Medicare Advantage enrollees in New Hampshire saw a big upheaval in the market for 2025. An even bigger one is expected in 2026 as two insurers have decided to leave the state.
Anthem and Martin’s Point are exiting the state entirely, Aetna is shrinking its coverage to just one county, and others are adjusting their plans, leaving some of the state’s counties — particularly its most rural — with limited choices.
About 77,000 Granite Staters — more than half of the total 120,000 enrollees — will be affected by changes to their Medicare Advantage plans in a market upheaval the state Insurance Department described as “unprecedented.”
Advantage plans (known as Part C) bundle Medicare Part A (hospital insurance), Part B (medical insurance), and Part D (drug coverage) into one plan that often includes extra coverage benefits such as vision, hearing, dental, and/or health and fitness/wellness programs.
“Yes, unfortunately, there is more disruption in the Medicare market for 2026 than there was in 2025,” said Christopher Cote, president of Core Insurance in Hampstead. Cote is an independent broker who helps individuals and businesses find the right insurance plan in which to enroll.
Reasons for the changes and the exits vary but include rising costs, reduced federal payments, and heightened federal regulatory requirements implemented last year, according to the insurance department and Cote.
As an example of what insurers said, Martin’s Point offered no explanation in its letter to its enrollees as to why it was leaving the New Hampshire market.
“Martin’s Point Generations Advantage won’t offer your Medicare plan in 2026,” it said. “This means your coverage through Martin’s Point will end December 31, 2025. You need to make some decisions about your Medicare coverage.”
It concluded its letter by apologizing “for the inconvenience caused by this change.”
“Over the past several years, policymakers and regulators in Washington have imposed new regulations, reduced payments, and added compliance burdens that have forced insurers nationwide to rethink their participation. As a result, plans are narrowing networks, cutting back benefits or leaving states altogether,” state insurance commissioner D.J. Bettencourt wrote in a recent op-ed piece.
About 44,000 enrollees were affected by Advantage changes going into 2025. The volume of 77,000 affected enrollees going into 2026 is unexpected, with Cote calling the new number “staggering.” He noted independent brokers such as himself “powered through” the changes that came about for 2025, but this enrollment period will require even more of an effort.
“2026 is definitely going to be more of a challenge, absolutely, 100%,” he said. “There’s just more changes. So it’s not necessarily just carriers; it’s also about the plans that they’re offering. The way Medicare works is everything’s specific to the county, so there were some significant county changes” for 2026.
Medicare is a government-funded health insurance program in the United States for people 65 and older, or for qualifying people with certain disabilities or illnesses.
Some people choose to manage their Medicare coverage (parts A and B) on their own with separate supplemental plans they can purchase to take care of their prescription needs (Part D) and dental, vision and hearing. They are known as Original Medicare enrollees, and there are about 225,000 of those beneficiaries in New Hampshire.
Others choose the Part C option that rolls all of that into one so-called Advantage plan (called Part C). Data shows that 35% of New Hampshire Medicare beneficiaries are enrolled in Medicare Advantage plans.
New Hampshire has the second oldest population by median age in the country, trailing only to Maine.
Among U.S. states, New Hampshire ranked fourth based on Medicare beneficiaries as a percentage of total population in 2021.
Maine ranks first, with 26% of the population receiving Medicare benefits of some kind. New Hampshire, in fourth, had 22.8% behind West Virginia (24.9%) and Vermont (24%).
Currently, there are six active carriers offering Medicare Advantage plans: Aetna, Anthem, Humana, Martin’s Point, UnitedHealthcare, and WellSense, according to the Insurance Department.
With Martin’s Point and Anthem out in 2025, Aetna, Humana, UnitedHealthcare and WellSense remain in the mix, though in diminished form, in some cases.
By county, here’s what the landscape looks like in 2026 in terms of major players who will still have some sort of an Advantage plan presence:
There are certain nuances among the insurers within each county in terms of the types of plans they will offer in 2026. Going forward, it’s important to understand differences in plans, such as how an HMO (health maintenance organization) plan differs from a PPO (preferred provider organization) plan.
