September enrollment shows a dramatic slowing going into open enrollment, with SNPs a majority of the increase
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. Each month since then, I have updated with monthly growth numbers. Now, we have September results. For those who may have missed earlier blogs, I am refreshing on some of the annual results.
The annual statistics show some of the financial struggles the industry continues to have. Annual 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 September, enrollment climbed by about another 480K. From August to September, enrollment grew about 29K. That is a dramatic slowing from 72K from July to August. In September, enrollment was about 36.294M.
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 205K from February to September 2026 and were down about 2K from August to September. Big MA plans now have about 26.716M 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. That contrasts with non-Big MA, which grew by about 443K in open enrollment.
Non-Big MA grew by about 275K from February to September, adding 30K from August to September. Non-Big MA plans now have about 9.578M. Non-Big MA plans have taken 57% of all enrollment growth since February and all new enrollees in September.
United Healthcare has contracted by about 25K between February and September 2026, with a growth of about 8K in September. Humana has grown by about 154K from February to September 2026, with a loss of about 10K in September.
CVS grew by about 72K from February to September 2026, with a growth of about 7K in September. Kaiser grew by about 56K from February to September 2026, with growth of about 3K in September. Elevance Health has shed about 14K since February, with a growth about 1K in September. Centene has lost about 44K since February, with a loss of about 10K in September. Health Care Service Corporation (HCSC) has grown about 17K since February, with Molina contracting about 10K.
Special Needs Plans continue to explode.
Special Needs Plans (SNPs) continued to see a healthy increase in enrollment. From February 2025 to February 2026, SNPs grew to about 8.2 million, a gain of about 647K or 8.56%. SNPs grew about 259K in open enrollment. SNP enrollment now stands in September at 8.437M. SNPs have grown by about 253K since February, with 16K of that in September. SNPs took 56% of all enrollment growth in September and 56% since February. SNPs are now over 23% of all MA enrollment.
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 September 2026, PPOs grew by about 78K, with no growth in September. From February to September, HMOs grew by about 396K, with about 29K new enrollees in September. HMOs took all growth in September and 83% since February. The meager growth in PPOs can be traced to the major contraction of PPO products as MA plans financially realign.
#medicareadvantage #enrollment
— Marc S. Ryan
