Medicare Advantage Market in 2026: Plan Availability, Coverage, and Market Dynamics

Medicare Advantage (MA) plans continue to play a significant role in the U.S. Medicare program, with enrollment exceeding 34 million beneficiaries in 2025, representing 54% of those eligible. For 2026, the average Medicare beneficiary will have access to 32 Medicare Advantage prescription drug (MA-PD) plans, a slight decrease from 34 in 2025 but still higher than offerings in years prior to 2022. This report analyzes individual Medicare Advantage plans available for general enrollment excluding employer plans and Special Needs Plans (SNPs), focusing on plan availability, types, and market dynamics. The availability of MA-PD plans varies widely by state, with 35 states seeing fewer options in 2026 compared to 2025. Notable market exits occurred in states like Minnesota and New Hampshire, affecting plan availability and potentially causing coverage disruptions in rural and low-enrollment areas. The national total of Medicare Advantage plans for individual enrollment decreased by 9%, from 3,719 plans in 2025 to 3,373 in 2026. Health Maintenance Organizations (HMOs) remain the dominant plan type but have declined in share, while local Preferred Provider Organizations (PPOs) have grown, reaching 42% of plans, reflecting beneficiary preferences for out-of-network coverage. An increasing trend is seen in the expansion of Special Needs Plans, particularly Dual Eligible SNPs (D-SNPs) and Chronic Condition SNPs (C-SNPs), which together address high-need populations with complex care requirements. Urban beneficiaries benefit from greater plan choices averaging 42 plans, compared to 29 in rural adjacent and 20 in non-adjacent rural counties. Market competition is concentrated among a few firms; UnitedHealthcare and Humana control nearly half of Medicare Advantage enrollment but have reduced their geographic footprints, exiting several hundred counties each in 2026. This contraction aligns with broader insurer market exits and entries, indicating shifting strategies driven by cost and local market conditions. Plan terminations and consolidations are increasing, impacting nearly 13% of MA-PD enrollees (2.6 million beneficiaries) who face discontinuation of coverage in 2026 without automatic reassignment, necessitating plan changes or reversion to traditional Medicare with special enrollment rights. Employer-sponsored Medicare Advantage plans remain opaque in public data due to separate administration. Furthermore, some insurers are introducing co-branded plans with partners such as retail and grocery companies to target enhanced benefits for populations with chronic conditions. The dynamic nature of the Medicare Advantage market requires beneficiaries and industry stakeholders to navigate changes in coverage options, insurer participation, and benefit structures as the program evolves.