As October officially gets underway, health insurers are gearing up for the start of Medicare's annual enrollment period.
The AEP is set to kick off Oct. 15 and run through Dec. 7. During this window, Medicare eligible individuals choose between enrolling in the traditional program or selecting one of the plan offerings available from private insurers across the country.
While enrollment in Medicare Advantage (MA) grew to include 50% of all Medicare eligibles in 2025, the Centers for Medicare & Medicaid Services (CMS) is projecting a decline for the 2026 plan year. The CMS said last week that insurer estimates suggest MA will account for 48% of all Medicare enrollees in 2026, or about 34 million people.
That enrollment decline is driven in large part by major financial pressures in MA that are dinging carriers. Those headwinds have led some payers to cut back their footprints for 2026, with industry leader UnitedHealthcare saying market exits will impact 600,000 enrollees.
The CMS also said it expects average premiums for MA plans to decline in 2026, from $16.40 in 2025 to $14.
Here's a deeper look at what some of the major payers are planning for the coming plan year.
UnitedHealthcare
The largest Medicare Advantage insurer said that its footprint will reach 94% of Medicare eligible individuals in 2026, despite plans to exit certain low-performing markets. Bobby Hunter, CEO of UnitedHealthcare Government Programs, told reporters during a press briefing that its exits include 100 plans, pulling out of 16 markets.
As it slimmed its portfolio, Hunter said a major area of focus was on HMO plans rather than PPO plans. About 92% of beneficiaries will have the option to choose a UnitedHealthcare HMO plan in 2026, and he said the goal was to really lean on the primary care provider at the center of the patient care journey.
He added that PPO plans are the most decommissioned for brokers as the team planned its 2026 slate.
Most beneficiaries will have access to $0 premiums as well as $0 copayments for preventive care, primary care visits and lab work. Most of its members will also have $0 copayments on Tier 1 medications at any in-network pharmacy, and $0 copays on Tier 2 drugs when they secure them through Optum Home Delivery.
UnitedHealthcare also said that its 2026 plans will have access to a network of close to 1 million providers.
"We also were focused on preserving access to the critical supplemental benefits that MA members rely upon ... dental, vision and hearing in particular," Hunter said during the briefing. "Nonetheless, given other benefit changes that we had to make in response to the funding challenges, a one-size-fits-all plan design is just not viable at this stage, so we had to further diversify our product portfolio to ensure that we have plans available to meet all the specific and unique needs of our Medicare consumers."
The insurer also highlighted that its dual special needs plans (D-SNPs) will be available to 80% of dually eligible beneficiaries, with plans offering a more flexible over-the-counter, healthy food and utilities credit. A quarter of D-SNP enrollees can access all covered prescriptions with a $0 copay, UHC said.
The "Essentials" and "Extras" plan designs, which allow consumers to choose between a broader slate of supplemental options or lower medical costs, will also reach 20 million Medicare eligibles for 2026, UnitedHealth said.
Humana
In its 2026 plan slate, Humana said in an announcement that it's putting a focus on "simplicity and clarity" for members. More than 80% of members will be enrolled in coverage where benefits are stable, and 100% of its MA plans include dental, vision and hearing benefits.
Humana said its approach to 2026 is based on feedback from thousands of its members, so all of its non-special needs plans include $0 copayments for covered preventive dental care as well as $0 copays on in-network preventive medical care.
Primary care visits also have a $0 copayment, as do Tier 1 medications, Humana said.
Humana's D-SNPs, meanwhile, similarly have $0 copayments for preventive services, as well as for covered vaccinations, care management for chronic needs, dental care, hearing care and vision care. The insurer added that most D-SNPs also include a stipend for covered over-the-counter items.
The insurer said it will offer plans across 46 states and Washington, D.C., for 2026, including 85% of counties. It will make new plan types available in four states and 177 counties. Humana will also grow the reach of its SNPs into new states, per the announcement.
In addition, Humana said it's aiming to support preventive care and wellness by offering screenings for critical conditions at no cost to beneficiaries. Preventive and diagnostic screenings for breast cancer, colon cancer and bone density are all covered under its MA plans for free.
