Record Growth Rates for Medicare Advantage Plans (Lowest) & PDPs (Highest)
April 30, 2026
Now that the 2026 Medicare Open Enrollment season is finished, over half, 51.8%, of people eligible for Medicare have decided on Medicare Advantage plans (MA), up from 51.6% in April of 2025. Based on the Centers for Medicare & Medicaid Services (CMS) enrollment data* for April 1, 2026, MA, including MA with Prescription Drug benefits (MA-PD) membership, stood at 35,539,581, with a net gain of 838,421 members from April 1, 2025. This is up only 2.4%; the lowest year-over-year percentage change since 2009 and lowest membership gain since 2011. The top 10 companies, out of 301 insurers offering coverage in the MA market, covered 78.2% of MA enrollees in 2026. Over a third, 36%, of people eligible for Medicare selected a stand-alone Medicare Part D, prescription drug plan (PDP). Medicare PDPs covered 24,936,720 members as of April 1, 2026, a net increase of 1.8 million from the previous year, the highest growth rate since 2013. This brief assesses MA and PDP performance, market share, and market growth by state as of April 1, 2026.
Medicare Advantage (MA) Membership
Medicare Advantage (MA) market penetration remains strong; however, with 51.8% of the 69.6 million people eligible for Medicare enrolled in an MA plan, the growth rate has noticeably slowed. According to CMS’s MA enrollment reports, aggregated by Mark Farrah Associates (MFA) in Medicare Business Online™, total MA plan enrollment, as of April 1, 2026, increased only 2.4% from April 2025, down from 3.8% between April 2025 and April 2024, and 6.4% between April 2024 and April 2023. The MA growth rate has been trending down since it reached a high of 9.7% between March 2020 and March 2021, which may have been a result of the Covid pandemic. For the years prior to Covid, the growth rate was relatively steady around 7.5%. Six of the top ten companies, each with more than 400,000 members in this segment, realized year-over-year declines, with an overall net gain of 1.5%.
MA Leading Plan Performance
There are 301 insurers covering the MA marketplace in the United States; however, 78.2% of MA enrollees selected one of only 10 insurers. As of April 2026, UnitedHealth continues to dominate in this highly competitive segment. With over 9.2 million enrolled, UnitedHealth now insures 26% of the MA market. Humana ranks second with 19.8% market share and 7.1 million lives; it was one of the four top plans to report enrollment increases year-over-year. CVS maintains the third position, enrolling over 4.1 million. Elevance Health, with a 15.8% decline in MA enrollment, dropped to fifth place below Kaiser Foundation Group, which gained 2.1% additional members in the same period. Devoted Health and Scan Health joined the list of top MA organizations in 2026. Together the top three insurers cover 57.4% of the MA market, a slight increase of 0.2% from last year.
The table below indicates the MA organizations with the largest membership gains from April 2025 to April 2026. Humana had the largest increase in membership, adding over 1.3 million members year-over-year, for a net gain of 23%. Devoted Health Group experienced the second largest gain with more than 266,000 new members. Scan Health Group joined the top MA organizations in 2026 with the addition of nearly 140,000 new members.
Two trends that also impacted MA plans’ growth in 2026 were in MA plans without prescription drug coverage and Special Needs Plans (SNPs). The growth in MA plans with no prescription drug (RX) coverage is related to a trend by some insurance carriers to split employer-based MA-PD plans into medical and stand-alone prescription drug plans (PDPs) in 2026; this includes Humana, UnitedHealth and CVS. More on this trend is noted in the PDP section below. In total, SNPs gained nearly 869,000 members between April 2025 and April 2026. Except for Blue Cross Blue Shield of Michigan (BCBS of MI) and Health Care Service Corporation (HCSC), the other top plans had enrollment growth in their SNPs, with Humana and UnitedHealth gaining the most at approximately 258,000 and 130,000, respectively.
MA Individual and Group Enrollment
As of April 2026, 84% of membership was from individual MA policies with approximately 29.9 million enrolled lives. UnitedHealth, with its AARP branded products, consistently leads in the individual sector with nearly 7.6 million members enrolled in individual MA plans. In addition to direct purchase policies, nearly 5.7 million MA members originated through an employer group health plan or retirement health benefit. Group membership declined by approximately 27,000 members as compared to the same period a year ago. UnitedHealth’s MA group enrollment declined by approximately 220,000, with the company’s total employer-group membership still over 1.6 million. Humana had the largest gain from employer group MA plans with over 149,000 additional members.
MA Enrollment Growth by State
As of April 1, 2026, MA enrollment increased in forty-three states, the District of Columbia, and most U.S. territories. Four states, Idaho, New Hampshire, Minnesota and Vermont, had declines of more than 10,000 MA members year-over-year. Overall, a net membership gain of approximately 832,000 was seen nationally. Texas, New York, California, Florida, and North Carolina experienced significant enrollment gains, each with increases of 50,000 members or more. Texas experienced the most sizeable year-over-year increase, gaining approximately 95,000 members.
