Why do people leave their Medicare plans? Surveys from the Centers for Medicare & Medicaid Services (CMS) offer nearly 30 different reasons from five major categories. I pulled together five years of survey data to analyze trends across nearly 100 companies offering Medicare Advantage and/or Part D prescription drug plans.
Here’s what I learned about the most common problems and how you can avoid them when you shop during open enrollment this fall. These are listed in order of the most commonly cited reasons for leaving Medicare Advantage plans.
1. Premiums, copays and other costs
Cost was the most common reason people left both Medicare Advantage and Medicare Part D plans. For example, their premiums or copays went up, they found a cheaper plan or they could no longer afford the plan.
About 21% of people leaving Medicare Advantage surveyed said they left because of <a d pay for primary care, specialist visits, hospitalizations and prescription drugs. These out-of-pocket costs might more meaningfully affect what you spend on healthcare.
For example, for a seven-day hospital stay, among the companies in NerdWallet’s 2027 analysis, Medicare Advantage companies’ average out-of-pocket costs range from about $225 up to $2,400. If you think you might spend some time in the hospital, choosing a plan with lower hospital copays could make a huge difference.