It's also making investments in wellness programs, such as Go365, to encourage healthy behaviors. Through this program, members can earn rewards by completing certain health-related tasks and activities, such as having their annual wellness visit or having preventive screenings.
"For decades, Humana has been dedicated to making healthcare easy to navigate for Medicare beneficiaries, offering clear and consistent options that prioritize stability, quality and affordability," said George Renaudin, president of insurance at Humana, in the announcement. "Our 2026 plans reflect valuable feedback from Humana members and a sustained commitment to supporting the health and independence of our members."
Aetna
CVS Health's Aetna will make Medicare Advantage Prescription Drug plans available in 43 states and the District of Columbia for 2026, reaching 57 million eligible enrollees.
Aetna said in an announcement that it put a focus on maintaining essential benefits. For instance, at least one plan with a $0 monthly premium is available in each county. All plans include $0 copayments on Tier 1 medications, dental benefits, hearing coverage, vision care and a Silver Sneakers fitness membership.
The insurer projected that 82% of MA-eligibles will have access to a $0 premium plan through Aetna.
In addition, certain plans will offer $0 copayments for key preventive screenings, including annual physicals, mammograms, colonoscopies and routine eye and hearing exams. Some plans will also have primary care visits and lab tests with a $0 copayment.
Aetna also offers members the Extra Benefits Card, which manages over-the-counter benefits and other supplemental offerings. Beneficiaries can use this allowance on products and services at CVS locations, and, in certain plans, at more than 70,000 other participating locations.
Members can undergo a Healthy Home Visit from Signify Health at no cost, according to the announcement, which includes a health assessment as well as an evaluation of the home for risks. These visits are a collaborative effort with the primary care team, identifying potential challenges before the member experiences negative outcomes.
Aetna also said it is "deepening" its focus on SNPs, expanding its footprint for both D-SNPs and chronic SNPs. Aetna will offer C-SNPs in 16 new states, and plans include $0 copayments for primary care services, certain visits related to chronic needs as well as dental, vision and hearing benefits.
All members in its D-SNPs receive a monthly stipend for key over-the-counter products, Aetna said.
“We’ve built our plans around what matters most to our members—access, simplicity and care that meets them where they are,” said Jeff Fernandez, senior vice president of Medicare at Aetna, in the announcement. “Backed by CVS Health and our care delivery partners, we are committed to supporting our members at every point in their health care journey, whether it’s in the doctor’s office, at home or at the pharmacy.”
Centene
Centene's WellCare unit will offer MA plans in 32 states, including 1,850 counties. The insurer is adding 51 new counties to its footprint across eight states, a spokesperson told Fierce Healthcare.
All of its MA Prescription Drug plans will include a low or $0 copayment for primary care visits, as well as $0 cost-sharing on key Part D vaccinations under recommendations from the Advisory Committee on Immunization Practices.
Other benefits with $0 copayments include routine physical exams at annual wellness visits, kidney screenings and A1c labs, preventive and diagnostic mammograms, preventive and diagnostic colonoscopies, routine eye exams for diabetic members and for Tier 6 adherence medications at preferred pharmacies, the spokesperson said.
Members can also tap into services from DarioHealth in managing digital health and social support needs. DarioHealth will offer virtual behavioral health supports around the clock, including peer-to-peer coaching, self-guided programs and resources available through Centene.
For patients who need it, WellCare will cap the cost of insulin at either $35 or 25% of the drug's maximum negotiated or fair price, whichever costs less. Members' overall out-of-pocket costs in the prescription drug benefits will continue to move through three phases, with a cap at $2,100 for the year.
As for supplemental benefits, the spokesperson said MA enrollees can lean on the WellCare Spendables card, which includes preloaded funds that they can spend at more than 66,000 retailers across its geographic footprint.
While the exact implementation varies between plans, members can use these funds to cover eligible over-the-counter products or out-of-pocket costs for dental, hearing and vision services. Eligible members may also be able to use the card on other wellness options.
The card also combines the Spendables benefit with WellCare's rewards program, which will allow them to earn rewards for completing certain tasks, such as annual wellness visits, health screenings, flu vaccinations and signing into their member portal.