Medicare Advantage passes 36 million members, CMS's October file shows

CMS counted 36,024,875 people in Medicare Advantage plans in its October 2026 monthly summary. A year earlier, in October 2025, the count was 35,117,910. That is 906,965 more people, a rise of 2.6%. Both counts reflect enrollment as of the Oct 1 payment. The 2026 file covers enrollments CMS accepted through Sept 4, 2026.

Medicare Advantage plans are run by private insurers and replace traditional Medicare for the people who join them. KFF puts Medicare Advantage at 55% of eligible people in 2026, or 35.2 million of the 64.2 million who have both Part A and Part B. That figure uses March 2026 data, so it sits below CMS’s October count.

Where the growth came from

Special needs plans added 774,709 members, about 85% of Medicare Advantage’s growth over the year. They now hold 23.6% of all Medicare Advantage members. These plans are open only to people who also have Medicaid, who have certain severe or chronic conditions, or who have certain health care needs, according to Medicare.gov. All other Medicare Advantage plans together added 132,256 members.

PACE grew by 9,150 people, to 82,218, and CMS lists 208 PACE contracts, up from 198. PACE is a Medicare and Medicaid program for people 55 and older who need a nursing home level of care but can live safely at home with help. It is offered only in some states.

More members have a plan without drug coverage

Most Medicare Advantage members are in plans that include Part D drug coverage, KFF says. The number of members in those plans fell by 330,832 over the year, to 32,105,702. The number in Medicare Advantage plans without drug coverage rose by 1,237,797, to 3,919,173.

KFF saw the same move in February data and tied it to employer retiree coverage. From February 2025 to February 2026, enrollment in employer group Medicare Advantage drug plans fell by 1.2 million, the first drop since 2010. Employer group standalone drug plans gained 1.2 million. KFF wrote that the shift “may reflect a strategy” by employers and unions of buying medical coverage from a Medicare Advantage plan without drugs and buying drug coverage from a separate standalone plan. That lets them use the Part D premium stabilization demonstration, which in 2026 pays employer group drug plans that join it a $10 per member per month premium subsidy. Medicare Advantage drug plans can’t get it.

CMS’s October files are consistent with that. Employer group standalone drug plan members rose by 1,221,336, to 6,418,647, while employer group Medicare Advantage enrollment stayed close to flat at 5,847,113. CMS’s summary does not split the members without drug coverage by employer status, so the file alone can’t confirm KFF’s explanation.

What it means for you

The shift KFF describes is in employer and union retiree plans. If your retiree coverage comes through a former employer or union, your medical coverage and your drug coverage may now come from two separate plans. Special needs plans are where most new members went, and they are open only to people who qualify.

What’s next

People can change plans during open enrollment until Dec 7, 2026, and those changes take effect Jan 1, 2027. CMS’s monthly files from January on will show how 2027 enrollment moved. For people in the 193 counties losing every Medicare Advantage drug plan open to general enrollment, see what to do if your plan is leaving your county.

This story reports public data. It is not insurance or enrollment advice. For help with your own coverage, call 1-800-MEDICARE or a free SHIP counselor.