Medicare Advantage growth driven by Special Needs Plans

Special Needs Plans (SNPs) have become the primary driver of Medicare Advantage enrollment growth. According to a KFF analysis, SNPs accounted for 85 percent of net Medicare Advantage enrollment growth between 2025 and 2026, a significant increase from 48 percent the previous year. Total SNP enrollment reached approximately 8.2 million people in 2026, representing 23 percent of all Medicare Advantage enrollees.

This shift follows a trend where major insurers are pivoting away from conventional plans. For instance, UnitedHealth Group saw an overall loss of over 530,000 members but added 267,000 SNP enrollees, while CVS Health gained 40,000 SNP members despite a total loss of 29,000 members. Growth is particularly strong in Chronic Condition SNPs, which grew by 45 percent, largely driven by plans for individuals with diabetes or cardiovascular conditions.

In a related regulatory development, the Centers for Medicare & Medicaid Services (CMS) has proposed new rules to improve the accuracy of provider directories for Medicare Advantage plans. Starting in 2028, the proposed regulations would require regular verification of directory information and provide cost-sharing protections for members who rely on incorrect directory data. Under the proposal, if an enrollee uses an incorrect directory to book an appointment, they would only be responsible for the lower in-network cost-sharing rate.