A First Look at Medicare Advantage in 2026
ATI Advisory recently hosted a two-part webinar series analyzing the 2026 Medicare Advantage (MA) and Part D landscape. The discussions focused on overall Medicare Advantage and Part D market dynamics and a deep dive into Special Needs Plans (SNPs). Together, the sessions revealed a market that appears stable on the surface but is undergoing meaningful shifts beneath.
A Stable Market with Shifting Composition
For 2026, overall MA availability holds steady, and affordability remains strong—96% of beneficiaries will continue to have access to a $0 premium plan. But the mix of plans is changing:
- General enrollment MA plans (available to all Medicare beneficiaries) are declining by nearly 10%, indicating market consolidation as plans learn what products are most meaningful to beneficiaries.
- MA-only products are down 13%.
- SNPs are expanding rapidly, now representing about one-third of all MA plans, up from just over a quarter in 2025. This reflects the changing demographic in our country and an increase in complex care needs.
- Standalone Part D plans (PDPs) are contracting sharply, with a 23% reduction in enhanced alternative PDPs, reflecting the Inflation Reduction Act’s (IRA) redesign of the prescription drug benefit.
Carrier Dynamics: National Contraction, Regional Expansion
Strategies are diverging between large national carriers and regional players:
- National carriers (e.g., UnitedHealthcare, Humana, CVS/Aetna) are pulling back in some markets, collectively exiting 41 counties and cutting general enrollment offerings by 11%. This could indicate market entry opportunities for new players and new care models.
- Regional carriers are expanding, adding coverage in 22 counties and increasing plan offerings across both general enrollment and SNP products.
- Provider- and health system–led plans are emerging as important players, leveraging local networks and care models.
- This marks a new phase in the MA market: growth is less about geographic saturation and more about focusing on populations and markets where plans can succeed clinically and financially.
The Rise of Special Needs Plans
SNPs are the growth story of 2026, and each type is evolving differently. Chronic Condition SNPs (C-SNPs) are the fastest-growing category, up 42% year-over-year. Growth is concentrated in cardiovascular disease, heart failure, and diabetes products, largely driven by a few carriers. C-SNPs are attractive as vehicles for targeted benefit design, especially as the VBID demonstration sunsets in 2025 and Medicare Advantage plans will be required to target certain supplemental benefits based on chronic conditions.
We see D-SNP expansion through Exclusively Aligned Enrollment D-SNPs (EAED-SNPs), particularly in states transitioning from Medicare-Medicaid Plan (MMP) demonstrations. However, the loss of MMP integration tools like passive enrollment and state shared savings may reduce incentives for states to prioritize Medicare-Medicaid integration.
Institutional SNPs (I-SNPs) are declining overall but showing growth in provider-led models that leverage close facility-provider relationships. With the growing 85+ population, I-SNPs and their community equivalents may play a larger role in supporting long-term care needs.
Benefit Design: What to Expect
The release of benefit files will provide more clarity, but ATI experts highlighted several expectations:
- Core SNP benefits are likely to be preserved, even as broader MA cost pressures mount.
- Flex benefits and grocery/food card offerings may be reduced, particularly without VBID authority. But these popular benefits are unlikely to go away.
- Table-stakes benefits such as dental and vision could shift, with a stronger focus on network access and benefit generosity.
- Beneficiaries will now see Medicaid benefits displayed in Plan Finder, influencing how dual eligible consumers evaluate D-SNPs compared to other Medicare Advantage product types.
Implications for Plans and Beneficiaries
The 2026 landscape signals both opportunity and challenge. For health plans, success will increasingly depend on focusing resources where they have a competitive edge—whether through local provider relationships, targeted care models, or specialized products.
For states, advancing Medicare-Medicaid integration will require intentional effort, especially amid competing budgetary priorities.
For beneficiaries, shopping will be more important than ever. With fewer general enrollment plans, narrower networks (more HMOs, fewer PPOs), and changing supplemental benefits, enrollees must pay close attention to how plans align with their care and financial needs.
Looking Ahead
The Medicare Advantage market is in transition. While total plan availability remains stable, the shift toward SNPs, the retrenchment of large carriers, and the contraction of Part D choices all point to a more tailored market ahead.
Policymakers, payers, and providers face the challenge of designing products and partnerships that meet the needs of complex populations while navigating new constraints. ATI will continue to monitor the release of supplemental benefit files and enrollment data to provide further insights in the months ahead.