AvMed, a Sentara Health Care subsidiary, has announced it will discontinue all Medicare Advantage plans in Florida by December 31, 2025, affecting approximately 12,555 Medicare beneficiaries across the state.
The decision comes as part of broader industry-wide challenges facing Medicare Advantage insurers.
Here’s what you need to know.
What’s Happening
AvMed will completely exit the Medicare Advantage market in Florida starting in 2026. The Miami-based insurer has notified members throughout the state, including significant numbers in Broward County and surrounding areas.
Coverage for current AvMed 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 to December 7th.
According to enrollment data, approximately 12,555 Medicare Advantage members will be affected by this market exit.
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 pAvMed’s exit from Florida’s Medicare Advantage market adds to the significant upheaval facing Florida’s 5 million Medicare enrollees in 2026. The company joins a growing list of insurers scaling back coverage, including UnitedHealthcare, Humana, Samaritan Health Plans, and UCare.
The exit reflects mounting financial pressures on Medicare Advantage insurers:
- Industry-wide headwinds including reduced reimbursement rates from the federal government
- Rising healthcare costs that outpace premium revenue
- Increased utilization of medical services
- Regulatory changes making these products financially unsustainable
A Sentara spokesperson stated that “these products are no longer financially sustainable in the current environment. Industry-wide headwinds and market dynamics, including reimbursement trends and regulatory changes, are leading many insurers to reassess their participation in Medicare Advantage.“
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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