2026 Medicare Advantage Enrollment Winners and Losers

The most recent Medicare Annual Election Period revealed an important trend in the Medicare Advantage market.

While overall enrollment in Medicare Advantage continues to grow nationwide, the latest enrollment data shows a market that is beginning to shift. Some insurers gained hundreds of thousands of members, while others lost large portions of their enrollment.

In some cases, entire plans disappeared.

The enrollment data released by the Centers for Medicare & Medicaid Services (CMS), comparing December 2024 and February 2025 enrollment, clearly illustrate the winners and losers heading into the 2026 Medicare Advantage plan year following the 2025 Annual Election Period.

Winners of the 2026 Medicare Advantage Enrollment Season

Several insurers experienced strong growth during the most recent enrollment cycle.

#1. UnitedHealthcare

UnitedHealthcare remains the largest Medicare Advantage insurer in the country and continues expanding its membership.

UnitedHealthcare now serves nearly 10 million Medicare Advantage beneficiaries, reinforcing its dominant position in the market.

#2. Elevance Health

Elevance Health posted one of the strongest percentage growth rates among large insurers.

It is also important to note that CMS has frozen new enrollment for certain Elevance Medicare Advantage plans effective March 31, 2026, due to operational and compliance concerns.

When CMS imposes an enrollment freeze, the insurer is prohibited from adding new members until regulators determine that the issues have been corrected.

These types of enforcement actions typically occur when CMS identifies problems related to:

• Member services
• Claims processing
• Provider network adequacy
• Compliance with Medicare regulations

Enrollment freezes like this are relatively rare and signal increasing federal scrutiny of Medicare Advantage plan operations.

#3. Cigna

Cigna recorded the fastest percentage growth among several national insurers.

Although smaller than some competitors, Cigna’s rapid expansion reflects aggressive growth strategies in several markets.

The Losers of the 2026 Enrollment Season

While some insurers gained members, others experienced substantial declines heading into the 2026 plan year.

Humana

Humana experienced the largest membership decline among major Medicare Advantage insurers.

Humana remains one of the largest Medicare Advantage insurers in the country, but the enrollment drop reflects changing competitive dynamics across multiple markets.

Aetna (CVS Health)

Aetna also experienced a significant decline in membership.

These losses highlight how quickly membership can shift during a single enrollment season.

A Major Market Exit: UCare

One of the largest disruptions of the enrollment season came from Minnesota-based insurer UCare, which exited the Medicare Advantage market entirely.

UCare previously covered approximately 158,000 Medicare Advantage members in Minnesota and western Wisconsin.

Before leaving the market, UCare held about 26% of the Minnesota Medicare Advantage market, making it the second-largest insurer in the state.

When the company withdrew from Medicare Advantage, all 158,000 members were forced to choose new coverage during the 2025 Annual Election Period for the 2026 plan year.

For many retirees, that meant evaluating unfamiliar plans, reviewing new provider networks, and making coverage decisions under time pressure.

Disruptions in Smaller Medicare Advantage Markets

While national insurers dominate headlines, some of the most significant disruptions occur in smaller states with fewer Medicare Advantage options.

States such as Vermont and New Hampshire experienced notable changes in Medicare Advantage availability heading into the 2026 Medicare Advantage plan year.

In smaller markets like these, even a single insurer’s exit can dramatically reduce plan choices for beneficiaries.

For beneficiaries living in smaller states, the loss of even one plan can significantly limit coverage options and force many retirees to reconsider their healthcare strategy during the Annual Election Period.

What We Started Hearing From Clients

During the most recent enrollment season, our office received an increasing number of calls from retirees who had received letters from their insurance companies stating that their plan would not be renewed for the upcoming 2026 coverage year.

Many of those conversations began the same way:

“I just received a letter saying my Medicare Advantage plan is going away. What am I supposed to do?”

For these beneficiaries, the enrollment season was not simply about reviewing their options. It was about replacing coverage that was disappearing altogether.

Some retirees discovered their doctor was no longer in the network. Others saw benefits reduced. And in some cases, the entire plan they had relied on for years was discontinued.

For retirees who had grown comfortable with their coverage, such changes can be unsettling. But for those of us who work with Medicare every day, the underlying causes have been building for years.

The 10-Year Boom of Medicare Advantage

Over the past decade, Medicare Advantage has been one of the fastest-growing segments of the health insurance industry. Enrollment surged as insurers invested heavily in expanding their Medicare businesses.

