This Florida Medicare Advantage 2026 market intelligence report covers payer rankings, Stars enrollment, AEP benefit trends, and D‑SNP/C‑SNP growth across the state.
Three moves that actually matter right now
Defend and grow Stars before 2027
Close HEDIS gaps (diabetes control, blood pressure, post‑discharge reconciliation) and fix the CAHPS basics: appointment access, scheduling ease. Every 4+ Star plan carries real rebate value.
Move on displaced members first
Sentara, Elevance, and CVS all trimmed service areas this cycle. Target the affected counties directly. This window closes fast.
Build a real D‑SNP/C‑SNP strategy
Chronic‑condition plans grew across the board this AEP. A credible high‑acuity strategy is the difference between share gain and long‑term erosion.
Who’s actually winning Florida
The 8 largest non‑SNP parent organizations, ranked by post‑AEP membership. Humana and UnitedHealthcare lead by scale; Devoted and Health First are gaining fastest.
HWAI Score blends product, network, marketing, and brand strength into one number (0–100). AEP movement is Dec ’25 to Feb ’26, non‑SNP individual & group MA only. TPV (True Plan Value) estimates what a plan is actually worth to the member enrolling in it, netting cost‑sharing and supplemental‑benefit savings against the premium.
Why this matters
A competitor’s move is old news by the time most teams see it
- Competitive reads live, not stale
- Updated within 12 hours of CMS
- Tracks plan design and enrollment shifts
- See moves the week they happen
Stars is buying share
Low‑rated and unrated plans keep shrinking while the highest tier keeps absorbing their members.
CMS cut CAHPS’ weighting from 4x to 2x for 2026, but it still swings retention.
The cost story and the benefit story are moving in opposite directions
Across 605 plans, deductibles and MOOP climbed while premiums gradually declined. Dental/OTC benefits got trimmed even as copay structures got friendlier: this is the pattern worth watching before 2027 filings open.
Cost provisions
Benefit provisions
Why this matters
The pattern is only obvious after someone reads all 605 PBP files
- All 605 plan files, parsed automatically
- Decision‑ready within 48 hours
- Catches deductible and dental shifts
- Ready before next year’s bid
D‑SNP vs. C‑SNP: opposite momentum
Dual‑eligible plans are contracting among incumbents while chronic‑condition plans are growing for everyone tracked, including three brand‑new entrants.
D‑SNP: dual‑eligible
Enrollment is shrinking among the biggest incumbents while smaller regional plans pick up share.
C‑SNP: chronic condition
Every tracked C‑SNP payer grew this AEP, including three plans starting from zero.
Why this matters
Your fastest‑growing members are the ones you know least about
- Benchmarks your network, one to many
- Compares by product type directly
- Shows where SNP challengers gain strength
- Sizes network adequacy with real data
Where the map actually moves
Miami‑Dade, Broward, and Palm Beach still decide statewide scale, but the real openings are where carriers just left.
- Sentara exited MA, MAPD HMO, and C‑SNP in Florida, Virginia, and North Carolina for 2026, a market withdrawal, not a Stars loss. Its members are now in play statewide.
- Elevance and CVS also trimmed service areas this cycle, each termination concentrated in specific counties worth targeting directly.
- South Florida stays the battleground for head‑to‑head share, but lower‑penetration counties carry the least competitive density for new entry.
- Provider‑affiliated regional plans (BayCare, Health First) keep growing precisely where tighter provider alignment exists: a signal for where partnership beats scale.
Why this matters
The exit filing is public. Knowing who it frees up isn’t.
- Flags county exits as they happen
- First movers capture displaced members
- Tracks service‑area changes county by county
- Timing favors you, not brokers
Florida Medicare Advantage 2026, the questions people are asking
Which Medicare Advantage payer had the fastest AEP growth in Florida for 2026?
Devoted Health posted the fastest 2026 AEP growth among Florida’s top 8 non‑SNP payers, up 36.8%, according to HealthWorksAI’s Market Snapshot data.
How much did 4.5‑Star plan enrollment grow in Florida for 2026?
4.5‑Star Medicare Advantage enrollment in Florida grew from 100K members in 2024 to 165K in 2025 and 284K in 2026, nearly tripling in two years.
Which Medicare Advantage payers exited or trimmed their Florida service areas for 2026?
Sentara exited Medicare Advantage, MAPD HMO, and C‑SNP entirely in Florida for 2026, while Elevance and CVS both trimmed service areas in specific counties.
How many Florida Medicare Advantage plans changed drug deductibles or dental coverage for 2026?
Across 605 Florida MA plans analyzed, 302 raised drug deductibles and 222 cut dental coverage for 2026, while copay structures broadly got friendlier.
Is D‑SNP or C‑SNP enrollment growing faster in Florida?
C‑SNP (chronic‑condition) plans grew across every tracked payer in the 2026 AEP, including three brand‑new entrants, while D‑SNP (dual‑eligible) enrollment contracted among the largest incumbents.
Florida Medicare Advantage 2026 sources & methodology
This Florida Medicare Advantage 2026 report is built from CMS Medicare Advantage enrollment files, Plan Benefit Package (PBP) data, and Star Ratings releases, cross‑checked against HealthWorksAI’s Market Snapshot. For the underlying federal data set, see the CMS Medicare Advantage plan directory.
Want a deeper dive, county by county?
We’ll run this same read for the specific counties and carriers you’re actually competing against, ahead of 2027 filings.
Where market, product, and network insights intersect
One data layer behind every market, product, and network read in this report.
