Medicare open enrollment is underway. Tell patients where you stand

Medicare open enrollment runs through Dec. 7, and with dozens of health systems leaving Medicare Advantage networks, the next seven weeks will decide how much of that disruption lands on patients and on your revenue cycle.

A busy enrollment season

Medicare’s annual open enrollment period opened Oct. 15. CMS projects that the average monthly Medicare Advantage premium will fall from $14.37 in 2026 to $12.00 in 2027, a drop of about 16.5%, and expects roughly 34 million people, about 47% of Medicare enrollees, to be in Medicare Advantage next year. Lower premiums will keep the plans attractive to seniors comparing options this fall.

At the same time, the provider side of the market is fracturing. Becker’s Hospital Review has tracked 34 health systems ending contracts with one or more Medicare Advantage insurers in 2026, from Sentara Health and Anthem to NewYork-Presbyterian and UnitedHealthcare. Systems most often point to prior authorization denials and slow payment; in some cases the insurer ended the contract.

Where the risk sits

A network exit only works if patients understand it before they choose a plan. Seniors who pick a low-premium plan that no longer includes their hospital will either face out-of-network costs or arrive at your door expecting coverage that has lapsed. That confusion shows up as complaints, delayed care, eligibility denials and write-offs in January and February.

• Patients: Those in active treatment, such as oncology, dialysis and post-acute care, need continuity plans and clear timelines.
• Physicians: Employed and affiliated groups need consistent answers so the message patients hear in the clinic matches what they read in the mail.
• Finance: Contract changes alter 2027 volume and payer mix assumptions, and the budget should reflect where patients actually enroll.

What to do before Dec. 7

Publish a plain-language list of the Medicare Advantage plans you will and will not accept in 2027, and keep it current on your website, in patient portals and at registration. Brief financial counselors, schedulers and access staff now, and give them a referral path to unbiased help such as the State Health Insurance Assistance Program. For systems still negotiating, set a decision date well before open enrollment closes so patients are not left guessing.

Sources

• Medicare Advantage and Medicare Prescription Drug Programs Expected to Remain Stable in 2027 (CMS, Sep 28, 2026)
• 34 health systems dropping Medicare Advantage plans (Becker’s Hospital Review, Oct 6, 2026)