As of early 2026, Medicare Advantage enrollment has grown to roughly 35.5 million beneficiaries, representing more than half of all Medicare beneficiaries.

During this period, insurers invested enormous resources into:

• Marketing campaigns
• Broker commissions
• Expanding geographic coverage
• Enhancing plan benefits

Medicare Advantage has become one of the most profitable and competitive sectors of the health insurance industry.

Why Does This Happen?

When people see insurance companies suddenly dropping plans, exiting counties, or losing hundreds of thousands of members in a single enrollment season, the natural question is: “Why does this happen?”

The answer comes down to the economics of the Medicare Advantage program and the ongoing balancing act between insurance companies and the federal government.

Every year, the Centers for Medicare & Medicaid Services (CMS) determines how much it will reimburse insurance companies for covering Medicare beneficiaries through Medicare Advantage plans. These payments are adjusted annually based on healthcare cost projections, demographic trends, and program spending.

Below is how Medicare Advantage reimbursement rates have changed over the past several years.

The 2022 and 2023 plan years were unusually strong years for Medicare Advantage reimbursement, with payment increases of roughly 8.5% each year. When reimbursement increases are that strong, insurance companies often respond by expanding their Medicare Advantage offerings.

This is when we saw:

• Aggressive national marketing campaigns
• Heavy broker commission spending
• Rapid geographic expansion
• Richer supplemental benefits
• The explosion of so-called “free” extras like grocery cards and over-the-counter allowances

Those high reimbursement years encouraged insurers to grow enrollment quickly. Millions of beneficiaries enrolled in Medicare Advantage plans during that period, and the program experienced some of its fastest growth in history.

But the following years told a different story.

Beginning in 2024 and 2025, reimbursement increases dropped significantly compared with the previous two years. While CMS still increased payments, the growth rate slowed dramatically compared with the earlier 8.5% increases.

At the same time, insurers began seeing higher-than-expected healthcare utilization from the rapidly growing Medicare Advantage population.

Plans began reporting increases in:

• Hospital admissions
• Outpatient procedures
• Specialist visits
• Prescription drug utilization

When reimbursement growth slows while medical utilization continues to rise, insurance companies begin to experience pressure on their margins. That pressure often forces companies to make adjustments quickly.

Those adjustments may include:

• Reducing plan benefits
• Increasing copayments
• Narrowing provider networks
• Discontinuing certain plans
• Exiting counties or states
• Limiting or discouraging new enrollment

In many ways, what we are seeing now is the natural correction that follows a period of rapid expansion.

The generous reimbursement increases in 2022 and 2023 helped fuel rapid growth in the Medicare Advantage market. Insurers expanded aggressively, marketed heavily, and offered increasingly rich benefit packages.

But when reimbursement growth slowed, and healthcare utilization increased, the economics of those plans began to shift. And when that happens, the market corrects itself. That correction is exactly what we are beginning to see across the Medicare Advantage landscape today.

The Era of “Free” Benefits

As insurers competed for market share, Medicare Advantage plans began offering increasingly generous benefits.

For many retirees, these plans appeared to offer more benefits than traditional Medicare at little or no cost. But from an economic standpoint, the question has always been whether this model could continue indefinitely.

Why None of This Surprises Me

For several years, I have been telling my clients something very simple:

The Medicare Advantage market cannot continue offering richer benefits and $0 premiums indefinitely without eventually making adjustments. Insurance companies cannot sustain expanding benefits, heavy marketing spending, and aggressive growth without eventually correcting course.

Those corrections often appear as:

• Higher copayments
• Narrower provider networks
• Increased prior authorization requirements
• Reduced benefits
• Insurers exiting certain markets

Now we are beginning to see those corrections happen.

What I’ve Observed in the Industry

Over the years, I’ve also observed a pattern that often occurs when large Medicare Advantage insurers decide to reduce enrollment.

When major carriers like UnitedHealthcare or Humana determine that certain blocks of business are becoming unprofitable, they may drop plans or allow large numbers of members to leave during the Annual Election Period.

When that happens, something interesting occurs in the market.

Smaller regional insurers often become excited about the disruption because it gives them an opportunity they rarely get – the chance to compete for members who are leaving the large national carriers.

Smaller companies typically do not have the same marketing budgets or brand recognition as large national insurers. When a large carrier drops members or exits a market, it suddenly creates an opening. Those smaller insurers step in and aggressively market their plans to the displaced beneficiaries.

