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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 📚 - Original Medicare Is Growing Again: Medigap Trends, 2021 to 2025
Sponsor Snapshot 🚀 - brought to you by VRI
It’s only a 5 minute read, but it will make you 10x smarter.
Here are IMPORTANT LINKS 🔗 for the week:
Medicare Advantage Patients Less Likely to Receive Care at Top-Rated Nursing Homes - (link)
CVS Health plans to split pharmacy business from Aetna, Caremark - (link)
Humana’s stars rebound could unlock $4.8bn, but brokers paid a price - (link)
Clover Health boosts outlook amid continued membership growth, financial momentum in Q3 - (link)
Humana’s 2027 Medicare Advantage sign-ups beat expectations - (link)
Medicare Advantage Plan Availability Varies Widely by County for 2027 - (link)
House Dems reintroduce 'Medicare for America' public option bill - (link)
HealthTap unveils virtual primary care program for Medicare Advantage plans - (link)
Jared’s recent LinkedIn posts:
DEEP DIVE 📚
Original Medicare Is Growing Again: Medigap Trends, 2021 to 2025
We pulled year-end Original Medicare and Medicare Supplement enrollment for every December from 2021 through 2025 using the new Original Medicare and Medicare Supplement Enrollment feature in MMI+. Two things stand out: Original Medicare has stopped shrinking, and Medigap now covers a bigger share of it than it did four years ago.
Three years of decline. Original Medicare (Parts A & B) fell from 34.9 million in December 2021 to 31.9 million in December 2024, a loss of 3.0 million (8.6%).
Then a turn. Original Medicare added 501,000 enrollees in 2025 (1.6%), reaching 32.4 million.
Medigap turned first. Medicare Supplement enrollment fell in 2022 and 2023 to a low of 14.1 million, then grew by 142,000 in 2024 and 190,000 in 2025, reaching 14.4 million. It started growing a year before Original Medicare did.
More of Original Medicare has a Med Supp. Med Supp enrollment as a share of Parts A & B rose from 41.6% to 44.5%, and it rose in 46 of the 49 states we compared, plus DC.
The Medicare Advantage slowdown
Medicare Advantage grew from 27.7 million to 35.2 million over the same period, but the pace has slowed. MA added 2.3 million enrollees in 2023, 1.8 million in 2024 and 1.2 million in 2025.
From 2021 to 2024, the Original Medicare pool shrank almost everywhere; Alaska was the only state where Parts A & B grew. In 2025 that flipped, with Original Medicare growing in 37 of 50 states plus DC. The timing lines up with the MA pullback: carriers exited counties and trimmed benefits for 2025, and beneficiaries whose MA plan leaves their area get guaranteed issue rights to certain Medigap plans.
One wrinkle: Med Supp's share of Original Medicare slipped from 44.6% to 44.5% in 2025. Original Medicare grew faster than Med Supp, so not everyone returning to Original Medicare is buying a Medigap policy, at least not yet.
Where Medigap is growing fastest
Vermont leads. MVP's UVM Health Advantage and WellCare left the state for 2025 (VTDigger). Vermont was the only state where MA enrollment fell in 2025 (-4.2%), and Med Supp grew 14.4% from December 2023 to December 2025.
New England and the West follow. Two-year Med Supp growth was 10.4% in New Hampshire, 9.3% in Oregon, 9.1% in Washington and 7.0% in Colorado. Washington stands out: Med Supp grew 9.1% while Original Medicare shrank 3.6%, lifting Med Supp's share from 45.6% to 51.5%.
California and Texas lead in raw growth. Over two years, California added 60,000 Med Supp enrollees and Texas added 52,000, followed by Washington (+28,000) and Florida (+26,000). In Texas, Med Supp now covers 54.0% of Parts A & B enrollees, up from 46.7% in 2021.
Where it isn't
The South and Michigan are still shrinking. Original Medicare kept falling in 2025 in West Virginia (-2.7%), Alabama (-1.5%), Michigan (-1.4%), North Carolina (-1.0%), Kentucky (-1.0%), Mississippi (-1.0%) and Arkansas (-0.9%).
Alabama is losing Med Supp. Alabama's Med Supp enrollment is down 14.0% since 2021, and only 21.9% of its Parts A & B enrollees have a Med Supp. West Virginia, the Dakotas and North Carolina also lost Med Supp enrollment over the past two years.
Share varies widely. Med Supp covers about three in four Parts A & B enrollees in Iowa (74.6%), Nebraska (73.6%) and Kansas (73.3%), but only 13.7% in Hawaii and 21.9% in Alabama.
What to watch
The 2026 exits aren't in this data yet. December 2025 is before the 2026 plan year. In Vermont alone, Vermont Blue Advantage and UnitedHealthcare left for 2026 (Vermont Public), so the year-end 2026 data should show a much larger shift there.
2027 disruption. We've reported that 11% of MA enrollees are losing their plan in 2027 and that 183 counties have no MA-PD option.
Whether Medigap keeps pace. If Original Medicare keeps growing faster than Med Supp, more returning beneficiaries are going without supplemental coverage or choosing other options.
The data in this deep dive comes from the new Original Medicare and Medicare Supplement enrollment feature in the MMI+ Enrollment Insights Web App. Data can be broken down or filtered by state and county for Original Medicare, and by state, county, marketing organization, parent organization and plan for Med Supp.
Current MMI+ Members: find it in the web app.
New members: get 20% off your first year when you join by Nov 30, 2026 (learn more).
Methodology
All figures are as of December of each year, 2021 through 2025. Original Medicare is beneficiaries enrolled in Parts A & B, and Medicare Advantage is Part C enrollment, from CMS enrollment files. Med Supp share is Medicare Supplement enrollment divided by Parts A & B enrollment.
Medicare Supplement data is based on the NAIC Medicare Supplement Experience Exhibit (year-end) with permission, in some instances supplemented with company Annual Statement data and carrier reports filed with the State of California. The NAIC does not endorse any analysis or conclusions based upon the use of its data. County-level Med Supp figures are estimates calculated by Medicare Market Insights from Original Medicare enrollment data and should not be interpreted as reported values.
State comparisons cover the 50 states and DC and exclude territories.
Connecticut's Medicare Supplement data is excluded from all state comparisons and the state chart. Its December 2025 figure shows an unusually large increase (+23%) that is under review. Connecticut is included in national totals.
Claude was utilized throughout to help aid in the research.
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What MMI + Subscribers read this week…
MMI+ Data Drop: New 2027 Non-Commissionable Plans Loaded - HealthSpring, Anthem, UnitedHealthcare and Wellcare (link)
The Medigap Map🗺️: 183 Counties Where MA-PD Isn't an Option in 2027 - Where MA left, and where Medigap is filling the gap. (link)
Insurance Regulatory Insights November 2026 - Congress pitches a Med Supp annual enrollment window, NJ sets dental loss ratio floors, and CMS proposes $0 generics for the lowest-income duals. (link)
2027 MA Crosswalks: Who's Being Auto-Enrolled into New Plan IDs👟 - 2.1 million Medicare Advantage members land in a new plan on January 1. Here's who's moving them and where. (link)
Oct ‘26 MA/MAPD and PDP enrollment data - October enrollment data has been loaded. Here are a few observations. (link)
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