Source: Mark Farrah Associates' analysis of CMS data available in Medicare Business Online.
Stand-alone Prescription Drug Plan (PDP) Enrollment
Stand-alone prescription drug plans (PDPs), also referred to as Medicare Part D stand-alone plans, enrolled approximately 24.9 million members as of April 1, 2026, reflecting an increase of roughly 1.8 million enrollees, 7.8%, from April 1, 2025. This is the highest increase in PDP members and growth rate since 2013. PDP plans provide prescription drug coverage for over 36% of the 69.6 million people eligible for Medicare. Enrollment in products sold to individuals was 18.7 million in April 2026, an increase of 601,700, year-over-year. Approximately 6.3 million Medicare beneficiaries were enrolled in employer group PDPs as of April 1, 2026. It is important to note that this assessment is reporting on stand-alone PDP members only, and MA with prescription drug benefits (MA-PD) members are included in the MA portion of this report.
PDP Leading Plan Performance
There are currently 37 organizations, down from 38 in 2025, competing in Medicare stand-alone PDPs, as of April 2026. Five companies have more than 2 million members and insure 91.3% of the PDP market. As indicated in the table below, there were significant enrollment swings between April 2025 and April 2026 among leading PDP organizations.
- For 2026, Centene continued its expansion initiatives in MA and PDP markets; and it continues to cover the largest number of people enrolled in PDPs, having increased PDP membership by 11.8% between April 2025 and April 2026.
- With an increase of over 1.4 million PDP members in 2026, Humana increased its market share to 14.9% as of April 1, 2026, matching UnitedHealth’s share. The Humana Value Rx Plan, originally co-branded as the Humana Walmart Value Rx Plan until 2025, had a net gain in the Individual PDP market of almost 520,000 new members. Humana also gained over 340,000 net new PDP members from employer group accounts, due to its decision to split retiree medical and prescription drug plans for 2026. Humana is the plan administrator for both North Carolina’s and Alabama’s state employee retiree plans.
- CVS, which also split retiree medical and prescription drug plans for 2026, experienced significant gains from plans purchased through employer groups; however, its loss of more than 617,000 from direct purchase plans resulted in an overall net loss of PDP members.
PDP Individual and Group Enrollment
As of April 1, 2026, 75% of membership was from individual PDP policies with approximately 18.7 million enrolled lives. Enrollment in group PDP plans grew significantly between 2025 and 2026 primarily due to the decision to split retiree medical and prescription drug plans, particularly for state retiree groups. Group PDP membership increased by approximately 1.2 million members as compared to the same period a year ago. UnitedHealth gained over 441,000 PDP group members, more than any other plan. However, this was offset by a decline of 241,000 direct purchase individual policies. The company’s total employer-group PDP membership is over 1.3 million, significantly behind CVS, which as of April 1, 2026, had 2 million PDP members through employers. Centene does not offer PDP policies through employers, based on CMS data.
PDP Market Penetration by State
As of April 1, 2026, stand-alone PDP enrollment increased in all 50 states within the U.S., including the District of Columbia. North Carolina had the largest year-over-year aggregate increase with over 189,000 more enrollees in this segment. Michigan, California and Alabama also had noteworthy increases, each state adding more than 100,000 new PDP enrollees, respectively. North Carolina’s state employee retiree plan, along with many other employer group welfare plans (EGHPs), split their retiree medical and prescription drug plans for 2026.
Source: Mark Farrah Associates' analysis of CMS data available in Medicare Business Online.
About this Data
This brief is based on an analysis of enrollment data for Medicare Advantage (MA) and Prescription Drug Plans (PDPs) released by the Centers for Medicare & Medicaid Services (CMS). Mark Farrah Associates’ Medicare Business Online™ simplifies the tracking of monthly MA and PDP enrollment by competitor. Enrollment data is updated monthly as CMS releases new data.
* It is important to note that MA enrollment counts by company or geography for the same reporting period may be slightly different, depending on the CMS enrollment source. CMS county-level reports, used in the above analysis, do not output enrollment for plans with 10 or fewer members per county.
Many companies conduct their post-OEP competitive assessments by using tools such as Mark Farrah Associates’ (MFA) Medicare Business Online™, Medicare Benefits Analyzer™, and Health Coverage Portal™. Health insurers continue to invest in MA and PDP growth opportunities for increased enrollment, revenue, and profits as the number of people entering retirement increases each year. MFA will continue to monitor plan performance in this highly competitive Medicare segment.
About Mark Farrah Associates (MFA)
Mark Farrah Associates (MFA) is a leading data aggregator and publisher providing health plan market data and analysis tools for the healthcare industry. Our product portfolio includes Health Coverage Portal™, County Health Coverage™, Medicare Business Online™, Medicare Benefits Analyzer™, 5500 Employer Health PLUS, and Health Plans USA™. For more information about these products, refer to the product pages and brochures available under the Our Products section of the website (www.markfarrah.com), or call 724-338-4100.
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