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Consumers enrolled in Medicare Advantage health insurance are in the middle of a short annual window when they can reassess their coverage options — and experts say it’s smart to do so this year as both the Centers for Medicare and Medicaid Services and private insurers consider changes.
CMS announced in late January new proposed policies for Medicare Advantage and Part D that are aimed at ensuring payments to insurers are accurate, according to the agency. It also proposed new Medicare Advantage payment rates that would be mostly flat — up just 0.9% from 2026 to 2027, representing $700 million in payments to plans.
The government’s payment rate determines how much insurers can charge enrollees for premiums and plan benefits.
Stocks of large health care companies tumbled on the announcement. Analysts were expecting a 4% to 6% increase, and insurers have said that the proposed rates may prompt benefit cuts or plan closures.
In 2025, more than half — 54% — of Medicare beneficiaries were enrolled in Medicare Advantage, according to KFF, a nonpartisan health policy, research, polling and news organization. About 34.1 million beneficiaries were enrolled in Medicare Advantage, versus 62.8 million enrolled in Medicare Parts A and B, according to KFF.
UnitedHealthcare CEO Tim Noel said during a Jan. 27 earnings call that the company may lose an estimated 1.3 million to 1.4 million Medicare Advantage members in 2026 because a competitive market is causing more enrollees to shop around.
“That’s going to have a real-world impact at some point, in terms of people who’ve been dealing with these plans,” said Philip Moeller, author of “Get What’s Yours for Medicare: Maximize Your Coverage, Minimize Your Costs.”
In 2024, UnitedHealthcare or Humana represented the largest Medicare Advantage insurers in more than half of counties, according to 2025 research by KFF.
While changes are looming, the Medicare Advantage market for 2026 is “fairly robust,” according to Tricia Neuman, executive director of the program on Medicare policy at KFF.
“The average beneficiary has a choice of more than 30 Medicare Advantage plans, and virtually all plans offer extra benefits, such as vision, hearing and dental,” Neuman said via email.
Medicare Advantage open enrollment
Medicare Advantage plans, otherwise known as Part C, are provided by private insurance companies and typically cover the same areas as original government-run Medicare Part A and B plans, and possibly Part D prescription coverage.
Medicare Advantage open enrollment is available for enrollees through March 31.
During this time, current Medicare Advantage enrollees may switch to another Medicare Advantage plan or drop Medicare Advantage coverage and return to original Medicare — which typically includes Medicare Parts A and B hospital and medical insurance, as well as elective Part D prescription drug coverage.
“I urge people to spend some time researching, if they have Medicare Advantage,” said Moeller.
Medicare Advantage plans may have features that help attract enrollees. Some plans offer zero premiums, according to Moeller. Others provide supplemental benefits — such as dental, hearing and vision — that government-provided Medicare plans typically do not, he said.
“For people who have modest medical needs, Medicare Advantage can make good sense,” Moeller said.
What to know before switching to original Medicare
Medicare Advantage plans can come with higher costs if you have a serious illness.
“People love Medicare Advantage when they’re well, because it’s cheaper for them,” said Carolyn McClanahan, a physician and certified financial planner at Life Planning Partners in Jacksonville, Fla.
“But as soon as they get a serious illness, they have to go through all this preauthorization and get turned down and challenge it,” she said.
Medicare Advantage plans also often require patients to stay in network, rather than see their preferred doctor, said McClanahan, who is also a member of CNBC’s Financial Advisor Council.
The current open enrollment period allows Medicare Advantage enrollees to switch to Medicare original.
However, experts say prospective Medicare original enrollees need to be wary of potentially high out-of-pocket costs for Medigap private insurance plans, which are often needed to cover extra costs like copays, coinsurance or deductibles.
“People need to do their homework and see that they’re going to have a decent place to land,” Moeller said. “I would personally not have original Medicare without a [supplemental] plan. There’s just too much exposure.”
Most states require Medicare Advantage enrollees who want to switch to original Medicare to go through an underwriting process to be covered by Medigap.
“If you’re already sick, you’re not going to pass underwriting,” McClanahan said.
Just four states — Connecticut, Maine, Massachusetts and New York — allow for individuals to switch to a Medigap plan without underwriting, McClanahan said.
