Where the Battles Are Moving: 2026 Medicare Advantage SAE/SAR Insights
Our latest SAE/SAR analysis shows how payers are recalibrating service areas to balance growth and profitability.
- November 12, 2025
- 7 min read
The wait is over. After weeks of anticipation and a delayed data release, CMS has finally dropped the 2026 Medicare Advantage landscape data—and payers have come out in full force. While the industry is already strategizing for 2027, the real story lies in understanding what just happened.
Which payers doubled down? Which retreated? Where are the growth opportunities, and where did consolidation hit hardest?
This analysis cuts through the noise to reveal the patterns that matter: 889 bold new launches, 765 strategic exits, and a market realignment affecting over 3.13 million beneficiaries. Whether you’re planning your 2027 bids or evaluating competitive positioning, these insights show you exactly where payers expanded, where they contracted, and what it means for your strategy.
Lives Impacted
New Launches
Lives Impacted: Landscape Overview
The 2026 Medicare Advantage landscape reflects significant transformation with 889 new launches, 4,231 renewals, 1,508 SAE plans, 1,496 SAR plans, and 765 terminations across different counties. These shifts impact over 3.13 million beneficiaries, with 372K lives affected by payer exits, underscoring the ongoing transformation and competitive realignment within the Medicare Advantage market.
New Launches
Renewals
SAE Plans
SAR Plans
Terminations
Lives by Payer Exits
Plan Type Analysis
Special Needs Plans (SNPs) Comparison Matrix
| Metric | Non-SNP | D-SNP | C-SNP | I-SNP |
|---|---|---|---|---|
| Counties Covered | 3,134 | 3,030 | 2,421 | 2,121 |
| New Entries | 655 | 583 | 431 | 216 |
| County Exits | 1,054 | 603 | 139 | 9 |
| Lives Impacted (Total) | 2.8M | 269.6K | 53.9K | 1.9K |
| Payer Exit Impact | 335K | 27.9K | 9.6K | 48 |
SAE by Special Needs Plans Type
Numbers are expressed in percentages(%)
SAE by Plan Type
Numbers are expressed in percentages(%)
HMO & PPO Market Dynamics
County-Level Plan Activity
The 2026 Medicare Advantage landscape reflects significant plan movement across segments at the county level, with HMOs showing the most activity and robust SAE/SAR presence across all plan types.
| Plan Type | Terminations | New Plans | SAE Plans | SAR Plans |
|---|---|---|---|---|
| HMO | 405 | 583 | 967 | 721 |
| Local PPO | 341 | 305 | 529 | 735 |
| C-SNP | 36 | 217 | 257 | 71 |
| D-SNP | 94 | 212 | 344 | 194 |
| I-SNP | 18 | 9 | 60 | 35 |
| Non-SNP | 617 | 451 | 847 | 1196 |
Key Insights
- HMOs lead with the highest activity—583 new plans and 405 terminations—supported by 967 SAE and 721 SAR plans, maintaining their market prominence.
- C-SNPs show notable expansion with 217 new plans and minimal terminations (36), backed by 257 SAE plans, reflecting increased focus on chronic condition management.
- Non-SNP plans experienced significant restructuring with 617 terminations but 451 new launches, supported by 847 SAE and 1,196 SAR plans.
Leading Payers Analysis
United, CVS, and Elevance are the top three in lives impacted, with UnitedHealth Group maintaining the widest county presence at 2,787 counties.
Comprehensive Payer Comparison: Lives Impacted & Market Activity
United
Lives Impacted
Entries
22
Exits
131
New Plans
40
Terminations
112
SAE
101
SAR
215
CVS
Lives Impacted
Entries
17
Exits
115
New Plans
122
Terminations
106
SAE
208
SAR
309
Humana
Lives Impacted
Entries
5
Exits
199
New Plans
194
Terminations
39
SAE
257
SAR
124
Elevance
Lives Impacted
Entries
108
Exits
44
New Plans
42
Terminations
63
SAE
73
SAR
87
Centene
Lives Impacted
Entries
53
Exits
19
New Plans
32
Terminations
46
SAE
80
SAR
124
HCSC
Lives Impacted
Entries
0
Exits
104
New Plans
40
Terminations
104
SAE
46
SAR
168
Highmark
Lives Impacted
Entries
0
Exits
0
New Plans
0
Terminations
19
SAE
22
SAR
32
Devoted
Lives Impacted
Entries
394
Exits
0
New Plans
201
Terminations
7
SAE
306
SAR
9
County Distribution
Competition remains fierce in these top counties, with 130 to 198 new plan launches underscoring dense competition and constant reshuffling.
