CORRECTION: Health insurers in Maine cut back Medicare program as costs loom

Oct. 16—At least four companies that provide Medicare Advantage plans to older Mainers are cutting the options they offer in the state amid regional rollbacks and federal reductions to Medicare.

Anthem and Aetna are scaling back in the state, spokespeople for the companies confirmed Wednesday. Martin's Point Health is discontinuing a plan, according to a letter to members obtained by the Bangor Daily News, and UnitedHealthcare is cutting one of its own, the company said Tuesday.

It's not clear yet how many Mainers will be affected, how many companies are reducing their offerings here overall or if some counties will be more heavily affected than others, as is the case in New Hampshire and Vermont.

Medicare Advantage plans are offered by private insurers approved by the federal government to cover the same services as traditional Medicare with additional benefits including vision, dental and prescription drug coverage, usually through a set network of providers.

Insurers have cut plans more steeply elsewhere in northern New England and nationwide this month amid increasing costs, leaving the people they covered to return to traditional Medicare.

Maine state officials are investigating what insurers are pulling back and where, according to Bob Carey, superintendent of the Maine Bureau of Insurance.

There is no central source of information about to which degree specific insurers operate in Maine, partly because they are regulated at the federal level, he said Tuesday; the office is aware of a few plans leaving some counties.

More than 212,000 Mainers were enrolled in private Medicare Advantage plans last year, according to the health policy site KFF. Nationwide, about half of the population eligible for Medicare — those 65 and older, and younger people with certain disabilities — has an Advantage plan.

Anthem Blue Cross and Blue Shield is scaling back some plan offerings in Maine in 2026, according to its website. The company did not answer a question about how many Mainers would lose their plans. The insurer announced this month it would pull out of New Hampshire completely next year, according to New Hampshire Public Radio.

Aetna's coverage change will affect about 1,400 people in Maine, a spokesperson said Wednesday. It will still offer general Medicare plans and others designed for low-income seniors in some southern and central counties.

Another provider, UnitedHealthcare, is pulling out of Vermont and cutting a plan here next year that will affect about 100 Mainers, who will have access instead to another UnitedHealthcare with the same type of coverage.

"UnitedHealthcare is making strategic adjustments to our Medicare Advantage offerings for 2026 to ensure long-term affordability and stability of our plans," a spokesperson said Tuesday.

Cuts to Medicare, higher costs and more use of the programs led it to stop offering advantage plans in 109 counties nationwide, the company told Reuters earlier this month.

Martin's Point Generations Advantage is also discontinuing at least one plan, according to a letter to members that did not provide a reason for the change. Its site still lists several other plans available in Maine next year.

While Advantage plans have been marketed as a more affordable way for seniors to get more benefits, they are also generally difficult for health care providers to manage, which can lead providers to stop doing business with a plan carrier, according to Jeff Austin, vice president of government affairs and communications at the Maine Hospital Association.

The association has advocated for more federal oversight of these plans, which Austin said typically reimburse 20 percent below the cost of services compared to 10 percent by traditional Medicare. He also said the programs "aggressively deny" care authorization and make it difficult to get reimbursements.

Mainers enrolled in a plan that is being discontinued will be notified by their insurer, and that notice is important to keep because it allows them to choose another plan without going through medical underwriting, according to Carey, the state insurance bureau superintendent.

They can transfer to another Advantage plan or enroll in a Medicare Supplement, or Medigap, plan instead.

Supplement plans do not include those additional benefits, and members need to purchase prescription drug plans separately. They will be able to see any provider that accepts Medicare, regardless of network.

Other Maine insurers and consumer advocacy groups did not return requests for information. The Department of Health and Human Services forwarded questions to the insurance bureau.

Correction: An earlier version of this story had inaccurate information about the extent to which Aetna is reducing its Medicare Advantage coverage in Maine.

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