Medicare Advantage in 2026: Enrollment, Plan Options, and Terminations

After years of rapid growth, Medicare Advantage enrollment growth has slowed, a trend that continued into 2026. Whereas the market remains robust, changes in payment systems and insurer strategies are impacting plan availability and affecting beneficiaries. This article examines the state of Medicare Advantage in 2026, focusing on enrollment, plan terminations, and available options for those affected.

Medicare Advantage Enrollment and Plan Availability

As of February 2026, enrollment in Medicare Advantage surpassed 35 million people, with more than half of eligible beneficiaries receiving their Medicare coverage through a private plan . Despite a slight decrease in the number of available plans, beneficiaries still have a considerable range of choices. The average beneficiary has access to 32 Medicare Advantage plans in 2026, down from a peak of 36 in 2024, but higher than in 2022 and prior years .

Importantly, virtually all Medicare beneficiaries have access to at least one zero-premium Medicare Advantage plan with prescription drug coverage (excluding the standard Part B premium) . At least 98% of plans offer vision, dental, and hearing benefits, which are not typically covered by Original Medicare .

Rebate payments to Medicare Advantage plans from the Medicare program are expected to reach a record high in 2026, averaging over $2,600 per enrollee. These payments are intended to lower cost-sharing, fund extra benefits, and reduce premiums .

Plan Terminations and Affected Beneficiaries

Despite the overall stability of the Medicare Advantage market, approximately 2.6 million people who were covered by a Medicare Advantage plan in 2025 experienced plan terminations at the end of the year . This represents 13% of all enrollees in individual Medicare Advantage plans, a significant increase from the 6% affected in 2024 .

Several factors contributed to these terminations, including increased healthcare utilization, slower growth in federal payments per enrollee, and insurers’ efforts to stabilize margins. Some insurers are also prioritizing Special Needs Plans (SNPs), which cater to individuals with specific health needs or dual eligibility for Medicare and Medicaid .

Options for Beneficiaries Affected by Plan Terminations

The good news is that the vast majority of beneficiaries affected by plan terminations (98.9%) have at least one Medicare Advantage plan available to them in 2026 . On average, these beneficiaries have 25 Medicare Advantage plan options to choose from .

For most beneficiaries (68.7%), their existing insurer continues to offer a plan in 2026, providing continuity of care. Another 29.8% have options from other insurers . Only a small percentage (1.1%, or less than 30,000 people) have no Medicare Advantage plan options available in their area .

Beneficiaries who lose their Medicare Advantage coverage have the option to switch to Original Medicare. Original Medicare offers broader provider access and less utilization management, but does not include extra benefits like dental, vision, and hearing. Those who switch to Original Medicare will need to enroll in a separate prescription drug plan and may also choose to purchase a Medigap policy to supplement their coverage. Beneficiaries who lose their Medicare Advantage plan have a guaranteed issue period for Medigap policies, meaning they cannot be denied coverage or charged a higher premium due to pre-existing conditions.

Impact by Insurer and Geography

While smaller insurers accounted for roughly half of the enrollees affected by plan terminations, UnitedHealth Group had the largest share (20%) . However, a relatively small percentage of UnitedHealth Group enrollees (less than 2%) had no Medicare Advantage options in 2026.

Plan terminations disproportionately affected beneficiaries in rural areas. Nearly one-quarter (23%) of enrollees in terminated plans lived in rural counties, compared to 14% of all Medicare Advantage enrollees . Plan terminations in rural areas were also more likely to result in no Medicare Advantage options being available.

The impact of plan terminations varied significantly by state. Vermont experienced the highest rate of terminations, with over 90% of Medicare Advantage enrollees in a plan that was terminated. Other states with high termination rates included Wyoming, South Dakota, Idaho, New Hampshire, and North Dakota .

Looking Ahead

The Medicare Advantage landscape continues to evolve. While most beneficiaries affected by plan terminations in 2025 have alternative options, it’s crucial for beneficiaries to carefully review their choices during the annual enrollment period to ensure they have the coverage that best meets their needs. The future of Medicare Advantage will depend on ongoing policy decisions and the ability of insurers to balance cost control with the provision of valuable benefits.