The Centers for Medicare & Medicaid Services (CMS) has estimated that individuals enrolled in private versions of government-backed health plans called Medicare Advantage (MA) will decline by nearly 1M in 2026 from this year.
Its projection came as CMS plans to run the next Medicare Open Enrollment period from Oct. 15 to Dec. 7, giving Americans, mainly those aged 65 and older, the ability to compare their 2026 coverage options.
“Millions of Medicare beneficiaries will continue to have access to a broad range of affordable coverage options in 2026,” CMS Administrator Mehmet Oz said as his agency projected a stable outlook for premiums and medical benefits across MA and the Medicare Part D plans next year.
However, according to CMS, MA enrollments are expected to decline by ~3% to 34M in 2026 from 34.9M this year, indicating a potential headwind for MA-focused health insurers such as UnitedHealth (NYSE:UNH) and Humana (NYSE:HUM).
Other players operating in the MA market include CVS Health (NYSE:CVS), Cigna (CI), Clover Health (CLOV), and Alignment Healthcare (NASDAQ:ALHC).
“However, based on recent historical experience and enrollment trends, CMS anticipates that enrollment in MA in 2026 will be more robust than the plans’ projections and that enrollment will be stable,” the agency added.
CMS also projected that, as a percentage of total Medicare beneficiaries, people enrolled in MA plans will drop to 48% next year from 50% in 2025, while the average monthly plan premium across all MA plans will drop to $14.00 from $16.40 this year.
Meanwhile, the total number of MA plans available across the U.S. is expected to reach approximately 5,600 in 2026, a slight drop from 5,633 in 2025, with 99% of Medicare members having access to a plan.
As for Part D coverage, the average total premium for standalone plans will decline by $3.81 from 2025 to $34.50 in 2026, CMS said, adding that the average Part D total premium for MA plans with prescription drug coverage is set to drop $1.82 to $11.50.