Winners and Losers of MA market in 2026

Medicare Advantage Winners Losers 2026 — Enrollment & Competitive Shifts

Enrollment levels, market share, growth rates, and plan portfolio strategies together reveal a reshaping competitive hierarchy among major MA insurers. The Medicare Advantage winners losers 2026 analysis shows UnitedHealth Group remaining the largest payer with 7.64M members, though its share slipped to 25.8% as it lost ~725K members — even while maintaining a large portfolio of 846 plans after trimming offerings from its 2025 peak. In contrast, Humana delivered the strongest rebound, adding ~1.03M members (20% YoY growth) and expanding its share to 21.1%, while growing its footprint to 887 plans — the largest portfolio among peers.

CVS Health remained relatively stable at ~2.7M members (~9% share) but reduced its plan offerings from 742 in 2024 to 642 in 2026, signaling a more selective strategy. Elevance Health experienced the steepest contraction, losing ~318K members and declining to 5.1% share, while maintaining a relatively steady plan portfolio.

At the same time, fast-growing challengers are rapidly scaling both membership and product presence. Devoted Health expanded from 60 plans in 2022 to 427 in 2026 and more than doubled membership to ~456K (119.7% growth), while SCAN Group surpassed 426K members (44.5% growth) with a stable but targeted plan lineup. Together, these shifts illustrate a market where growth is increasingly captured by focused, high-growth disruptors and selective incumbents, while several established players face slowing momentum or portfolio rationalization.

Medicare Advantage Winners Losers 2026: Plan Types — HMO & PPO Drive Humana's Growth

Humana's growth was driven primarily by Local PPO and Local HMO plans, each reaching about 3 million members in 2026. Local PPO plans recorded the fastest growth, adding 562.7K members (27% YoY) and expanding plan offerings from 360 to 435, increasing their share to 48.8%. Local HMO plans also grew, adding ~490K members with plan count rising from 391 to 412, though their share declined slightly to 49.8% as PPOs expanded faster. Together, HMO and PPO plans now account for nearly the entire portfolio with roughly 50% share each. Meanwhile, PFFS and Regional PPO segments declined, and MMP plans phased out, reflecting a continued shift toward more flexible PPO structures. Humana's enrollment is heavily concentrated in Florida, leading with ~684.7K Local HMO and ~426.9K Local PPO members. Smaller segments include PFFS in Georgia (~6.8K) and Regional PPO in Texas (~10.9K).

Geographic Concentration — Humana's State-Level Growth

Humana's enrollment changes were largely driven by growth in a few key states while declines occurred in smaller markets. Florida remained the largest market with ~1.12M members, adding ~114K members, followed by Texas with ~79K net gains and Georgia and Illinois contributing ~47.6K and ~54.6K AEP gain, respectively. Missouri recorded the fastest growth rate with a 74% YoY increase (~61.4K members), while North Carolina saw moderate expansion. In contrast, declines were concentrated in Minnesota losing ~8.0K members, while Puerto Rico, South Dakota and North Dakota saw complete enrollment exits. Humana holds the leading enrollment position across 14 states, with its strongest presence in Florida (~1.29M members) and North Carolina (~712.5K). Other major markets include Illinois (~502.5K) and Georgia (~419.0K). Overall, Humana's dominance is concentrated primarily across the Southeast and parts of the Midwest, where it leads enrollment in states such as Alabama, Kentucky, Tennessee, and Louisiana.

Cost Strategy — The $0 Premium Shift

Humana's portfolio has shifted decisively toward $0 premium plans, which grew from 376 plans in 2022 to 683 in 2026 and now account for 77% of all plan offerings. Enrollment in these plans also rose sharply from 2.84M to 5.49M, showing that growth has been concentrated in zero-premium products. In contrast, higher-premium segments steadily contracted, with both plan counts and enrollment declining across nearly all bands above $25, indicating a clear strategy toward lower-cost, more competitive offerings.

County-Level Footprint — Optimization Over Broad Expansion

Humana maintained a broad geographic presence in 2026, operating across 2,657 counties while exiting 199 counties and entering 5 new ones. The portfolio saw notable restructuring, with 194 new plans launched compared to 39 terminated plans, alongside 257 service area expansion (SAE) plans and 124 service area reduction (SAR) plans at county level. These changes impacted approximately 114.2K members, including 22.5K lives affected by payer exits, reflecting ongoing adjustments to optimize market coverage and plan offerings.