Medicare Advantage Enrollment and Plan Exits in 2026
Key Takeaways
- →Medicare Advantage enrollment reached 35.2 million in March 2026 - 55% of all Medicare beneficiaries with Part A and Part B.
- →Approximately 2.9 million beneficiaries were forced to leave discontinued plans entering 2026, with rural beneficiaries experiencing higher rates of disruption.
- →Special Needs Plans now account for 23% of Medicare Advantage enrollment (8.2 million), and drove most of the net enrollment growth from 2025.
- →Plan exits affect far more than premiums - networks, formularies, prior authorizations, supplemental benefits, and care-management programs all change.
- →Carriers, providers, and agents each carry distinct operational responsibilities when coverage transitions occur. A compliant notice is not a transition system.
- →The Medicare Annual Election Period runs October 15 through December 7. Coverage selections take effect January 1.
Approximately 11,200 Americans are turning 65 each day. Medicare Advantage now covers 35.2 million beneficiaries. Another 14.5 million people carry Medicare Supplement coverage. At the same time, approximately 2.9 million Medicare Advantage beneficiaries were forced to leave plans that did not continue into 2026.
These figures describe a Medicare market that continues to grow while becoming harder to navigate. For carriers, providers, agencies, and beneficiary-support organizations, this creates an operating challenge. Enrollment growth has to be supported by accurate plan information, dependable provider directories, sufficient service capacity, compliant communications, and clear transitions when coverage changes.
11,200
Americans turning 65 per day
4.1M+ annually through 2027
35.2M
Medicare Advantage enrollees
55% of Part A & B beneficiaries
14.5M
Medicare Supplement members
Medigap policyholders (2026 est.)
2.9M
Forced to change plans
Discontinued MA plans entering 2026
Medicare in 2026 at a glance
| Medicare market measure | 2026 figure | What it represents |
|---|---|---|
| Americans turning 65 | ~11,200/day | More than 4 million people reaching age 65 annually |
| Medicare Advantage enrollment | 35.2 million | 55% of Medicare beneficiaries with both Part A and Part B |
| Medicare Supplement enrollment | ~14.5 million | Policyholders using private supplemental coverage with Original Medicare |
| Beneficiaries affected by plan exits | ~2.9 million | People forced to select new coverage after plans were discontinued |
These figures use different populations and measurement periods and should not be added together to estimate total Medicare enrollment.
Medicare Advantage enrollment growth
A KFF analysis of CMS data found that 35.2 million people were enrolled in Medicare Advantage in March 2026 - up approximately 1.1 million from 2025, a 3% increase. The program is still growing, though the pace has slowed from earlier years.
Medicare Advantage enrollment (millions)
Source: KFF analysis of CMS enrollment data
2020–2025 figures are approximate based on published KFF and CMS enrollment reports. 2026 reflects March 2026 enrollment.
Special Needs Plans drove most of the growth
Nearly 8.2 million beneficiaries were enrolled in Special Needs Plans in 2026, representing 23% of Medicare Advantage enrollment. Most of the net enrollment increase from 2025 came from these plans.
Special Needs Plans as share of Medicare Advantage enrollment
Source: KFF / CMS 2026
Share of SNP enrollment by plan type (approximate)
Operational consequence of SNP growth
Beneficiaries in D-SNPs, C-SNPs, and I-SNPs often require coordination across Medicare, Medicaid, providers, pharmacies, community services, and caregivers. A member appearing correctly in one system does not guarantee that the provider, pharmacy, care manager, billing department, and state Medicaid program see the same information at the same time.
Approximately 2.9 million people were forced to leave discontinued plans
A 2026 study published in JAMA estimated that approximately 2.9 million beneficiaries in Medicare Advantage HMO and PPO plans faced forced disenrollment following plan exits - roughly one in ten affected Medicare Advantage enrollees in the population studied.
These beneficiaries did not lose Medicare eligibility. Their existing plans were no longer available, requiring them to select another Medicare Advantage plan or return to Original Medicare. The distinction is important, but it does not make the disruption minor.
What changes when a Medicare Advantage plan is discontinued
Rural beneficiaries face compounded risk
The JAMA study found that rural beneficiaries experienced higher rates of forced disenrollment. Rural areas often have fewer participating plans, narrower provider capacity, longer travel distances, and less access to in-person assistance. A beneficiary in a competitive metropolitan county may have several reasonable alternatives. Someone in a rural county may face fewer plans and greater difficulty preserving access to existing doctors or hospitals.
Why Medicare Advantage plans exit markets
A carrier's decision to discontinue a plan usually reflects several pressures working together. Medical utilization can come in higher than expected. Provider and pharmaceutical costs can increase. Risk-adjustment changes can affect revenue. Star Ratings can alter quality bonus payments. Supplemental benefits, administrative costs, and broker compensation also contribute to plan economics.
These pressures vary by county and contract. A plan can remain sustainable in one market and become difficult to support in another. The operational problem appears when plan exits are identified late in the cycle, member communication is difficult to understand, or the surrounding enrollment system lacks enough capacity to help people make informed decisions.
Medicare Supplement covers approximately 14.5 million people
Medicare Supplement insurance (Medigap) helps people with Original Medicare pay certain deductibles, coinsurance, and copayments. The latest industry reporting places enrollment at approximately 14.5 million policyholders.
