Big Medicare news out of New Mexico.
Presbyterian Health Plan will stop offering most of its Medicare Advantage plans starting in 2027, leaving about 30,000 members to find new coverage for next year.
This does not mean your 2026 coverage is changing, so there is most likely no need to act before the 2026 Annual Enrollment Period (Oct. 15-Dec. 7). But it’s worth understanding what’s coming so you can plan ahead.
Here is what’s happening and what it means for you.
What’s Happening
Presbyterian Healthcare Services, the parent company of Presbyterian Health Plan and New Mexico’s largest health system, confirmed in June 2026 that it will discontinue most of its Medicare Advantage plans for the 2027 plan year. The change affects roughly 30,000 members across the state.
This does not mean your 2026 coverage is changing. If you are a Presbyterian Medicare Advantage member, your plan works as usual through the end of 2026. The change takes effect for 2027.
There is also one plan Presbyterian is keeping in place:
If you are on that plan, this announcement does not affect you.
Its Medicare Advantage Dual Plus Special Needs Plan (a D-SNP), which serves about 13,000 people who have both Medicare and Medicaid, will continue.
Why Is Presbyterian Leaving Medicare Advantage?
Like a number of other insurers, Presbyterian pointed to the rising cost of care. The company said its Medicare Advantage plans lost more than $59 million in 2025, part of a broader operating loss of about $568 million across the health system that year.
In February 2026, Fitch Ratings lowered Presbyterian’s credit rating from AA to AA-. The company said staying in most of the Medicare Advantage market would limit its ability to invest in care, staffing, and access for New Mexicans.
Presbyterian is not alone. Other regional health plans have made similar moves recently, including Sentara Health Plans in Virginia and University of Michigan Health, as rising medical costs and tighter margins push more plans out of certain Medicare Advantage markets.
Who Will Be Affected?
About 30,000 Presbyterian Medicare Advantage members are projected to lose coverage for 2027.
- You are most likely affected if you have a Presbyterian individual Medicare Advantage (HMO) plan.
- You are most likely not affected if you are on the Presbyterian Dual Plus D-SNP for people with both Medicare and Medicaid, since that plan is continuing.
If you are affected, Presbyterian is supposed to send you a Plan Non-Renewal Notice by the end of September 2026, and the company has said it will begin reaching out to affected members around the start of fall open enrollment in October.
Not sure which plan you have? Check your member ID card, or call our team of licensed insurance agents at +1 877-360-6565 (TTY: 711) and we will look it up for you, at no cost to you.
Your Options if Your Plan Is Ending
If your plan ends and you do not enroll in something new, your coverage will typically revert to Original Medicare on January 1, 2027. If you would like to continue coverage beyond Original Medicare, here are the options available to you:
- Another Medicare Advantage plan. You can enroll in another Medicare Advantage plan available in your area during the Annual Enrollment Period, which runs October 15 to December 7, 2026. Any plan you enroll in during this window takes effect January 1, 2027. You can change your selection as many times as you like during this period, and the last plan you enroll in before it closes is the one that takes effect. Because your plan is leaving the market, you typically also qualify for a Special Enrollment Period that runs from December 8 to the end of February.
- A Medicare Supplement (Medigap) plan. Because you would be losing your plan due to the carrier leaving the market, you would qualify for guaranteed issue rights, which let you enroll in a Medicare Supplement Plan A, B, C, D, F, G, K, or L without undergoing medical underwriting. This period starts 60 days before your plan ends and ends 63 days after. Medicare Supplement plans work differently from Medicare Advantage plans and do not include prescription drug coverage, so people who choose this route often add a standalone Part D plan.
- Help from a licensed insurance agent. If you would like help comparing your options, you can contact a licensed insurance agent. Licensed Insurance agents typically work with several insurance companies, so they can help you compare the plans available in your area without bias. They are paid by the insurance company, so there is no cost to you.
Need Help With Medicare?
If you have any questions about this situation (or Medicare in general), our licensed insurance agents are here to help.
Simply call us at +1 877-360-6565 (TTY: 711) or click the button below to schedule an appointment.
Calvin Bagley is the founder of PlanFit, The Medicare Store, and Nuvo Health. He and his team have helped over 60,000 people navigate Medicare options, and he’s a nationally recognized speaker in the Medicare industry. Most importantly, he’s someone who believes every American deserves clear, honest information without pressure.
