works for Texans:

• It’s an excellent option for people who are healthy, budget-conscious, or transitioning off employer coverage.
  
• It protects against major medical expenses - the “worst-case” scenarios - without a large monthly commitment.
  
• Many Texans like that it keeps costs low month to month but still gives them full Medigap protection when they need it most.
  

HDG gives you the same nationwide access and lifetime renewability as every other Medigap plan - just with more flexibility for those watching expenses closely.

Bottom Line

All three of these Medigap plans - Plan G, Plan N, and High Deductible G - offer what Texans value most: freedom, stability, and no surprises.

They all work alongside Original Medicare, they’re accepted nationwide, and once you enroll, your coverage doesn’t change unless you decide to make a change.

If you’re comparing your options for 2026, these plans are the safest, most reliable alternatives to Medicare Advantage - and they’re built to stay that way.

What to Do If Your Plan Is Being Dropped

If you’ve received a letter saying your Medicare Advantage plan won’t be renewed for 2026, take a deep breath - you’re not alone, and you have good options.

Tens of thousands of Texans are in the same boat this year after major carriers like UnitedHealthcare and Humana announced they’re cutting a combined 1.1 million members nationwide. The good news is, when a plan ends through no fault of your own, you’re protected by federal Medicare rules.

Here’s exactly what to do if your plan is being dropped:

Step 1: Don’t panic - you have rights. If your Medicare Advantage plan is being discontinued, you qualify for a Guaranteed Issue Right. That means you can switch to a Medicare Supplement (Medigap) plan without medical underwriting.

No health questions, no denials, no rate increases based on preexisting conditions.

This protection exists specifically for situations like this - so you can move into stable coverage without penalty.

Step 2: Keep your non-renewal notice and proof of coverage. Hang on to any letters or notices your plan sends you. These documents serve as proof that your Advantage plan was discontinued, which you’ll need when applying for Medigap coverage under your Guaranteed Issue Right.

Step 3: Compare your Medigap options right away. As soon as you receive your notice, start looking at Medicare Supplement plans available in your area. Don’t wait until the last minute - the Annual Enrollment Period gets busy, and rates can vary depending on the carrier and timing.

Focus on the plans that offer the best long-term stability: Plan G, Plan N, and High Deductible G are the most popular options for Texans. These plans provide predictable costs, nationwide coverage, and no prior authorizations.

Step 4: Add a Part D prescription plan if needed. If you’re switching from Medicare Advantage to Medigap, you’ll also need to choose a standalone Part D drug plan for prescription coverage.

The good news is, you can pick whichever plan best fits your medication list - you’re not locked into one carrier’s formulary anymore.

Step 5: Get guidance from a licensed agent. This is one of those times when having an experienced Medicare agent in your corner makes all the difference. They can walk you through which Medigap companies are the most stable in Texas, help you pair the right Part D plan, and ensure you don’t miss any deadlines.

Timing Tip: Most Texans will receive their non-renewal notices in October - right before the Annual Enrollment Period (October 15 – December 7). Start comparing early so you don’t feel rushed or miss out on your Guaranteed Issue window.

Having your plan dropped isn’t the end of the road - it’s a chance to move into something far more reliable. With Medigap, your coverage won’t change every year, your doctors stay your doctors, and you’ll never have to worry about getting another “termination” letter again.

Final Thoughts: Protecting Your Coverage Before It’s Too Late

If there’s one thing we want every Texan to take away from this, it’s that this isn’t about fear - it’s about being prepared.

Medicare Advantage plans can look attractive at first glance. The low premiums, extra benefits, and flashy advertising make them sound like the best deal in town.

But as we’ve seen across Texas this year, those plans can change overnight. Providers drop out, benefits get trimmed, and in some cases, entire plans disappear.

You deserve better than that kind of uncertainty.

That’s why it’s so important to review your Annual Notice of Change as soon as it arrives in the mail this fall - usually in October. That letter tells you exactly what’s changing in your plan for the upcoming year.

If you see higher copays, a smaller network, or a dropped benefit, that’s your signal to start comparing alternatives right away.

Remember, there’s no harm in looking - but there can be real harm in waiting too long.

If your Medicare Advantage plan is changing or being dropped, our licensed Texas agents can help you review Medicare Supplement (Medigap) options that never disappear or change without your consent.

We’ll walk you through which plans fit your budget, explain how Guaranteed Issue Rights work, and make sure you have coverage you can count on for the long run.

How We Can Help

Here at Policy Guide, helping Texans navigate Medicare isn’t just what we do - it’s what we care about.

We know how overwhelming this process can feel. Every year, plans change, benefits shift, and the mail starts filling up with advertisements promising “free” coverage.

It’s hard to know who to trust or where to even start. That’s why our approach is different - we focus on education first, not sales.

When you call us, you’re talking to a licensed Medicare agent who’s been doing this for years - someone who knows exactly how these plan changes affect Texans because we work with them every single day.

We’ll take the time to:

• Review your current coverage and explain what’s changing for 2026.
  
• Compare your options side-by-side, including Medigap and Part D plans, so you can see the pros and cons clearly.
  
• Help you transition smoothly if your Medicare Advantage plan is being dropped - including walking you through your Guaranteed Issue Rights.
  
• Find a long-term solution that won’t change underneath you year after year.
  

We don’t push one company or plan over another. Instead, we help you find what actually fits - your doctors, your budget, and your peace of mind.

So whether you’re worried your plan is ending, or you just want to make sure you’re protected for the long haul, we’re here to help you make sense of it all.