Medicare Advantage
35.2M enrolled- →Replaces Original Medicare
- →Network-based (HMO/PPO)
- →Often includes supplemental benefits (dental, vision, hearing)
- →Prescription drug coverage usually included
- →Prior authorization requirements vary by plan
- →Cannot generally be used with Medigap
Medicare Supplement (Medigap)
~14.5M enrolled- →Works alongside Original Medicare
- →Broader provider access (any Medicare-accepting provider)
- →Helps cover deductibles, coinsurance, copayments
- →Separate Part D plan needed for prescriptions
- →Monthly premium required
- →Enrollment protections are time-limited and situation-specific
Plan-exit guidance is especially sensitive
A beneficiary should not be told that Medicare Supplement is automatically available on the same terms in every situation. The person's eligibility, timing, prior coverage, location, health status, and state protections must be reviewed. Certain circumstances, including some Medicare Advantage plan terminations, may create guaranteed-issue rights - but those protections are time-limited and situation-specific.
What each stakeholder should do
Carriers need more than a compliant notice process. They need a transition system that can withstand increased member questions and coverage comparisons.
Identify affected members early
Segment by county, product, provider usage, medication needs, dual-eligibility status, language preference, and care-management needs.
Make notices understandable
State clearly that the current plan is ending, when it ends, what actions the member can take, and what happens if no active selection is made.
Validate provider and formulary information
Transition guidance becomes damaging when directories, drug information, or benefit summaries are inaccurate.
Coordinate high-risk cases
Members receiving cancer treatment, dialysis, home health, post-acute care, behavioral healthcare, or complex specialty medications may need direct assistance.
Measure transition outcomes
Track unanswered calls, complaints, grievances, abandoned enrollments, provider-access issues, pharmacy problems, and continuity-of-care requests.
Agents will often be the person a beneficiary calls when a plan terminates. A good plan review should verify each of the following before making a recommendation.
Verify all physicians and facilities
Confirm every provider the beneficiary wants to keep is in-network under the recommended plan.
Check every prescription
Review dosage, formulary tier, preferred pharmacy, and cost-sharing for each medication.
Compare full cost exposure
Premiums, deductibles, copayments, coinsurance, and maximum out-of-pocket - not just the monthly premium.
Review supplemental benefits actually used
Dental, vision, hearing, transportation, and fitness benefits vary significantly across plans.
Audit compliance documentation
Higher enrollment volume does not reduce the need for compliant, supportable recommendations. Review recorded calls, scripts, and plan comparisons.
Health systems and medical practices should build a plan-change readiness process across contracting, patient access, revenue cycle, and clinical operations before the new coverage year begins.
Identify terminating plans by service area
Confirm payer participation and update internal systems before the new plan year.
Identify patients by current coverage
Flag patients with scheduled procedures or active treatment for proactive outreach.
Update front-office scripts
Establish clear escalation rules for continuity-of-care questions. Avoid giving unlicensed insurance advice.
Monitor early claims and denials
Eligibility verification before appointments and procedures. Early monitoring of denials and rejected claims catches systemic failures before they compound.
Document payer communications
Maintain records of authorization status and payer communications. A plan transition should not first become visible when a claim rejects.
Where better data and workflow controls can help
The Medicare market produces large amounts of enrollment, eligibility, provider, claims, authorization, and benefit information. The problem is often the timing and consistency of that information across organizations.
An effective transition operating system should be able to:
AI can support document review, case prioritization, data matching, and call-quality monitoring - but these uses require human review, validated source data, access controls, and clear accountability. Coverage recommendations and high-risk clinical or financial decisions should remain subject to qualified human judgment. Better visibility cannot prevent every carrier exit, but it can reduce the confusion, revenue leakage, rework, and patient disruption that follow when organizations do not share a reliable view of the transition.
Medicare Annual Election Period: October 15 – December 7
Coverage selections made during the Annual Election Period take effect January 1. Other enrollment opportunities may apply based on the beneficiary's circumstances, including Special Enrollment Periods triggered by plan exits. Organizations should have staffing, systems, and compliance controls in place before October 15.
Frequently asked questions
How many people are enrolled in Medicare Advantage in 2026?
Approximately 35.2 million people were enrolled in Medicare Advantage in March 2026, representing 55% of Medicare beneficiaries with both Part A and Part B, according to KFF's analysis of CMS enrollment data.
How many Medicare Advantage beneficiaries lost their plans in 2026?
A 2026 JAMA study estimated that approximately 2.9 million Medicare Advantage beneficiaries were forced to leave plans that were discontinued. They did not lose Medicare eligibility, but they had to select different coverage.
How many Americans turn 65 each day?
Approximately 11,200 Americans are turning 65 each day during the Peak 65 period, equaling more than 4.1 million people annually through 2027.
How many people have Medicare Supplement coverage?
Approximately 14.5 million Americans have Medicare Supplement (Medigap) coverage. Medicare Supplement works with Original Medicare and cannot generally be used with Medicare Advantage.
What happens when a Medicare Advantage plan is discontinued?
The beneficiary can select another available Medicare Advantage plan or return to Original Medicare. A nonrenewal may also create a Special Enrollment Period and, in some circumstances, a guaranteed-issue right to purchase Medicare Supplement coverage. Eligibility and deadlines should be confirmed for the individual situation.
Does forced disenrollment mean a beneficiary loses Medicare?
No. Forced disenrollment from a discontinued Medicare Advantage plan does not end Medicare eligibility. It means the beneficiary must move to another Medicare Advantage plan or Original Medicare.
When is the Medicare Annual Election Period?
The Medicare Annual Election Period runs from October 15 through December 7 each year. Coverage selections generally become effective January 1.
Sources
- 1.KFF Medicare Advantage enrollment analysis, March 2026. kff.org
- 2.JAMA study on forced disenrollment from discontinued Medicare Advantage plans, 2026. jamanetwork.com
- 3.CMS Medicare enrollment guidance and Special Enrollment Period rules. cms.gov
- 4.AHIP Medicare Supplement enrollment reporting, 2026. ahip.org
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