Blue Cross Blue Shield of Massachusetts announced it will discontinue several Medicare Advantage plans in 2027, affecting approximately 20,000 seniors across the state. The move comes as the insurer seeks to curb significant financial losses incurred from these programs over the past two years.
The state’s largest health insurer reported a combined $275 million loss on Medicare Advantage plans in 2024 and 2025. These plans are part of the federal Medicare system for individuals aged 65 and older but are administered by private insurers. Blue Cross also plans to restrict new enrollments in its remaining Medicare Advantage offerings, allowing a limited number of new members to join on a first-come, first-served basis.
“While we remain committed to Medicare Advantage and serving seniors in Massachusetts, the cost of care has outpaced the premiums we receive from the federal government,” said Sarah Iselin, chief executive of Blue Cross Blue Shield of Massachusetts. The insurer is withdrawing specific plans in Middlesex, Essex, and Worcester counties, spanning both preferred provider organization (PPO) and health maintenance organization (HMO) options. PPO plans generally charge higher premiums but allow access to a broader network of providers, while HMO plans are typically more affordable but require members to use in-network providers.
Krista Bowers, senior vice president of government programs at Blue Cross, acknowledged the difficult decisions the company faced. “We’ve made tough choices to protect many members and avoid widespread premium hikes or benefit cuts,” she said.
Blue Cross’s reduction in Medicare Advantage offerings aligns with broader market trends in Massachusetts. Several other insurers, including Mass General Brigham Health Plan, Point32Health, and Mass Advantage, have also scaled back their presence or exited Medicare Advantage markets. Mass General Brigham is ending all its PPO plans within the program for 2027, while Point32Health is terminating one PPO plan. Mass Advantage has completely withdrawn from Medicare Advantage, citing “significant changes in the Medicare landscape.”
Market-wide losses have intensified in recent years, partly due to rising costs associated with new medications such as GLP-1 weight loss drugs, which have contributed to financial strain across health plans. Blue Cross implemented cost-cutting measures, including employee buyouts and limiting coverage for GLP-1 medications, and returned to profitability in the first half of 2026. However, premiums are anticipated to rise as medical and pharmaceutical expenses continue to increase.
Blue Cross projects that its reduced Medicare Advantage participation will be temporary, with hopes to re-enter the market more fully by 2028.
Affected members like 74-year-old Tom Stambaugh of Somerville expressed frustration with the changes. After his plan was discontinued, Stambaugh found alternatives in Middlesex County either limited or significantly more expensive. He ultimately opted for Original Medicare, supplemented by two additional plans to cover copayments and prescription drugs, resulting in a monthly cost of about $315—nearly triple his current expenses.
Similarly, 74-year-old Sharon Kling of Sutton is transitioning to Original Medicare after her Blue Cross Medicare Advantage plan was canceled. The need to enroll in supplemental coverage to address gaps previously consolidated under a single plan has caused concern for Kling, who anticipates increased administrative complexity and multiple billing sources.
As the Medicare Advantage market undergoes these shifts, seniors across Massachusetts face growing challenges in securing affordable coverage that meets their health needs.