New Analysis Finds Rising Out-of-Pocket Costs and Fewer Plan Choices Ahead for Medicare Advantage Beneficiaries in 2026
Avalere analysis of CMS data shows median MOOP up nearly $1,000 in two years as plan options shrink
WASHINGTON – Seniors enrolled in Medicare Advantage will face higher out-of-pocket limits and fewer plan options in 2026, even as premiums remain stable, according to a new analysis by Avalere of the Centers for Medicare & Medicaid Services’ (CMS) 2026 Medicare Advantage Landscape File. The findings point to an affordability squeeze with real consequences for beneficiaries.
“For the second year in a row, seniors are being asked to pay more for their health care while having fewer choices. That’s not sustainable,” said Mary Beth Donahue, President and CEO of the Better Medicare Alliance. “Even with stable premiums, rising out-of-pocket costs and shrinking plan options make it harder for seniors to access care when they need it most. These challenges stem from continued policy and funding changes in the previous administration — and they show why we must protect Medicare Advantage and ease pressure on the program, not threaten it with further cuts.”
Key findings include:
- Rising out-of-pocket limits: The national median maximum out-of-pocket (MOOP) will increase from $5,400 in 2025 to $5,900 in 2026—a 9.3% rise and nearly a $900 increase over two years.
- Fewer plan choices: There will be 335 fewer non–special needs plans offered in 2026, continuing a two-year trend of shrinking plan availability.
- Fewer plans offering lower MOOPs: 11% fewer plans will offer MOOPs below the CMS limit in 2026.
- Premiums stable, affordability pressure rising: While 59% of offerings remain $0-premium, higher MOOPs, fewer sub-limit MOOP options, and fewer overall plan choices mean beneficiaries may still face higher costs when they need care and fewer avenues to find lower-cost options.
This memo is an initial analysis of the 2026 landscape; additional analysis will follow as more data becomes available. Better Medicare Alliance will continue tracking these trends and urges policymakers to support a stable, forward-looking policy environment that protects affordability and preserves choice for 35.1 million seniors who choose Medicare Advantage.
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Better Medicare Alliance is a community of hundreds of thousands of grassroots beneficiaries and 200+ ally organizations working to improve health care through a strong Medicare Advantage. Learn more at bettermedicarealliance.org.