Lately, there’s been a lot of talk about changes to Medicare plans — letters in the mail, headlines about insurance companies pulling back, and questions about what it all means. What’s going on? In this post, we’ll walk you through what we’re seeing in the Mid-Atlantic (especially Virginia and nearby states) with Medicare Advantage (“MA”) and marketplace exits, what it means for you, and the simple steps you can take — with help from EMS — so you stay covered and comfortable.

What's Happening Now

Over the next couple of years, major insurance carriers are exiting or scaling back both the Affordable Care Act (ACA) individual market and Medicare Advantage offerings. Carriers like Aetna Health Inc. (part of CVS Health) have announced they will no longer offer ACA-market individual plans in Virginia starting January 1, 2026. Likewise, in the Medicare Advantage space, many insurers are reducing their service areas, dropping certain counties, or ending specific MA products due to rising costs and lower-than-expected federal reimbursements.

For example, in Virginia, some counties are already showing multiple MA plans that will not renew for 2026 — meaning if you’re currently in one of those plans, you’ll need to take action before the end of the year. Additionally, Sentara Health Plans (part of Sentara Health) has announced it will no longer offer several MA products in Virginia (as well as in North Carolina) effective January 1, 2026.

What’s important to understand is that this isn’t just a case of “your plan changed its benefits a little.” In many areas, plans are leaving entirely — or certain counties may no longer be covered in the same way.

Why Does This Matter?

If you are 65 or older (or soon will be) and you’re enrolled in a Medicare Advantage plan — or considering one — this shift matters for a few key reasons:

• Continuity of care: Your doctor, pharmacy, or specialist may currently be part of your plan’s network. If your plan disappears or changes networks, you could find yourself needing to switch providers or paying more out of pocket.

• Coverage options may shrink: With carriers pulling back, there may be fewer plans competing in your county. That can lead to limited choices, higher costs, or reduced network flexibility.

• It triggers a decision moment: When a plan exits, you’ll receive a written notice (often in September or October) explaining what’s happening and what your next steps are. You’ll need to make a decision before the deadlines to ensure continuous coverage.

What You Should Do

1. Read your plan notice carefully. If you’re enrolled in a MA or ACA plan, look for the Annual Notice of Change (ANOC) or non-renewal letter. It will tell you if your plan is ending or changing, and when that change takes effect. Most exits take effect on December 31, but always confirm the exact date on your notice.

2. Confirm your end date and your options. Note when your current coverage ends and what your rights are to switch or enroll in a new plan. For Medicare Advantage, even if your plan isn’t ending, you still have the Annual Election Period (October 15 – December 7) to make changes for the following year. For ACA marketplace coverage (if applicable), the open enrollment period in Virginia typically runs from November 1 through mid-January — but it’s always best to double-check the official Virginia Marketplace site for your exact dates.

3. Check your options — with help. You can use Medicare.gov’s Plan Finder to see available options on your own, but you don’t have to go through it alone. Contact Elite Medicare Specialists (EMS) — our licensed agents specialize in these types of plan changes. We’ll help you compare options in your county, confirm your doctors and prescriptions are covered, and handle the paperwork at no cost to you. Some questions we can help answer include:

• Which plans will still be available in my county for 2026?

• Will my provider or pharmacy still be in-network?

• How will my premiums or benefits change?

  
  

4. Set yourself in a “safe zone” by acting early. Even if your current plan is staying, don’t assume everything will remain the same. With fewer carriers in the market, benefits and premiums often shift. If your plan is ending, don’t wait until December to decide — reaching out early gives you more time to explore your best options and avoid a coverage gap.

And remember, this is what we do every day at EMS — from plan comparisons and provider verification to enrollment support, we’re here to make sure your transition is smooth and stress-free.

Why EMS Is Your Trusted Partner

At Elite Medicare Specialists, we focus exclusively on Medicare and marketplace guidance. Our goal is simple: to keep you covered, comfortable, and confident — without confusion. If your current plan is exiting, or if you simply want to make sure you’re in the best plan available for 2026, we’re ready to help. We stay on top of announcements from the Centers for Medicare & Medicaid Services (CMS), track plan changes across Virginia, and tailor our recommendations to your needs, doctors, and budget.

If you’re thinking, “I don’t want any surprises on January 1,” you’re right to stay ahead. The healthcare landscape is shifting, but you don’t have to face it alone. By staying informed and partnering with Elite Medicare Specialists, you’ll have peace of mind knowing your coverage is right where it needs to be.

We’re here for you. Reach out to EMS today — we’ll help you review your options, choose the best plan, and make the switch with confidence. Because your health and comfort are worth that kind of care.

Guiding you through healthcare, one post at a time — Jaiden Logan, Elite Medicare Specialists.

Sources

• “Aetna members with ACA plans will need new coverage in 2026” — AJMC, 2024.

• “5 payers exiting Medicare Advantage markets in 2025” — Becker’s Payer Issues, 2024.

• “Sentara exits Medicare Advantage products in Virginia, North Carolina, Florida” — The Medicare Analyst, 2024.

• “Plan Year 2026 Updates | Virginia’s Insurance Marketplace.” marketplace.virginia.gov, 2024.

• “Medicare Advantage Market Watch: The Latest Exits and Expansions.” Rise Health, 2024.

• “Medicare & You 2025 Handbook.” Centers for Medicare & Medicaid Services (CMS).

• “Six Medicare Changes Coming in 2026.” Kiplinger, 2024.

• “AARP: Medicare Part B Premiums Expected to Increase in 2026.” AARP, 2024.