（NewsNation）—— 联合健康保险公司和 Humana 正在取消 Medicare Advantage（医疗保险优势计划）计划，这一举措将影响近 100 万人。这两家公司是美国为老年人提供私人健康保险的两大巨头，它们正在结束在盈利较低的特定地区的计划，此举正值 Medicare 参保季开始之际。《财富》杂志报道称，这一决定是为了保护企业利润。
(NewsNation) — UnitedHealthcare and Humana are canceling Medicare Advantage plans, a move that will affect nearly one million people. The companies are the two largest private health insurance companies for older adults in the U.S. and are ending plans in specific areas where they are making less money, a shift that comes as Medicare enrollment season starts. The decision was made to protect corporate profits, Fortune reported.
被终止的计划主要是首选提供者组织（PPO）计划，此类计划提供更灵活的医疗服务提供者网络。据《财富》杂志报道，联合健康集团表示，约 39 万名会员将失去保障，原因是意外的高额医疗使用量和不断上涨的医疗成本导致该公司 2025 年股价下跌。约 60 万人将通过 Humana 失去医疗保障。健康保险公司通常会取消利润较低的计划，以促使客户退出或转投成本较低的其他计划，这通常意味着为客户提供的福利更少。
The plans being discontinued are primarily Preferred Provider Organizations, which offer more flexible provider networks. UnitedHealth Group said about 390,000 members will lose coverage, Fortune reported, due to unexpectedly high healthcare usage and rising medical costs that lowered the company's stock value in 2025. Around 600,000 people will lose care through Humana. Health insurance companies typically cancel plans that have lower profits to encourage customers to leave or switch to a different plan that costs the insurer less, often by offering fewer benefits to the customer.
这意味着患者可能面临更少的计划福利、覆盖医生范围的更多限制以及更高的自付费用。联合健康保险公司的削减重点在于允许患者看网络外医生的计划。转向受限计划使保险公司能够通过赋予保险公司更大影响力来控制患者就诊或进行医疗检查的频率，从而保持较低的支出。大多数主要保险公司正在缩减福利以应对不断上涨的医疗成本并保护利润，减少牙科保障并增加自付金额。
That means patients could find themselves facing fewer plan perks, more limits on covered doctors and higher out-of-pocket costs. UnitedHealthcare's cuts focused on plans that allow patients to see out-of-network doctors. Moving to restricted plans allows insurers to keep spending lower through policies that give the insurer more influence in how often patients visit doctors or get medical tests. The majority of major insurers are scaling back benefits to protect profits amid rising medical costs, reducing dental coverage and increasing out-of-pocket amounts.
老年人还面临 0 美元处方药计划的消失，这意味着他们现在必须支付月费才能获得处方药保障。在公司削减部分计划的同时，它们也在扩大针对重症的专项计划。
Seniors are also seeing the disappearance of $0 prescription drug plans, meaning they will now have to pay a monthly fee to have prescriptions covered. While companies are cutting some plans, they are also expanding specialized plans for severe illnesses.
公司不得向医疗保险受益人收取此类计划的额外费用，此类计划仅限于特定病症，但公司确实能从政府获得更高的补贴。
Companies cannot charge Medicare recipients more for such plans, which are limited to specific conditions, but do receive higher subsidies from the government.