Medicare Advantage Enrollment Faces Challenges in 2026
The Centers for Medicare & Medicaid Services (CMS) has projected that Medicare Advantage enrollment will decrease to 34 million by 2026, down from 35 million this year. This marks the first decline in nearly two decades, signaling a shift in the dynamics of the Medicare market. Despite this projected drop, CMS maintains that the market will remain stable, with seniors expected to have an average of 10 plans to choose from when they begin reviewing 2026 options.
Market Stability Amid Changes
While the overall market is expected to remain steady, analysts have pointed out that health insurer filings suggest higher deductibles and out-of-pocket costs for 2026 Medicare Advantage (MA) plans. Insurers are also reducing broker commissions on 15% to 20% of plans, aiming to discourage enrollment in unprofitable offerings. According to data from Chapter, a Medicare advisory firm, these changes reflect a broader trend among insurers to prioritize profitability over growth.
Rising Costs and Benefit Cuts
Although the average monthly premium for Medicare Advantage plans is expected to decrease slightly from $16.40 to $14 in 2026, analysts at Evercore ISI note that initial data indicates higher pricing for major insurers such as UnitedHealth Group’s UnitedHealthcare, CVS Health’s Aetna, Elevance, and Humana. These increases are attributed to efforts by insurers to improve margins through benefit reductions, including higher premiums, deductibles, and out-of-pocket maximums.
Focus on HMO Plans
Insurers are increasingly prioritizing Health Maintenance Organization (HMO) plans for 2026, which typically feature more limited provider networks. While deductibles are rising on these plans, seniors may still find options with $0 premiums. However, plans that already carry premiums are likely to see increases. Analysts suggest that carriers are more cautious about adding premiums to $0 products, opting instead to cut benefits.
Plan Decommissioning and Broker Challenges
Seniors often rely on insurance brokers and agents to navigate their options during open enrollment. To boost enrollment in more profitable plans, insurers are adjusting commission rates, offering higher payments on some plans and none at all for others. This year, many insurers are eliminating broker commissions on less profitable plans.
In some regions, such as New York, insurers have cut commissions on more than 25% of plans, while in parts of Georgia, the figure exceeds 35%. This shift has created challenges for brokers, who may not have access to certain plans on their brokerage systems. Some brokers report that specific plans are being suppressed entirely, limiting seniors’ choices.
Open Enrollment Kicks Off
The 2026 Medicare open enrollment period begins on Wednesday, with seniors receiving notices from their insurers about changes to their current health plans. Brokers advise seniors to actively compare options this year, as doing so can save over $1,800 in out-of-pocket costs.
A potential government shutdown starting October 1 could add uncertainty to the process, although CMS has stated that critical services for Medicare and Medicaid will not be affected. Funding for contractors overseeing the enrollment process has already been allocated, ensuring continuity despite the shutdown.
Key Dates and Considerations
The Medicare open enrollment period runs from October 15 through December 7. Seniors are encouraged to review their options carefully, especially given the significant changes in the market. With so many adjustments to plans and benefits, it’s crucial to stay informed and seek guidance from trusted advisors.
As the landscape of Medicare Advantage continues to evolve, staying proactive and informed is essential for seniors navigating their healthcare coverage.
