Medicare Advantage in 2026: Enrollment Update and Key Trends
The Medicare Advantage program, a private plan alternative to traditional Medicare, has seen steady growth in enrollment over the past two decades. In 2026, over half (55%) of eligible Medicare beneficiaries are enrolled in Medicare Advantage plans, marking a significant jump from 19% in 2007. This growth has implications for federal spending, as Medicare payments to private plans are higher than those for traditional Medicare.
Key Findings:
- Enrollment Growth: Medicare Advantage enrollment grew by 1.1 million beneficiaries between 2025 and 2026, maintaining a similar growth rate to the previous year. The Congressional Budget Office (CBO) projects a steady rise in enrollment, reaching 63% by 2034.
- Special Needs Plans (SNPs): SNPs, catering to beneficiaries with specialized care needs, accounted for 23% of enrollees in 2026. The majority (78%) of SNP enrollees are in D-SNPs, designed for dual-eligible individuals.
- Concentration of Plans: Enrollment is highly concentrated among a small number of parent organizations. UnitedHealth Group and Humana dominate the market, accounting for nearly half (46%) of all enrollees.
- Market Share Changes: UnitedHealth Group's market share dropped to 26%, while Humana's increased to 20%. Humana had the largest growth in enrollment, while UnitedHealth Group saw a decline.
- Group Plans: Slightly less than one in five Medicare Advantage enrollees (16%) are in group plans offered by employers or unions. This share has fluctuated between 17% and 20% over the years.
Implications and Commentary:
The rise in Medicare Advantage enrollment raises questions about the impact on beneficiaries' choices and access to supplemental benefits. The concentration of plans among a few parent organizations is a concern, as it may limit competition and choice. The growth in SNP enrollment, driven by increased rebate payments and access to extra benefits, highlights the program's ability to cater to specific needs.
The analysis underscores the evolving landscape of Medicare Advantage, with a focus on enrollment trends, plan types, and market concentration. As the program continues to grow, policymakers must address the implications for federal spending, beneficiary choice, and access to benefits.
