Medicare Advantage Enrollment: A Shift Towards Specialized Plans
Medicare Advantage (MA) enrollment continues its upward trajectory, but a recent analysis of data released by the Centers for Medicare & Medicaid Services (CMS) reveals a significant shift in growth drivers. Whereas overall enrollment reached just over 35 million as of February 1, 2026 – a 3% increase from the previous year – the growth is increasingly concentrated in Special Needs Plans (SNPs).
The Rise of SNPs: Meeting Specialized Healthcare Needs
SNPs, designed for beneficiaries with specific health conditions or dual eligibility for Medicare and Medicaid, accounted for a remarkable 83% of the enrollment increase over the past year. More than 8 million people are now enrolled in SNPs, representing 23% of total MA enrollment. This growth reflects a deliberate strategy by insurers to cater to populations with complex healthcare needs and a permanent place for these plans within the Medicare program since 2018.
This trend suggests a growing demand for plans that offer tailored care and support services. SNPs often provide care coordination, disease management programs, and access to specialized providers, addressing the unique challenges faced by their target populations.
Individual Plan Growth Slows, While Group Plans See Mixed Results
In contrast to the robust growth of SNPs, enrollment in traditional individual Medicare Advantage plans increased at the slowest rate in decades. The increase was modest, rising by only 224,000 people. Employer- and union-sponsored group plans experienced a slight decline with a decrease of approximately 40,000 enrollees, though this was partially offset by growth in employer MA-only plans.
This divergence highlights a potential shift in the MA market. While individual plans remain popular, SNPs are rapidly gaining traction, potentially attracting beneficiaries who are seeking more specialized and coordinated care.
Insurance Company Performance: A Tale of Two Trends
The performance of major insurers varied significantly. Humana and Kaiser Permanente were the only large insurers to increase total Medicare Advantage enrollment, adding 1.2 million and 64,000 enrollees, respectively. UnitedHealth Group, the largest MA insurer, experienced a loss of over 530,000 enrollees, primarily due to declines in individual and group plans. CVS Health and Elevance Health also saw enrollment decreases.
These shifts in enrollment suggest that insurers are facing different levels of success in adapting to the changing dynamics of the MA market. Those who are effectively expanding their SNP offerings and catering to specialized populations appear to be faring better.
What Drives the SNP Surge?
Several factors contribute to the growing popularity of SNPs. The plans are designed to address the specific needs of vulnerable populations, offering targeted benefits and care coordination. CMS has been actively encouraging the growth of SNPs through policy changes and financial incentives. Insurers are responding by expanding their SNP offerings, recognizing the potential for growth in this segment.
The increasing number of beneficiaries eligible for both Medicare and Medicaid is also fueling the demand for SNPs. These dual-eligible individuals often have complex health needs and benefit from the coordinated care provided by SNPs.
Looking Ahead: Potential Future Trends
The trends observed in the latest enrollment data suggest several potential future developments in the Medicare Advantage market:
- Continued SNP Growth: SNPs are likely to continue to be the primary driver of MA enrollment growth in the coming years.
- Increased Competition: Insurers will likely intensify their focus on SNPs, leading to increased competition and innovation in this segment.
- Focus on Value-Based Care: SNPs are well-positioned to support value-based care models, which emphasize quality and outcomes over volume.
- Consolidation in the MA Market: The varying performance of insurers may lead to further consolidation in the MA market, as larger players acquire smaller ones.
Methods
This analysis uses data from the Centers for Medicare & Medicaid Services (CMS) Medicare Advantage Enrollment and Landscape files. The analysis aggregates enrollment data from the monthly enrollment by contract/plan/state/county files, which excludes county-plan combinations that have fewer than 11 enrollees, leading to somewhat lower Medicare Advantage enrollment counts than reported elsewhere. Cost plans, PACE plans, and HCPPs are excluded.
This function was supported in part by Arnold Ventures. KFF maintains full editorial control over all of its policy analysis, polling, and journalism activities.
Frequently Asked Questions
- What is Medicare Advantage? Medicare Advantage is a type of Medicare health plan offered by private companies approved by Medicare.
- What are Special Needs Plans (SNPs)? SNPs are a type of Medicare Advantage plan designed for people with specific health conditions or who qualify for both Medicare and Medicaid.
- Why are SNPs growing so quickly? SNPs are growing because they offer tailored care and support services to beneficiaries with complex healthcare needs.
- What does this mean for Medicare beneficiaries? Beneficiaries will likely have more choices, particularly in specialized plans, and potentially access to more coordinated and comprehensive care.
Explore further: Learn more about Medicare Advantage plans and uncover one that fits your needs by visiting the Medicare website.
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