Healthcare changes don’t always make headlines until they hit your wallet — or delay the care you need. This is Part 1 of Wellabe’s four-part series, "Medicare reality check,” focused on what’s changing in 2026 and how to protect yourself. In Part 1, learn why more people are leaving Medicare Advantage and returning to original Medicare paired with Medicare Supplement insurance (Medigap).
Healthcare trends show a clear shift: more Americans are leaving Medicare Advantage and returning to original Medicare with Medicare Supplement. Reduced perks, tighter prior-authorization rules, shrinking provider networks, and surprise billing are driving frustration. In some regions, insurers have even pulled plans entirely, forcing beneficiaries to seek new coverage during Special Enrollment Periods.
As insurers aim to protect their bottom line, many Medicare Advantage (MA) enrollees are prioritizing predictable costs, wider provider access, and fewer administrative hurdles by moving back to original Medicare with a Medicare Supplement plan.
Also known as Medigap, Medicare Supplement insurance helps cover the gaps in original Medicare Parts A and B, helping reduce out of pocket costs, like coinsurance, copayments, and deductibles. It cannot be used with Medicare Advantage.
How does Medigap help with deductibles? Each of the 10 standardized Medigap plans covers different portions of Parts A and B. More comprehensive options, such as Plans C or F,* help pay both deductibles, and Plan G helps cover the Part A deductible. No matter what the plan, Medicare Supplement can offer added stability and predictable costs, especially heading into 2026.
What’s driving the shift to original Medicare and Medicare Supplement? “There’s been a lot of disruption in the Medicare Advantage market,” says Erin Bueltel, Director of Product Solutions for Wellabe. “Older adults are getting hit from their own personal experiences.”
Bueltel says besides higher costs in 2026; some Medicare Advantage policyholders have also experienced:
In 2023 alone, Medicare Advantage insurers denied 3.2 million prior authorization requests, whether partially or fully — actions that more than 25% of physicians say put patients at risk. Over 20% of those affected had to be hospitalized, while 18% endured a life-threatening situation. Some required measures to prevent permanent damage. Another group, unfortunately, became disabled or suffered other tragic consequences. While efforts are underway to fix the process, these statistics may leave policyholders wary.
Prior authorizations aren’t just problematic for patients; physicians are experiencing burnout and frustration too. It’s a reason why a growing list of health systems are dropping some Medicare Advantage plans this year, limiting the choice of providers.
The perks that may have made a Medicare Advantage plan really attractive, like free gym memberships through the local YMCA or SilverSneakers, may soon disappear. Other Medicare Advantage perks, like vision and dental plan extras, transportation benefits, grocery allowances, and over-the-counter (OTC) credits may also vanish.
The J.D. Power 2025 U.S. Medicare Advantage StudySM reports a decrease in subscriber satisfaction and says it’s largely due to lack of trust in Medicare Advantage plans. Only 45% of established policyholders said their plan or insurer met their expectations, while less than 40% of new members were satisfied. Of the latter, they named lack of providers in network as well as issues with prior authorizations.
Continue to Part 2: The risks of staying with Medicare Advantage in 2026 (and when Medigap looks better) to learn about Medicare Advantage’s out of pocket exposure, plan discontinuation, and chronic care disruption.
Ready to speak to an agent? Call 866-739-8143 or request a free quote.
View the entire “Medicare reality check” series >
*Plans C and F are only available to those eligible for Medicare before Jan. 1, 2020.
Photo credit: iStock
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