More news on the contraction in MA due to the ongoing financial woes
On October 6, I ran my second installment on 2026 Medicare Advantage (MA) contraction. As more information becomes public, we have learned a bit more on the scope and depth of MA and standalone Part D (PDP) plans’ pullback in benefits, products, and footprints. So, a quick update on some new findings.
How many MA members will be forced to change plans during open enrollment?
Deft Research says up to 5% of current MA members, or about 1.8 million people, will need to change plans because their plan was terminated. As I suspected, the impact of the contraction would again be high. Up to 2 million had to do so in 2025. So 2026, is just short of 2025. This represents two years in a row of major displacement for enrollees.
Regional players filling the void?
While some regional plans left MA for fear of huge enrollments when big players pulled back in states, some regional players are viewing the big-plan contraction as an opportunity to gain market share. ATI Advisory says the average number of counties where regional insurers are offering MA grew by 6% while large national insurers’ footprint declined 3% and small insurers’ fell 5% for 2026.
KFF MA assessment
Healthcare policy group has done its annual review of MA offerings since our last installment, so here is a brief summary. Similar statistics were mentioned in the second installment and differ a little from KFF. This is not unusual given the sheer magnitude of the data and slight differences in interpretation or approach.
KFF’s analysis shows that Medicare beneficiaries will have the option of 32 MA-Part D (MA-PD) plans in 2026. This down from 34 in 2025 and does not count employer plans and special needs plans (SNPs). At the same time, KFF notes steady overall growth in offerings since 2010, peaking in 2024 at 36 options. Options remain higher than in 2022, which was 31.
The average Medicare beneficiary will have more than 30 MA plan options. But Medicare beneficiaries will have fewer than 5 options, on average, in four states: Alaska (0), South Dakota (4), Wyoming (3), and Vermont (1).
Better Medicare Alliance says out-of-pocket costs increasing
The nation’s biggest MA advocacy group, Better Medicare Alliance, has a new report that finds fewer choices as well and rising out-of-pocket costs due to the contraction of benefits. The analysis was performed by Avalere.
The analysis finds that plan offerings will be 335 fewer non-SNP plans. SNP investments and offerings will grow again in 2026.
Higher maximum out of pocket (MOOP) costs are already occurring. 11% fewer plans will offer MOOPs below the prescribed limit in 2026. The median MOOP will be up nearly $1,000 in two years. It goes from $5,400 in 2025 to $5,900 in 2026, an increase of 9.3%.
The analysis notes that premiums are stable, but affordability pressures are rising. While 59% of offerings have a $0 premium, higher MOOPs, fewer sub-limit MOOP options, and other changes mean beneficiaries may still face higher costs.
Oliver Wyman assessment
Oliver Wyman’s annual analysis came out too. It found that the total number of non-SNP MA-only and Medicare Advantage prescription drug plans (MAPD) nationally declined 10%, from 3,719 plans in 2025 to 3,373 plans in 2026. In terms of national plans, several scaled back plan offerings in at least 100 counties. As an example, the biggest MA plan, UnitedHealthcare, offered MA-only and MA-PD plans in 2,808 counties in 2025, but that will drop to 2,597 counties in 2026.
Preferred Provider Organization (PPOs) had a 12% year-over-year decline compared to 8% for Health Maintenance Organizations (HMOs).
It had different numbers as well on county offerings. It says Medicare beneficiaries in 2025 had access to an average of 42 plans per county in terms of non-SNP MA and MA-PD. That will drop to 39 plans per county in 2026. But again, it notes the major growth in Chronic Care or C-SNPs and Dual Eligible or D-SNPs.
Other expansion and contraction news
AmeriHealth Caritas, Blue Cross Blue Shield of Wyoming, and Scan Health Plan are expanding in MA in 2026.
AmeriHealth Caritas will add hundreds to thousands of new members after expanding into Louisiana and North Carolina, said Chris McDade, president of Medicare markets at the nonprofit insurer. They focus on dual eligible or D-SNPs and are in a joint venture with Blue Cross Blue Shield of Michigan and Independence Health Group.
Medica will increase MA in enrollment after UCare left the program.
#medicareadvantage #coverage
— Marc S. Ryan
