CMS sees the registration of Medicare Advantage in 2026
During a press conference on Medicare Advantage, the supporters stop in Washington, DC, in Washington on July 25, 2023.
Alex Wong | Getty Images News | Getty pictures
The enrollment of Medicare Advantage has fallen for the first time in almost two decades.
The agency estimates that the enrollment in the program will be 34 million in 2025 – which is less than half of all seniors – according to forecasts by health insurers compared to almost 35 million this year.
Despite the forecast withdrawal, the agency announced on Friday that it “expected this enrollment in [Medicare Advantage] In 2026, more robust than the forecasts of the plans “and that the market remains stable. The seniors will have an average of 10 plans to choose from in most markets if they have their first look at 2026 on Wednesday.
After growing in the Medicare Market for more than a decade, the health insurers have exposed a shrinking profit in their Medicare Advantage programs in the past two years, since the members have under pressure higher than expected medical costs and new regulations under pressure. The larger insurers now reduce unprofitable plans and leave some markets as a whole.
“We see that most of the health insurance providers that most Medicare Advantage Carrier-in compares to growth this year focuses much more on profitability,” said Cobi Blumenfeld-Gantz, founder and CEO of Chapter, a broker that helps Medicare members to register for the cover. “Some of the planning advantages will not be as robust as in the past.”
Higher costs in 2026 plans
CMS projects that the average monthly premium for Medicare Advantage plans from USD 16.40 will decrease to $ 14 in 2026 this year The period begins on Wednesday, seniors can find higher pricing in many of the major insurers.
Analysts from Evercore ISI say that the first data on the offers from 2026 for higher prices for plans from Unitedhealth Group‘s Unitedhealthcare, CVS healthAetna, ClimbPresent Humana and other.
“Our preliminary analysis shows that payers have taken measures to improve margins through performance reductions including higher premiums, deductible and maximum out of their own pocket,” said Elizabeth Anderson from Evercore ISI in a research note. “In particular, we saw how (insurers) took more measures against HMO plans, in which a significant reduction for the advantages was seen.”
Pensioners protest against the Medicare Advantage situation in relation to the 12-126 law outside the town hall in New York on October 12, 2022.
Shawn Inglima | New York Daily News | Tribune News Service | Getty pictures
According to analysts, insurers prioritize the HMO or the organization for health care, plans for 2026, which generally have more limited providers. Although companies increase deductibles for these plans, senior citizens will still see offers with 0 US dollar premiums, according to analysts.
“This is an area in which the airlines are very cautious.
Insurers decommissioning plans
Seniors usually work with insurance brokers and agents to sort their options during the open enrollment. One of the possibilities, as insurers try to increase enrollment in more profitable plans, is to prioritize the commission rates. You pay higher prices for some plans and none for others at all.
This year the airlines are increasingly eliminating broker commissions A large part of less profitable plans.
“It is not something that is from the standard that this happens, but the amount of the plans that are cut and shut down. This is not normal,” said Michael Antoine, an independent health insurance agent with partner insurance solutions.
More CNBC health insurance
For the open enrollment of 2026, 15% of the plans were decommissioned in most cases, according to the data compiled for CNBC according to chapter for CNBC. In some markets such as New York, insurers have reduced commissions for more than 25% of the plans, while in parts of Georgia it is over 35% of the plans.
“This year it is so important that people ask their Medicare consultant whether there are plans that the Medicare consultant may not be considered due to these non-commitment problems,” said Chapter Blumenfeld-Gantz.
Even if you are willing to do without orders, brokers may not be able to get access to some of these plans for your brokerage systems.
“I had an experience and I will not tell the wearer where I couldn’t even enroll the person on the plan,” said Antoine. “It was completely suppressed. They did not want membership into this plan.”
The insurers rely on the fact that they can receive better equipment for membership and costs for 2026 with more restrictive offers and registration. With so much market disorders, the uncertainty remains high.
“Enrollment is particularly difficult if plans in years like this project in which so many airlines reduce the advantages and adapt their portfolios,” said Conway. “A plan could expect to reduce [Medicare Advantage] Enrollment because they leaned out of (by) advantages only to find out that a large airlines have left their market and that the remaining airlines also bowed their advantages. “
Open registration begins
Medicare participants should receive changes to their current health plans from their insurers this week if the shopping period for the open enrollment of 2026 begins on Wednesday. At so many market changes, the brokers say that seniors have to shop this year and weigh their options.
“This is not the year in which Autopilot is striving for,” said Whitney Stidom, Vice President at online brokerage EHealth. “By shopping for comparisons, over $ 1,800 can only find something by comparing plans and potentially something that saves you more.”
This year’s enrollment could give a little more uncertainty, with this year’s enrollment, with the congress in a funding agreement.
A former CMS official announced CNBC that a brief closure should not have an impact on the open enrollment, since the financing for contractors who monitor the process has already been assigned and continued.
On Saturday, CMS announced that critical services for Medicare and Medicaid would not be affected by a shutdown, although the agency would not have any funds to provide the contractors, including those who manage the Medicare Call Centers.
The Medicare Open reign runs from October 15th to December 7th.
