Medicare Advantage Enrollment Trends and Implications for Federal Spending

Last updated Jun 5, 2026

TL/DR –

The enrollment in Medicare Advantage, a private plan alternative to traditional Medicare, has been increasing steadily with over half of eligible beneficiaries enrolled in it since 2023. The growth has implications for federal spending, as Medicare payments to private plans are higher than the spending for similar beneficiaries in traditional Medicare. As of 2026, payments are 14% more per person, translating to an additional $76 billion in federal spending for the year.

Medicare Advantage Enrollment Trends and Federal Spending Impact

Over the past two decades, enrollment in Medicare Advantage, the private alternative to traditional Medicare, has seen a steady rise. The increasing enrollment has significant implications for federal spending. In 2026, Medicare payments to these private plans were 14% higher per person than traditional Medicare. This resulted in an additional $76 billion in federal spending.

Policymakers are focusing on Medicare’s payments to private plans, given this trend. Changes to these payments could affect beneficiaries’ choice among plans and their access to supplemental benefits, like dental, vision, and hearing coverage. This brief offers current information about Medicare Advantage enrollment, plan types, and firms.

2026 Highlights

55% of eligible Medicare beneficiaries enrolled in Medicare Advantage in 2026.
23% of enrollees were in a special needs plan (SNP), showing a steady rise in recent years.
Medicare Advantage enrollment is highly concentrated, with UnitedHealth Group leading the market. UnitedHealth Group and Humana accounted for nearly half (46%) of all Medicare Advantage enrollees nationwide.

Concentration of Medicare Advantage Enrollees

Despite the range of options available, Medicare Advantage enrollment is highly concentrated among a small number of parent organizations. UnitedHealth Group Inc. accounts for 26% of all Medicare Advantage enrollment in 2026, while Humana Inc. accounts for 20%. These two organizations account for nearly half (46%) of all Medicare Advantage enrollees nationwide.

Enrollment in Special Needs Plans (SNPs)

Nearly 8.2 million Medicare beneficiaries are enrolled in SNPs. These plans restrict enrollment to beneficiaries with significant or specialized care needs, or those eligible for both Medicare and Medicaid. SNP enrollment represents a growing share of Medicare Advantage enrollment, accounting for 23% of enrollees in 2026.

Group Plan Enrollees

About 5.7 million Medicare Advantage enrollees, or 16%, are in a group plan offered to retirees by an employer or union. This is the lowest share since 2010, but the number of enrollees has increased from 1.8 million in 2010 to 5.7 million in 2026.

The methods used for this analysis include data from the Centers for Medicare & Medicaid Services (CMS) Medicare Advantage Enrollment, Benefit and Landscape files, and the CMS Chronic Conditions Data Warehouse Master Beneficiary Summary File (MBSF).

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