Medicare Beneficiaries Have 32 Medicare Advantage Prescription Drug Plans Available, on Average, for 2026

In anticipation of the Medicare annual open enrollment period, which runs from October 15 to December 7, the Centers for Medicare and Medicaid Services (CMS) recently released information about Medicare Advantage plans for the coming year. News articles following the release of plan information report that Medicare Advantage insurers are scaling back their offerings in response to changes in federal payments and because unexpected increases in the use of health services have led to rising costs and falling profits.

KFF’s analysis of plan offerings shows that Medicare beneficiaries will have the option of 32 Medicare Advantage prescription drug (MA-PD) plans in 2026, two fewer than the 34 options available in 2025 (excluding employer plans and special needs plans). The number of MA-PD options has grown steadily since 2010, peaking in 2024 when the average Medicare beneficiary had 36 options. Despite the decline in offerings over the last two years, the number of options available for 2026 will be higher than the number available in 2022 (31) and every year before (Figure 1).

Across all Medicare Advantage plans for individual enrollment, including those with and without prescription drug coverage, the average Medicare beneficiary has the option to choose among 39 plans in 2026, compared to 42 options in 2025. Similar to the trend for MA-PDs, the total number of Medicare Advantage plans available to the average beneficiary is higher than the average number of plans available in 2022 (38), and each year since 2010. While Medicare Advantage plans are required to cover all Medicare Part A and Part B benefits, plans decide whether to include Part D prescription drug coverage as part of the benefit package. Enrollees may pay a separate premium for Part D coverage, or plans can use the rebate portion of their payment from the federal government to cover these costs. Most Medicare Advantage enrollees are in plans that include prescription drug coverage.

The number of Medicare Advantage plans with prescription drug coverage available to the average beneficiary varies across states, as does the change in the number of plans compared to 2025 (Figure 2). In 35 states, DC and Puerto Rico, the average beneficiary has a choice of fewer plans on average in 2026 than in 2025. The states with the largest drop in the number of plans available were New Hampshire (13 fewer plans) and Minnesota (11 fewer plans). In Minnesota, UCare, the second largest Medicare Advantage insurer in the state, exited the market altogether, while UnitedHealthcare and Humana decreased their offerings, especially in more rural counties with lower enrollment. However, in 6 states (AL, HI, KS, MO, UT, and WV), the average beneficiary has access to more plans in 2026 than in 2025, on average. In the remaining 8 states, the number of plans available to the average beneficiary stayed the same. This includes Alaska, which had no plans available in 2026, as in 2025 (Alaska has historically had few or no Medicare Advantage plans available for general enrollment). Connecticut is not included in this calculation because of differences in how counties are reported across CMS enrollment and plan files.

While the average Medicare beneficiary will have more than 30 Medicare Advantage plans with prescription drug coverage to choose from, in certain states the number of options is substantially lower. Medicare beneficiaries will have fewer than 5 options, on average, in four states: Alaska (0), South Dakota (4), Wyoming (3), and Vermont (1). Within states, the number of plans also varies across counties (data not included). Historically, fewer Medicare Advantage plans have been offered in the most rural areas, and a larger share of Medicare beneficiaries in the most rural areas get Medicare coverage from traditional Medicare.   

The modest decrease in the average of Medicare Advantage plans means that some Medicare beneficiaries will find that their current coverage is no longer an option for next year. In most cases, these beneficiaries live in counties where they will continue to have dozens of other Medicare Advantage plan options available for 2026, as well as traditional Medicare. Some beneficiaries in plans that have exited the market will have the option to enroll in a plan offered by the same insurer, and in many cases, enrollees will be moved into a new plan offered by the same insurer automatically if the contract includes another plan of the same type (i.e., HMO or PPO) in the same county. Others will have to make an active choice about their Medicare coverage if they wish to enroll in another Medicare Advantage plan, or will be automatically covered by traditional Medicare.

Every year, Medicare Advantage plans change in ways that could be important to enrollees, including the scope and generosity of extra benefits, cost sharing for Medicare-covered benefits, rules for using covered services (such as referral requirements and prior authorization), drug formularies, and provider networks. Despite these changes, most Medicare beneficiaries report that they do not compare coverage options on an annual basis. Further, prior Medicare focus groups indicate that Medicare enrollees are often overwhelmed by the number of Medicare Advantage choices and have difficulty sorting through all plan options. With more than 30 Medicare Advantage plans with prescription drug coverage available in 2026, on average, understanding how plans differ, and why it may matter, may remain a challenge.