Maryland seniors are once again searching for new health coverage as insurers trim or eliminate Medicare Advantage plans across the state heading into 2027. Carriers have pointed to the cost of doing business under Maryland's hospital payment system as the reason for the pullback, leaving older residents to sort through fewer options during this year's enrollment window.
According to The Baltimore Sun, insurers say Maryland's current hospital system makes it too costly for them to operate in the state, a complaint that has been building for more than a year. As reported by Maryland Matters, state officials have approved a policy letting Medicare Advantage plans reimburse hospitals at a rate about 11.55% lower than what they currently pay, starting in 2027. To offset that financial hit to hospitals, the state's Health Services Cost Review Commission plans to raise rates charged to private insurers instead, according to the same outlet.
State documents cited in that report estimate those commercial rates will climb by 0.75% once the policy is fully implemented — a cost that could eventually be passed along to people with employer-based or individual private insurance, not just Medicare enrollees.
A Shrinking Pool of Carriers
The cuts aren't new to 2027. Maryland Matters reported in October 2025 that Humana notified members affected by plan terminations they would keep their current coverage only through the end of that year. The insurer said its Gold Plus SNP plan would stop being available beginning January 1, 2026, in Anne Arundel, Baltimore, Harford and Howard counties, plus Baltimore City, per the same outlet.
Aetna, meanwhile, told Maryland Matters it would only offer Medicare Advantage in three counties for 2026 — Frederick, Harford and Montgomery — a sharp narrowing of its footprint in the state. The article noted that a state grant that had been propping up Maryland's Medicare Advantage market was going away, and some insurers had already shrunk their presence as a result.
For 2027, state insurance regulators say insurance.maryland.gov UnitedHealthcare will continue offering two D-SNP plans while discontinuing six Medicare Advantage plans altogether. The insurer's I-SNP PPO plan will no longer serve Carroll County next year but will begin covering Allegany, Garrett and Worcester counties instead, according to that low-confidence state listing.
Maryland's Long-Running Cost Gap
The roots of the problem predate this year's cuts. The Baltimore Sun reported in September 2025 that of Maryland's 1.1 million Medicare recipients, only about 295,000 were enrolled in Medicare Advantage — a participation rate under 27%, well below the national norm. The same reporting found that insurance carriers in Maryland pay higher hospital rates than carriers in other states while receiving lower federal reimbursement for Medicare Advantage services, a structural mismatch that has squeezed insurer margins for years.
Former Health Services Cost Review Commission member Adam Kane told the Sun that state grants meant to help were supposed to be a temporary fix to a longstanding problem, not a permanent solution. Maryland Matters reported in November 2025 that insurance carriers blame the state's hospital system for being too costly to operate in, which it said was driving several carriers to pull out of the state entirely or reduce their coverage, leaving thousands of retirees without the plans they had relied on.
It isn't the first time Maryland seniors have faced this kind of disruption. The Sun's September 2025 reporting recalled that in 2021, Johns Hopkins Medicine ended its Medicare Advantage plans for Baltimore City residents, forcing roughly 5,000 seniors to find new coverage on short notice.
A Shift Years in the Making
The pressure on Maryland's market is tied to a bigger transition. The Sun reported in August 2026 that Maryland's AHEAD model, a new hospital payment framework, is expected to strip the state of its authority to set Medicare hospital rates starting in 2028. CareFirst executive Kim Robinson told the Sun the new system could shift costs onto the private market, with commercial payer rates anticipated to rise as a result.
A National Pattern, Too
Maryland's insurer exits are playing out against a broader national pullback in Medicare Advantage offerings. According to Healthcare Dive, UnitedHealthcare is cutting roughly 690 plans nationwide for 2027 while Humana is culling about 2,400, part of an industry-wide reduction that is projected to bring the total number of Medicare Advantage plans down from 5,553 in 2026 to 5,532 in 2027. Insurer projections cited by that outlet suggest national Medicare Advantage enrollment could fall by about 2 million people, to 34 million, next year.
Other major insurers are making similar cuts, Healthcare Dive reported, with reductions ranging from about 150 fewer plans for Elevance to roughly 3,000 fewer for Centene. The same report found that the average maximum out-of-pocket limit for Medicare Advantage plans is up 10% on average for 2027, while Part D deductibles have risen 30%. Still, the Centers for Medicare & Medicaid Services says more than 99% of beneficiaries nationwide will have access to at least one Medicare Advantage plan next year, and 97% will have access to 10 or more options, per Healthcare Dive.
Research from KFF shows the average Medicare beneficiary will be able to choose from 28 Medicare Advantage prescription drug plans in 2027, with the share of beneficiaries who have more than 40 options falling from 27% in 2026 to 20% in 2027. KFF also found that 193 counties nationwide will have no Medicare Advantage prescription drug plan available for general enrollment in 2027, up from 123 counties the year before — a sign that the plan reductions touching Maryland are part of a wider contraction playing out across the country.
