Medicare Advantage has skyrocketed in popularity over the past decade, reeling in new members with zero-dollar premiums and generous benefits. But the rate of growth has slowed in recent years, and in 2026, there’s a decent chance enrollment will contract for the first time in 20 years .

It’s happening because private Medicare insurers are increasingly paring back both the number of plans they offer and the benefits within those plans. They say the cuts are necessary because members’ care has gotten more expensive. That means that when Medicare’s annual enrollment period starts Wednesday, beneficiaries will face tough choices and, in many cases, fewer of them.

“Those people in Medicare Advantage who have pretty much had a stable, easy way to go through open enrollment? Not this year,”

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