Medicare Advantage · DC Metro · 2027 Plan Year

23 Plans Gone, 847,000 Seniors Exposed: The DC Metro Medicare Advantage Exit Nobody Explained Clearly — Until Now

By Sarah Chen-Watkins, Editor-in-Chief — Washington, D.C.

Published April 10, 2026 · Updated April 10, 2026 · 8 min read

Here's what the carriers' press releases won't say plainly: 23 Medicare Advantage plan benefit packages will not exist in the DC metro area come January 1, 2027. They're gone. Terminated. The enrollees in those plans — spread across Washington D.C., Montgomery County, Prince George's County, Fairfax County, Arlington County, and Alexandria — will receive a letter in the mail this fall. That letter will use careful, lawyerly language. It will say things like "your plan will no longer be available in your area" and "you may be eligible for other plans." What it will not say, with anywhere near enough urgency, is: you have six weeks to make a decision that affects every doctor visit, every prescription, and every dollar you spend on healthcare for the next year.

That's what we're for. Let's get into the numbers.

Why Are 23 Plans Leaving the DC Metro Area — And Why Now?

The short answer is money. The longer answer is also money, just with more syllables.

In April 2025, CMS finalized its 2026 Medicare Advantage benchmark rates — and then, after significant carrier lobbying, reversed course and added approximately $13 billion back into the rate structure for 2027. (We covered that reversal in depth: CMS Finalizes 2027 Medicare Advantage Rates: What the $13 Billion Reversal Means.) Despite that lifeline, several carriers concluded that specific service areas — particularly high-cost urban markets like the DC metro — were no longer financially viable at their existing premium structures.

The DC metro is expensive. MedPAC data consistently shows that Medicare fee-for-service spending in the Washington-Arlington-Alexandria core-based statistical area runs approximately $13,200 per beneficiary per year — well above the national average of roughly $10,500. (Source: MedPAC, March 2025 Report to Congress, Chapter 3.) When carriers set their bids against those benchmarks, the math gets uncomfortable fast.

The exits aren't random. CMS contract-level data (available via CMS.gov Medicare Advantage Contract Data) shows a pattern: plans with 3-star or below ratings, plans with high medical-loss ratios in urban markets, and plans where CMS audit exposure was elevated were disproportionately terminated or non-renewed. This is not a coincidence. This is triage.

Nationally, KFF analysis of CMS enrollment data found that Medicare Advantage penetration hit 54% of all Medicare beneficiaries nationwide in 2025, up from 42% in 2020. The DC metro tracks closely at 52%. That's a lot of people whose entire healthcare infrastructure — their provider network, their drug coverage, their dental and vision benefits — lives inside a private contract that can be terminated with one filing to CMS. (Source: KFF, Medicare Advantage in 2025: Enrollment Update and Key Trends)

Which Carriers Are Pulling Back — And From Which Counties?

Let's name some names. (The carriers certainly won't volunteer this information in their earnings calls, where "service area optimization" is the preferred euphemism for "we're leaving your county.")

Based on CMS Medicare Advantage contract data and carrier public filings as of Q1 2026, here is the breakdown of which major carriers are reducing their DC metro footprints for 2027:

Sources: CMS Medicare Advantage Contract Data (cms.gov), carrier 10-K filings (SEC EDGAR), CMS Medicare Plan Finder. Enrollment estimates derived from CMS Monthly Enrollment by Contract/State/County reports. Star ratings reflect CMS 2026 Five-Star Quality Rating System.

A few things jump out immediately. Wellcare's two departing plans in Prince George's County carried a 2.5-star rating — the lowest in the metro's departing plan cohort. CMS has the authority to terminate plans below 2.5 stars for two consecutive years under the Five-Star Quality Rating System; Wellcare apparently decided to exit on its own terms before CMS showed them the door. (Efficient, if not exactly heroic.)

Cigna-HealthSpring's 3.0-star average on its exiting plans is particularly notable because Cigna has been publicly signaling a broader retreat from individual Medicare Advantage markets. Their Q4 2025 earnings call explicitly referenced "geographic rebalancing" as a 2026-2027 priority. The DC market, with its high per-capita costs, was always going to be near the top of that list.

Why Is Prince George's County MD the Most Vulnerable Jurisdiction in This Exit?

Not all plan exits are created equal. A plan leaving Montgomery County — where median household income for seniors is approximately $78,000 and Original Medicare remains a robust fallback — is a disruption. A plan leaving Prince George's County is a crisis in slow motion.

Here's why. According to CMS Medicare-Medicaid Enrollment data (2025), Prince George's County has the highest concentration of dual-eligible beneficiaries — people who qualify for both Medicare and Medicaid — in the DC metro area. Approximately 28% of Medicare enrollees in Prince George's County are dual-eligible, compared to roughly 11% in Fairfax County, VA and 14% in Montgomery County, MD. (Source: CMS MMCO Dual Enrollment Data by State/County, 2023)

Dual-eligible beneficiaries aren't just losing a plan — they're losing the coordination infrastructure that D-SNPs provide. D-SNPs are specifically designed to manage the complex interface between Medicare and Medicaid benefits: care management, transportation, meal benefits, coordination with social services. When a D-SNP exits, beneficiaries don't just need to find a new insurance card. They need to rebuild an entire care ecosystem, often in the middle of managing chronic conditions.

CDC PLACES data for Prince George's County (2024 release) shows that 35.6% of adults aged 65+ in the county report having two or more chronic conditions, compared to 29.1% in Arlington County and 27.4% in Fairfax County. (Source: CDC PLACES County Data 2024) These are not healthy people who can seamlessly absorb a coverage disruption. These are people managing diabetes, heart disease, COPD — often simultaneously — who depend on the care coordination their plan provides to stay out of the hospital.

When Wellcare's two Prince George's County plans (both 2.5 stars, both D-SNP-adjacent products) exit, approximately 19,800 dual-eligible or near-dual-eligible enrollees in that county will need to act. The county's remaining D-SNP offerings post-2027 are projected to number fewer than 8 distinct plans, down from 14 in 2026. (Source: CMS Medicare Plan Finder, April 2026 contract data)