The Centers for Medicare and Medicaid Services (CMS) has released the Contract Year (CY) 2026 Medicare Advantage (MA) and Part D landscape file. This resource offers a comprehensive look at the MA plan and Medicare Part D prescription drug program (PDP) offerings, including plan choices, premiums, and benefits for the upcoming year.
Notably, MA enrollment is projected to decline to 34 million in 2026, down from 34.9 million in 2025 for the first time in over a decade. However, CMS anticipates that enrollment in MA plans will exceed the plans’ own projections, based on historical patterns and prevailing trends. Although the total number of available MA plans is projected to decrease slightly from 5,633 in 2025 to approximately 5,600, special needs plans continue to expand with a 33% increase in 2026.
Additional highlights include:
- Special Needs Plans (SNPs) are continuing to grow, with 1,797 SNPs available in 2026.
- C-SNPs showed the highest growth, increasing 42% to 556 plans.
- Dual Eligible SNPs (D-SNP) remain the largest segment, with 1,085 plans—a 15% increase from the previous year.
- Institutional SNP (I-SNPs) offerings declined by 5%, primarily due to large insurer-based plans exiting the MA marketplace. However, provider-led plans are experiencing growth.
- Over 99% of Medicare beneficiaries will have access to at least one MA plan, and 97% of beneficiaries will have access to 10 or more choices.
- Despite structural changes to Part D risk adjustment and benefit caps, actual premiums for both standalone Part D prescription plans and MA plans that included drug coverage decreased in 2026—contrary to earlier projections.
- The average premium for standalone Part D plans is expected to decrease from $38.31 in 2025 to $34.50.
- For MA-PD plans, the average Part D premium is projected to drop from $13.32 in 2025 to $11.50 next year.
Open enrollment starts October 15 and runs through December 7.
New CMS Rules Enhance MA Provider Directories, Introduce Temporary SEP
In a
recent update to the
previously finalized CY 2026 Medicare Advantage and Part D rule, CMS finalized proposals related to provider directories. This update ensures that users of Medicare Plan Finder can more easily access and compare Medicare Advantage plans’ provider directories when choosing a plan.
CMS finalized requirements for Medicare Advantage Organizations (MAOs) to:
- Share provider directory information with CMS to be published on a CMS/HHS website;
- Notify CMS of any updates to the provider directory within 30 days of any changes; and
- Attest at least annually that the data is accurate.
All MAOs must submit their directory information to CMS by January 1, 2026.
MA plans are ultimately responsible for the accuracy of their provider directories—even if they delegate directory management to another entity.
In addition, CMS will also introduce enhancements to the Medicare Plan Finder (MFP) to improve plan selection, including: comparison tools based on a beneficiary’s current providers; detailed information on supplemental benefits; enhanced security features, expanded filtering options; and an AI-powered prescription cost estimator for a beneficiary’s local pharmacies.
To address potential inaccuracies in the newly integrated provider directory date on MFP, CMS will offer a Special Enrollment Period (SEP) in 2026. This SEP allows beneficiaries who enroll in an MA plan via MFP and realize, within three months, that their preferred provider is not in-network to change their plan. This SEP requires CMS approval.
Eligible beneficiaries are those who previously made a 2026 MA plan election through MFP during any election period between January 1 and December 1, 2026. The SEP is available for three months after the effective date of the MA plan election via MPF. This SEP is temporary, for the first year of the MFP MA provider directory. Eligible beneficiaries may switch to another MA (MA-Only or MA-PD) plan; disenroll and return to Medicare fee-for-service (FFS); or enroll in a PDP return to Medicare FFS with Part D coverage. All elections made under this SEP are prospective, taking effect on the first day of the month following the application date.
Please reach out to AHCA’s Population Health Policy Analyst Rohini Achal and Nisha Hammel, VP, Reimbursement Policy & Population Health with any questions.