April enrollment tails off
In a February 16 blog, I detailed the growth in Medicare Advantage (MA) from February 2025 to February 2026 after a delay from the Centers for Medicare and Medicaid Services (CMS) in posting the annual data. As I noted, the January enrollment statistics in both years seemed off so many analysts are comparing February to February each year. On March 30, I updated my blog site with results for March 2026. Now, we have April results. For those who may have missed the earlier blogs, I am refreshing on some of the annual and February results.
The annual statistics show some of the financial struggles the industry continues to have. Growth is way down compared with prior years in the 2020s due to major geographic contractions as well as plan benefit reductions by major MA players the past few years.
As the chart below shows, February 2025 to February 2026 enrollment growth was just 874K or 2.5% — way down from annual growth from January 2020. MA enrollment continues to grow due to aging in America each month as well as the secondary enrollment process from January through March of each year.
What do the latest statistics show?
Enrollment in MA reached 35.815M in February 2026. From February to March 2026, enrollment climbed by about another 129K lives. From March to April 2026, enrollment climbed by about another 55K. In March enrollment was 35.999M.
How did Big MA do?
From February 2025 to February 2026, Big Plan MA enrollment grew by about 861K or 3.4%. Big MA enrollment hit 26.511M in February 2026. Big MA’s penetration was 74.02% in February 2026. Big MA plans grew about 86K from February to March. From March to April, Big MA plans grew by about 11K. Big MA plans now have about 26.608M enrollees.
However, hidden in these numbers is a very poor open enrollment season. From December 2025 to February 2026, Big MA contracted by about 328K before rebounding by 86K in March. That contrasts with non-Big MA, which grew by about 443K in open enrollment and another approximate 43K in March. Non-Big MA grew by about 44K from March to April. So, non-Big MA continues to grow better than Big MA.
United Healthcare contracted by about 17K from February to March and 24K from March to April. Humana grew by almost 70K from February to March and another 29K from March to April. CVS grew by about 12K in March and 13K in April, while Kaiser grew by about 28K in March and 5K in April. Centene was basically flat in March and lost 5K in April. Elevance Health shed about 7K in both March and April. Health Care Service Corporation (HCSC) grew by about 2K in each month and Molina shed about 2K in each month.
Special Needs Plans chugging along
Special Needs Plans (SNPs) continued to see a healthy increase in enrollment. From February 2025 to February 2026, SNPs grew to about 8.200 million, a gain of about 647K or 8.56%. SNPs grew about 259K in open enrollment. From February to March, SNPs added about 61K more lives, but just 13K from March to April. SNP enrollment now stands at 8.275M.
PPOs vs. HMOs
Over the years, PPOs began growing and competing well with HMOs in terms of raw numbers as well as percentage growth. While PPOs’ sheer number and percentage growth were beating HMOs over the past several years, that trend changed beginning in 2025. From January 2023 to January 2024, HMOs grew about 853K (4.8%) and PPOs 1.861 million (14.8%). From January 2024 to February 2025, HMOs grew more than PPOs in terms of numbers and percentage: HMOs up about 882K (4.7%) vs. PPOs up about 580K (4%). From February 2025 to February 2026, HMOs were up about 937K (4.8%), while PPOs were down by about 103K (-0.7%).
From February to March, PPOs grew by about 27K, while HMOs grew by about 101K. From March to April, PPOs grew by about 8K, while HMOs grew by about 46K.
#medicareadvantage #enrollment
— Marc S. Ryan
