The latest updates on UnitedHealthcare Medicare Advantage plans 2026 show important shifts in service areas, plan design and regulatory rules ahead of the new year. For those enrolled in or considering these plans, it’s essential to understand what’s changing, why it matters, and how you may be affected.
Major Changes to Be Aware Of
1. Service-Area Reductions & Plan Discontinuations
UnitedHealthcare (UHC) has announced that effective January 1, 2026, certain Medicare Advantage plans will be discontinued or the service area will be reduced. These notices are being mailed to affected members on October 2, 2025.
In recent filings the company said they anticipate accelerating medical-cost trends nearly 10 percent in their 2026 pricing and benefit designs, up from about 7.5 percent trends in 2025.
2. Regulatory & Policy Changes by CMS
The Centers for Medicare & Medicaid Services (CMS) has finalized its Contract Year (CY) 2026 rule for Medicare Advantage and Part D. Key take-aways:
- The average MA plan payment increase for 2026 is projected at 5.06 %.
- Prior-authorization protections are strengthened: MA plans must honour inpatient prior-authorisation approvals through discharge, and appeal rights are expanded to decisions made during treatment.
- For insulin in MA-Part D plans: beginning in 2026 and later years, cost-sharing for covered insulin products will be the lesser of $35, 25% of the maximum fair price or 25% of the negotiated price.
- Supplemental benefits under SSBCI (Special Supplemental Benefits for the Chronically Ill) will face new restrictions — MA plans may offer fewer of the non-medical perks (like over-the-counter credits, meals, transportation) starting in 2026.
3. UHC-Specific Changes and Market Strategy
While UHC continues to be one of the largest MA plan providers, the company has signalled a pull-back in certain markets. For example:
- UHC announced it will exit certain Medicare Advantage markets in 109 US counties in 2026, impacting approximately 180,000 members.
- The company noted that while they expected a 5 % cost trend when pricing for 2025, actual trends ran closer to 7.5 %; for 2026 they expect trends to approach 10 %.
- UHC published a 2026 Quick Reference Guide for providers: effective Jan. 1, 2026, most members in UHC MA HMO and HMO-POS plans will require a referral from their PCP (Primary Care Physician).
What This Means for You if You’re Enrolled (or Considering Enrollment)
✔ Check your Annual Notice of Change (ANOC) and non-renewal letters
If you currently have a UnitedHealthcare Medicare Advantage plan, watch for letters sent in early October 2025. These will tell you if your plan is discontinued, your service area is changing, or your premiums/benefits will shift for 2026. UHC posted that members in affected areas will receive non-renewal notices dated October 2, 2025.
✔ Evaluate network, referral and access changes
Since UHC is moving many members into HMO or HMO-POS formats with referral requirements and tighter networks, you’ll want to ask:
- Will I need a referral from my PCP for specialists? (Yes, in many UHC HMO/HMO-POS plans starting Jan. 1, 2026.)
- Can I still see out-of-network providers and what costs will I incur?
- Has the plan’s provider network changed (in-network hospitals, specialists, etc.) due to service-area reduction?
✔ Review benefit changes – especially supplemental perks
If you value extras like gym memberships, transportation services, over-the-counter product credits or meal delivery, be aware: MA plans (including UHC’s) will offer fewer non-medical benefits under the SSBCI rules in 2026.
✔ Compare plans in your ZIP code before the Annual Enrollment Period (AEP)
If your current plan is affected (service area reduction or discontinuation), you may need to shop for a replacement. The AEP runs from October 15 to December 7, 2025 for coverage starting January 1, 2026. Use tools like Medicare.gov or contact your State Health Insurance Assistance Program (SHIP) to compare.
2026 Highlights at a Glance – UnitedHealthcare Medicare Advantage Plans
| Feature | What’s New / Changing in 2026 |
|---|---|
| Service Areas | UHC will discontinue or reduce some plans in select counties; non-renewal notices for affected members. |
| Premiums & Cost Trends | UHC expects medical cost trends nearing 10% in 2026 and is adjusting pricing/benefit design accordingly. |
| Network & Referrals | Most UHC HMO/HMO-POS MA plans will require referrals from PCPs starting Jan 1, 2026. |
| Supplemental Benefits | Fewer non-medical extras under SSBCI allowed; focus will return to core health/medical benefits. |
| Regulatory Rule Changes | CMS final rule boosts MA payments ~5.06%, strengthens prior-authorization/appeals protections, insulins cost-sharing limits. |
Why These Changes Are Happening
The MA market is under pressure. Insurers such as UnitedHealthcare face a confluence of headwinds: rising utilization of services by members, escalating provider/practice costs, reductions or slower growth in Medicare plan payments, and tighter regulatory oversight. For example:
- UHC reported that more than half of its additional $6.5 billion medical cost burden in 2025 came from its Medicare lines.
- Service-area exits and plan pulls reflect a strategy to drop less profitable markets and refocus on sustainable geographies.
- CMS’s regulatory changes are aiming to curb excessive favourable risk-scoring and ensure more appropriate use of MA prior-authorization and appeals processes.
Key Enrollment & Plan Considerations for 2026
- Ensure you’re eligible for a plan that remains active in your county. If your current plan is discontinued or your county is removed from the service area, you’ll need to select a new plan during AEP.
- When comparing plans, look beyond the monthly premium. Examine network access, out-of-pocket maximums, referral requirements, and how benefits (medical and supplemental) may have shifted.
- Ask about extras: If you valued gym membership, transportation or healthy‐food credits under your MA plan, confirm whether those remain in the 2026 version.
- Keep an eye on prescription‐drug coverage as part of your MA plan (MA‐PD). While UHC highlights $0 premium options in many regions, benefits vary by ZIP code.
- Talk with a licensed agent or your SHIP counsellor if you feel overwhelmed. Changes this year are larger than usual.
Bottom Line
When reviewing your UnitedHealthcare Medicare Advantage plans 2026 offering, you’re witnessing more than routine tweaks. The landscape is shifting: service areas are being reduced, medical costs are rising, supplemental benefits may shrink, and regulatory rules are tightening. If you’re enrolled with UHC or considering it for 2026, take action now to understand your status, compare plans in your area and make an informed choice by the December 7 deadline.
Stay proactive—your choice of plan in 2026 may look different than in previous years, and staying ahead of the change matters.