Counties with the Most Payers
Washington
Lives Impacted 36.3K
New Plans 195
SAE / SAR 274 / 240
Franklin
Lives Impacted 29.4K
New Plans 153
SAE / SAR 211 / 187
Montgomery
Lives Impacted 48.4K
New Plans 130
SAE / SAR 171 / 173
Jefferson
Lives Impacted 23.8K
New Plans 198
SAE / SAR 258 / 226
Jackson
Lives Impacted 7.1K
New Plans 153
SAE / SAR 204 / 160
Counties by Highest Lives Impacted
Monroe
Lives Impacted 95.7K
New Plans 114
SAE / SAR 147 / 150
Erie
Lives Impacted 65.3K
New Plans 34
SAE / SAR 45 / 39
Hennepin
Lives Impacted 37.9K
New Plans 2
SAE / SAR 2 / 23
Top Populous Counties
Maricopa
Lives Impacted 27.3K
New Plans 12
SAE / SAR 17 / 11
Los Angeles
Lives Impacted 19.4K
New Plans 20
SAE / SAR 25 / 10
Orange
Lives Impacted 18.9K
New Plans 79
SAE / SAR 101 / 69
Cook
Lives Impacted 24.1K
New Plans 17
SAE / SAR 30 / 38
Harris
Lives Impacted 21.9K
New Plans 27
SAE / SAR 35 / 36
San Diego
Lives Impacted 10.6K
New Plans 16
SAE / SAR 20 / 11
Key State Market Dynamics
New York
Total Lives Impacted
Counties 62
County Entries 40
County Exits 27
SAR Plans 89
Top Payers by Impact:
Lifetime Healthcare 107K
UnitedHealth Group 63K
Minnesota
Total Lives Impacted
Counties 87
County Entries 0
County Exits 72
SAR Plans 60
Top Payers by Impact:
UCare Minnesota 156K
UnitedHealth Group 16K
California
Total Lives Impacted
Counties 56
County Entries 27
County Exits 33
SAR Plans 76
Top Payers by Impact:
UnitedHealth Group 62.8K
CVS Health 39K
Pennsylvania
Total Lives Impacted
Counties 67
County Entries 42
County Exits 0
SAR Plans 69
Top Payers by Impact:
Highmark Health 76K
Independence Health Group 40K
Indiana
Total Lives Impacted
Counties 92
County Entries 52
County Exits 46
SAR Plans 62
Top Payers by Impact:
UnitedHealth Group 56K
Elevance Health 51.6K
States Leading Expansion
The largest MA footprints are seen in these states where payers maintain expansive local networks and pursue aggressive rural and metro reach.
Texas
Counties
New Plans 77
SAE Plans 125
Lives Impacted 76.2K
Georgia
Counties
New Plans 28
SAE Plans 61
Lives Impacted 121K
Virginia
Counties
New Plans 24
SAE Plans 32
Lives Impacted 84.5K
Kentucky
Counties
New Plans 12
SAE Plans 31
Lives Impacted 12.3K
Disclaimer:
This analysis presents insights based on individual MA and MAPD plans for 2026. Data points are shown at the CPID level to account for overlapping crosswalk descriptions. As a result, figures at the Bid ID level may show minor variations. These differences are expected and do not impact the overall accuracy, validity, or interpretation of the insights presented.
Why HealthworksAI
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Benefits that actually convert
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20-min readout: top counties, rival moves, benefit levers, commission signals.
Insights from CMS Landscape (<36h turnaround)