But in many cases, the story does not end there. What often happens is that smaller companies begin to experience the same claims data that led the larger insurers to step away in the first place.

After one or two years, those insurers may discover that the business they eagerly picked up is also financially challenging. And the cycle begins again.

Something Unusual Happened During the 2025 Annual Election Period

Another development during the 2025 Annual Election Period, which determined coverage for the 2026 Medicare Advantage plan year, was something I have never seen before in more than 20 years in the insurance business.

Many insurance companies suppressed certain Medicare Advantage plans, meaning they would not pay commissions to agents for selling those plans in specific counties.

In practical terms, this meant:

• The plans were technically available
• But agents were discouraged from selling them
• Because there was no compensation for the sale

What made this even more unusual was that multiple insurers appeared to be taking similar defensive measures simultaneously. For the first time in my career, it felt as though companies across the industry were effectively aligning with each other to prevent new business from entering the market.

The message seemed clear. Whether large national insurers or smaller regional carriers, no company really wanted new business during that enrollment season.

Instead, many companies appeared focused on reducing or reshaping their existing membership.

By dropping unprofitable plans, suppressing new sales, and limiting enrollment growth, insurers seemed to be trying to remove higher-cost members from their books and stabilize their financial performance.

The goal appeared to be simple: clean up their risk pools so they could return to more profitable growth in future years. Seeing companies simultaneously drop members while discouraging new sales was highly unusual.

In more than two decades in the insurance industry, I had never seen that level of defensive behavior across the Medicare Advantage market.

Signs the Market Is Entering a New Phase

Several developments suggest the Medicare Advantage market may be entering a more volatile phase.

Approximately 1.1 million new beneficiaries joined Medicare Advantage between 2025 and 2026, compared with annual increases of more than 2 million beneficiaries in several previous years.

At the same time:

• Some insurers are discontinuing plans
• Others are exiting certain counties
• Regulators are increasing oversight of plan operations

CMS has even taken steps in certain situations to freeze enrollment for plans that fail to meet operational or compliance standards. These developments reflect a market that is beginning to mature and adjust.

What This Means for Medicare Beneficiaries

For Medicare beneficiaries, the developments we saw during the 2025 Annual Election Period for the 2026 plan year should serve as an important reminder about how Medicare Advantage plans work.

Unlike Original Medicare, Medicare Advantage plans are private insurance plans that operate in a competitive marketplace. Because of that, they can change every year.

During each Annual Election Period, insurance companies can:

• Exit certain counties or states
• Change provider networks
• Modify copayments and cost sharing
• Remove or reduce extra benefits

For beneficiaries enrolled in these plans, those changes can sometimes happen quickly and with very little warning.

One year, your plan may include a specific network of doctors, certain copays, and a set of extra benefits. The following year, some of those doctors may no longer participate in the network, benefits may be reduced, or the plan itself may be discontinued.

This is exactly what many retirees experienced during the most recent enrollment season when they received non-renewal notices informing them their plans would no longer be offered for 2026.

For years, Medicare Advantage plans have competed aggressively by offering generous benefit packages and advertising $0 monthly premiums along with a variety of additional perks.

But as the market matures and financial pressures increase, beneficiaries should understand that these benefits may not remain as generous as they have been in the past.

Going forward, many Medicare Advantage plans may begin to rely more heavily on:

• Narrower provider networks
• Greater use of prior authorization
• Higher copayments for certain services
• Fewer supplemental benefits

Some plans may also begin introducing monthly premiums where none existed before, particularly as insurers adjust their pricing to reflect rising healthcare costs.

For Medicare beneficiaries, the key takeaway is that understanding Medicare Advantage requires looking beyond the marketing. It is important to understand how these plans operate, how often they can change, and what those changes could mean for your healthcare access in the future.

My Perspective After 15 Years in Medicare

After helping people navigate Medicare for more than 15 years, one thing has become very clear: healthcare coverage in retirement should prioritize stability and predictability.

The events we saw during the 2025 Annual Election Period – clear winners and losers, plan exits, enrollment freezes, commission suppression, and non-renewal notices – highlight the reality that Medicare Advantage operates within a private insurance marketplace.

And in private insurance markets, change is constant. For retirees making Medicare decisions, understanding that reality is essential.

Because when it comes to healthcare in retirement, stability often matters more than marketing promises.