Ochsner Health Plan, the Medicare Advantage arm of one of Louisiana’s largest healthcare systems, has announced it will discontinue all Medicare Advantage plans by December 31, 2025, affecting approximately 6000 beneficiaries.
The decision marks a significant retreat for the Jefferson-based health system’s insurance operations.
Here’s what you need to know.
What’s Happening
Ochsner Health Plan will completely exit the Medicare Advantage market starting in 2026. The insurer currently serves approximately 6,000 total Medicare Advantage members, with the majority enrolled in HMO plans and some in Dual Special Needs Plans (D-SNP).
Coverage for all current Ochsner Medicare Advantage members will end December 31, 2025. Members will need to select new coverage during Medicare’s Annual Enrollment Period (AEP), which runs from October 15th through December 7th.
Why It Matters
Ochsner Health Plan’s exit represents a significant loss of coverage options for Louisiana seniors, particularly in the New Orleans metro area and surrounding parishes where Ochsner Health is a dominant healthcare provider. The companies join a growing list of insurers exiting Medicare Advantage, including UnitedHealthcare, Humana, Samaritan Health Plans, and UCare.
The decision reflects mounting pressures facing Medicare Advantage insurers nationwide:
- Ongoing federal reimbursement changes that have reduced payments to plans
- High medical utilization rates exceeding expectations
- Rising healthcare costs that outpace premium revenue
- Increasingly competitive health insurance landscape
Many insurers have cited these same challenges as they scale back or exit Medicare Advantage markets for 2026. Ochsner Health Plan received an overall star rating of 3.5 out of 5 stars from Medicare for 2025, but financial pressures proved too significant to continue operations.
What Are Medicare Advantage Plans?
Medicare Advantage (also called Medicare Part C) plans are an alternative to Original Medicare, offered by private insurers approved by Medicare. These plans often bundle:
- Hospital coverage (Part A)
- Medical coverage (Part B)
- Prescription drug coverage (Part D)
- Potential additional benefits such as dental, vision, or hearing
With Medicare Advantage, your coverage is administered by a private insurer rather than directly through the government. These companies receive payments from Medicare to provide your benefits.
It’s important to know that most Medicare Advantage plans operate with networks of doctors and hospitals, and some may require referrals to see specialists. However, they can offer lower monthly premiums and additional benefits that Original Medicare doesn’t include.
Medicare Advantage has grown significantly in popularity, with over 32 million beneficiaries enrolled in 2024, making up roughly 54% of all Medicare participants.
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