For instance, UnitedHealthcare has withdrawn completely from Coos County. It is offering variations of the AARP Medicare Advantage plan and a nursing home plan in Hillsborough, Merrimack, Rockingham and Strafford counties. It is not offering any Advantage options in Belknap, Carroll, Cheshire, Grafton and Sullivan, but it is offering a nursing home plan in each of those counties.
WellSense is dropping its popular PPO in 2026. So, while it still has a presence in each of the 10 counties, it is offering what Cote describes as “a look-alike plan” that combines Medicare and Medicaid benefits into one HMO plan for individuals who qualify for both programs, according to Cote. WellSense will keep its PPO plan in Hillsborough County only, according to Cote.
For Carroll County, that means there is no true Advantage plan being offered in 2026. Some other counties are left with just one choice: Humana.
“Consumers should carefully review their options, confirm that their providers and prescriptions are covered, and seek free, unbiased help from the Insurance Department, the State Health Insurance Assistance Program (SHIP) or another legitimate resource,” Deputy Insurance Commissioner Keith Nyhan said in a statement. “While the scale of change this year is unprecedented, Granite Staters are not alone — our team is here to help them make informed decisions and maintain uninterrupted access to care.”
The enrollment period runs from Oct. 15 to Dec. 7. The enrollment period is extended for those who are losing their 2025 coverage.
Cote advises, first, that consumers read through the notice-of-change letter from their insurer. Then, he suggests they contact an independent insurance broker and start educating themselves on what is available in their county.
Be on the lookout, he said, for seminars that insurers or senior centers or others might sponsor that offer insight to the plans that will be available for 2026.
The assortment of plans can be confusing, which is why education is important, according to Cote.
In addition to PPO and HMO plans, there are HMO-POS (Health Maintenance Organization – Point of Service) plans that are hybrid health insurance plans that combine features of an HMO and a POS plan, offering the cost-savings of an HMO for in-network care and the flexibility to see out-of-network providers for a higher cost.
Also, the names of some plans in some counties might not be recognizable as coming from a major insurer. For instance, a PPO plan called Care Improvement Plus/South Central Insurance Co. that is being offered in nine counties is actually a UnitedHealthcare product.
The insurance department in September issued a press statement with the ill tidings, warning “consumers should expect additional carrier withdrawals in the coming year. Even when carriers do not exit entirely, enrollees are likely to see fewer plan benefits or network changes as insurers streamline offerings to focus on markets where they have stronger provider relationships and better financial results.”
“While recent Medicare Advantage withdrawals will present real challenges for impacted consumers, New Hampshire’s competitive market still offers strong plan choices and meaningful consumer protections,” Bettencourt said in that September statement.
He pointed to legislation from the 2025 session that allows the department what he described as “stronger oversight of Medicare Advantage withdrawals to ensure that Granite Staters receive clear, accurate information and timely support. Consumers should take action early to secure uninterrupted coverage and continued access to quality care.”
The state does not regulate Medicare Advantage plan offerings or pricing, but Bettencourt said the legislation requires carriers to provide advance notice and detailed reporting of Medicare Advantage market withdrawals beginning in 2026.
If consumers choose to switch to or remain with Original Medicare, they have the option of purchasing Medigap insurance to cover more of the costs associated with parts A and B. Medigap insurance does not cover dental, vision and hearing; separate coverages, if desired, are needed there.
Also out there for 2026 is the Medicare Tax that is deducted monthly from Social Security. Most people don’t pay a Part A premium because they paid Medicare taxes while working. Most people pay the standard Part B monthly premium amount ($185 in 2025). Social Security will tell you the exact amount you’ll pay for Part B in 2026.
Nationally, according to MarketWatch, enrollment in Medicare Advantage is projected to be 34 million subscribers in 2026, a decrease from the current 34.9 million in 2025.
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