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- 2026 MA, MAPD, Part D Landscape 🏞 - Part 2
2026 MA, MAPD, Part D Landscape 🏞 - Part 2
Premiums, Deductibles, MOOPs are all changing.
Jared Strock
October 09, 2025
This week’s newsletter is sponsored by: Spark
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Here is what you’ll find in this week’s newsletter!
Important links 🔗 - the best articles we found this week about the Medicare Market along with links to Jared’s recent LinkedIn posts.
Deep Dive 📚 - 2026 MA, MAPD, Part D Landscape 🏞 - Part 2
Sponsor Snapshot 🚀 - brought to you by Spark
It’s only a 6 minute read, but it will make you 10x smarter.
Here are IMPORTANT LINKS đź”— for the week:
Medicare Advantage Plans Zero Out Agents - (link)
Medicare Supplement Rate Filings – October 2025 - (link)
NeueHealth closes $1.5B deal with VC firm, goes private - (link)
New Med Supp Regulatory Updates (Delaware and Indiana) - (link)
Health Insurers Are Reducing Medicare Advantage Options Next Year - (link)
Seniors with Medicare Advantage scrambling as market dramatically shrinks - (link)
Sentara Health Plans no longer offering certain Medicare Advantage plans in 2026 - (link)
Understanding the Difference Between Anniversary Rating and Next Renewal Rating in Medicare Supplement Policies - (link)
Jared’s recent LinkedIn posts:
DEEP DIVE đź“š
2026 MA, MAPD, Part D Landscape 🏞 - Part 2
The 2026 Annual Enrollment Period (“AEP”) starts next week.
There is still some uncertainty on what the full landscape looks like. CMS still hasn’t released the Crosswalk file. So, we don’t know which plans are consolidating (“cross walking”) to other plans and still don’t have full clarity on which plans are terminating, or reducing service areas.
With that said, we can analyze some of the plan characteristics of plans that are in both the 2025 and 2026 Landscape files (“renewing plans”).
In Part 1, we covered the difference in distinct number of Contract and Plan combinations between 2025 and 2026. Today, we look at how plan designs themselves are changing — premiums, drug deductibles, and MOOPs, using CMS enrollment and Landscape data.
Monthly Premium comparisons between 2025 and 2026 for plans that are renewing in 2026
Drug Deductible comparisons between 2025 and 2026 for plans that are renewing in 2026
OOP Max comparisons between 2025 and 2026 for plans that are renewing in 2026
When CMS released the 2026 Landscape, their newsroom released the following headline:
Given the expected Carrier exits and plan terminations, along with the large number of Carriers removing or adjusting commissions on large portions of their plans, I wouldn’t consider this AEP to be stable.
With that said, let’s look at how some of the high level plan characteristics are changing for plans renewing in 2026. How stable are premiums, deductibles and MOOPs?
Given the pressure on MA/MAPD plans, you might expect that premiums will be going up in 2026. But are they?
Not really.
The enrollment-weighted average monthly premium is actually decreasing slightly, from $16.80 → $16.20 (-3.6%)
Currently, 64% of the individual MA/MAPD market had a $0 premium plan.
If everyone sticks with their same plans in 2026, 63% of the market will have $0 plans.
The majority of the current market will see premiums that either stay the same or decrease (85%).
15% of the market will see an increase in premiums, with the enrollment weighted average change of $19 per month.
Premium Bucket | Current Enrollment | % | Average $ Change |
|---|---|---|---|
Premiums Increasing in 2026 | 3,727,159 | 15% | $18.62 |
Staying the Same | 15,458,143 | 63% | $0 |
Premiums Decreasing in 2026 | 5,332,678 | 22% | ($15.78) |
Drug Deductible
The story flips when it comes to drug deductibles.
With the Inflation Reduction Act capping Part D out-of-pocket costs ($2,000 in 2025 → $2,100 in 2026) shifting more risk to plans, MAPD drug deductibles are jumping.
The overall enrollment weighted average Drug Deductible is going from $308 in 2025 to $417 in 2026 (up 35%). This is up from $176 in 2024.
Currently, 31% of the individual MAPD market has a $0 Drug Deductible (this was 60% in 2024).
If everyone sticks with their plans in 2026 only 14% of the market will have a $0 Drug Deductible.
You can see (chart below) a large decrease in the share of enrollees with $0 Drug Deductibles, and a large increase in enrollees with Drug Deductibles in of $400 and over. 37% of enrollees would see the max drug deductible ($615 in 2026).
The majority of the current market will see drug deductibles increase (75%).
Only 6% of the market will see an decrease in their drug deductible.
Drug Deductible Bucket | Current Enrollment | % | Average $ Change |
|---|---|---|---|
Drug Deductible Increasing in 2026 | 17,900,639 | 75% | $161 |
Staying the Same | 4,515,456 | 19% | $0 |
Drug Deductible Decreasing in 2026 | 1,311,281 | 6% | ($234) |
The share of $0 deductible MAPDs is being cut in half for the second straight year. A clear sign of carriers shifting cost burden toward the member side of the benefit design.
In Network Max Out-Of-Pocket (“MOOP”)
Premiums are generally not increasing, drug deductibles are increasing significantly, what about the In Network Max out-of-pocket (“MOOP”) amounts?
Yes and No.
The overall enrollment weighted average MOOP is going from $5,688 in 2025 to $5,950 in 2025 (up 5%).
But, the details are a bit more important on this one.
65% of current enrollees will see either no change or a decrease in MOOP.
But, the weighted MOOP change for the 35% that is increasing is $981.
25% of current enrollees will have the max MOOP $9,250.
MOOP Bucket | Current Enrollment | % | Average Change |
|---|---|---|---|
MOOP Increasing in 2026 | 8,478,703 | 35% | $981 |
Staying the Same | 8,888,165 | 36% | $0 |
MOOP Decreasing in 2026 | 7,130,931 | 29% | ($267) |
Bottom Line
So, what did we learn about Individual MA/MAPD plans as we go from 2025 to 2026?
Premiums Level/Down.
Drug Deductibles Up significantly.
MOOP Mixed, though largely up.
This is only scratching the surface on plan changes in 2026. A more detailed view of plan benefits will reveal changes to formularies, along with large changes to supplemental benefits.
That’s all for now.
Happy AEP!
Enrollee Count Source: Medicare Advantage Enrollment Insights web app available to MMI+ subscribers
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