Medicare Advantage insurance companies anticipate another year of enrollment declines, the Centers for Medicare and Medicaid Services announced Monday.
Insurers project Medicare Advantage membership will fall from 36.3 million this year to 34 million in 2027, CMS said in a news release. Companies made a similar prediction for the 2026 plan year that failed to come to fruition. CMS wrote that it expects Medicare Advantage enrollment for 2027 to again be higher than insurer estimates.
If enrollment falls, 2027 would represent the first time since at least 2007 that Medicare Advantage sign-ups decreased, according to KFF.
The annual enrollment period runs from Oct. 15 to Dec. 7.
Medicare Advantage insurers also predict that private plans will lose ground to fee-for-service Medicare in 2027. Medicare Advantage enrollment made up the majority of the market starting in 2023, but will cover 47.4% of beneficiaries in 2026, down from 58.8% this year, according to industry estimates reported to CMS.
“CMS is fighting to keep high-quality care options affordable and accessible for the millions of beneficiaries who rely on Medicare Advantage and Part D prescription drug plans,” said CMS Administrator Dr. Mehmet Oz.
The total number of Medicare Advantage policies available is essentially flat, falling from 5,553 in 2026 to approximately 5,532 in 2027. More than 99% of eligible enrollees will have access to at least one Medicare Advantage policy, and 97% will be able to choose from at least 10, CMS said. The average Medicare Advantage premium, which includes general enrollment and special needs plan policies, is expected to fall from $14.37 to $12, according to CMS.
Medicare Advantage insurance companies are prioritizing profit margins over membership expansion for 2027 after reckoning with high medical costs, a challenging coding and Part D prescription drug benefit update, smaller quality bonuses and lower federal payments for the past three years.
Humana will exit markets representing 600,000 members. Centene will shut down plans enrolling more than 1 in 3 of its members. CVS Health subsidiary Aetna will not pay marketers to promote several of its policies. Other companies, such as Providence Health Plan, will exit the program entirely.