As many insurance carriers scale back or leave markets entirely, one Medicare Advantage insurer will expand its footprint this year. Here’s a look at the latest comings and goings.
SCAN Health Plan, one of the largest not-for-profit Medicare Advantage organizations, intends to expand into Washington state and broaden its presence in California and Texas.
In an announcement, SCAN said it still needs approval from the Centers for Medicare & Medicaid Services, but once it receives the go-ahead, it will offer plans in Pierce, Spokane, and Thurston counties, Washington; Sacramento, Placer, Yolo, San Joaquin, Kings, and Tulare counties, California; and Fort Bend and Montgomery counties, Texas, beginning January 1, 2026.
“This is more than a geographic expansion; it’s a reaffirmation of our mission to meet the needs of seniors at every stage of their aging journey,” said Karen Schulte, president of Medicare at SCAN Health Plan, in the announcement. “In today’s environment, when many insurers are narrowing or exiting their Medicare Advantage offerings, SCAN is stepping up to serve communities that deserve the stability, compassion, and personalized care that come with a nonprofit health plan.”
Through these expansions, SCAN will offer plans to nearly nine million Medicare-eligible seniors in its new service areas, while continuing to serve more than 310,000 members across 33 counties in six states: California, Arizona, Nevada, New Mexico, Texas, and Washington.
Nationwide, financial pressures and shifting reimbursement rates have led many Medicare Advantage plans to reduce service areas or terminate offerings. KFF analysts estimate that more than one million seniors may need to seek new coverage, and up to 1.8 million could be affected by plan closures or consolidations. SCAN said its expansion bucks this trend, offering seniors a stable, mission-driven option in an increasingly uncertain market.
Indeed, UnitedHealth, Aetna, Humana, and Sonder Health Plans have previously announced they will pull out of some Medicare Advantage markets. This week more carriers said they would drop Medicare Advantage plans:
- Samaritan Health Plans sent a letter over the Labor Day weekend to 13,881 Medicare Advantage members in Lincoln, Benton, and Linn counties in Oregon announcing plans to drop its coverage at the end of the year, according to The Lund Report. Although the letter gave no reason for the exit, the Lincoln Chronicle received an emailed statement from Samaritan Health Plans CEO Bruce Butler that said the organization “has not been immune to nationwide challenges in health care.” Butler said the organization is evaluating options for long-term sustainability and, in the meantime, will continue to provide health coverage in its Medicare, Medicaid, and commercial group lines of business.
- Financial challenges have caused UCare to exit the Medicare Advantage market in Minnesota, Modern Healthcare reports. It’s the second-largest Medicare Advantage carrier in that market.
- Modern Healthcare also reports that Elevance Health will cut some Medicare Advantage plans and fully exit the Medicare Part D standalone market next year.