Medicare’s annual enrollment window is open now and closes December 7. What you can change, and when.
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Search for the best Medicare Advantage plan and you’ll find dozens of articles naming a winner. Most are built the same way: a carrier per category, a confident sentence about each, and no explanation of how any of it was decided. We’re not going to add another one, because for this particular product a national ranking can’t be right — and the reason why is genuinely useful to understand before you start comparing anything.
The Quick Answer
- Medicare Advantage is sold county by county, so “the best carrier” describes an average of plans, most of which you cannot buy
- The average beneficiary has 39 plans to choose from in 2026 — down from 42 last year, as the total number of plans fell by 9%
- The differences that matter are within your county: out-of-pocket maximums, copays and formularies, which vary enormously between plans sold by the same carrier
- What’s worth knowing about carriers is structural, not a ranking — how each one is built changes what it can offer you
- We checked every county for 2027: the company most often selling the most protective $0 plan wins in only 29.7% of counties, and the winner changed from 2026 in more than half of them
Why There Is No National Best Plan
Medicare Advantage isn’t a national product. Each plan is approved for a defined service area, priced against a benchmark set for that area, and built on a network of local doctors and hospitals. The same carrier’s plan in one county can have a different premium, a different out-of-pocket maximum, a different formulary and an entirely different network from its plan two counties over.
That makes a carrier-level ranking an average across thousands of plans, nearly all of which are unavailable to any one reader — and in the case of the Blue Cross Blue Shield brand, an average across a dozen independent companies that happen to share a name. It’s not that such rankings are dishonest. It’s that the thing they measure isn’t the thing you buy.
There’s a second problem with how these lists get built, and it’s easy to spot once you know to look. Carriers get credited for several unrelated strengths at once — quality ratings, network size, extra benefits, low premiums — as if a plan that wins on one must be strong on the others. They’re independent. A carrier can hold excellent star ratings while offering $0 premiums on relatively few of its plans, and when we priced every plan against its own rating the better-rated ones turned out to cost only a few dollars a month more. Another can lead on premiums with middling ratings. Collapsing those into a single “best overall” produces a sentence that reads like a recommendation and contains no information about the plan in front of you.
What follows is what can actually be said about 2026 from published data, and then what to do with it.
What Actually Changed for 2026
| 2026 | Figure | Compared with 2025 |
|---|---|---|
| Plans available nationwide | 3,373 | Down 9% — 346 fewer plans |
| Options for the average beneficiary | 39 | Down from 42 |
| Average plan premium | $14.00/month | Down from $16.40 |
| Enrollment | 35.2 million, or 55% of beneficiaries | Up 3%, similar to the prior year’s 4% |
| Payments to plans | +5.06%, over $25 billion | A substantial increase |
| Average star rating | 3.98 | Broadly flat |
Read those rows together and a pattern emerges that no “best carrier” list would tell you. Payments to plans rose by more than $25 billion, and the number of plans fell by 9%. Insurers were paid more and offered less choice — consolidating into the counties and products that work for them.
The growth went somewhere specific, too. Overall enrollment rose about 3%, but 85% of that net increase came from Special Needs Plans, up from 48% the year before. Standard Medicare Advantage is close to flat. SNP enrollment now stands at nearly 8.2 million, with chronic-condition plans up 45% in a single year.
For you, that translates into one practical instruction: do not assume your plan survived unchanged into 2026. With 346 plans withdrawn and carriers reshaping what they offer, a plan that still exists may have a different network or a different out-of-pocket maximum. Read the Annual Notice of Change your plan sends each September rather than letting it renew unread.
How the Big Carriers Actually Differ
Carriers aren’t interchangeable, but the meaningful differences are structural rather than a matter of rank. Three are worth understanding because they change what the carrier can do.
Kaiser Permanente owns its hospitals and employs its own doctors. Care is coordinated because it all happens inside one organization — and for the same reason, you use Kaiser’s facilities or you’re out of network. It operates in only part of the country, so for most people it isn’t a choice at all.
UnitedHealthcare is the largest carrier by enrollment and contracts with independent providers rather than employing them. Scale means wide availability and a broad choice of plan types; it does not mean any particular doctor near you is in the network of the specific plan you’re considering.
Humana is one of the largest national carriers and has leaned heavily into supplemental benefits. It also offers the clearest recent lesson about star ratings: its share of members in four-star-or-better plans fell sharply across 2025 and 2026, and it lost two lawsuits against CMS over how the ratings were calculated. That was a scoring story more than a care story — which is exactly why our guide to star ratings is worth reading before you weight them heavily.
Notice what none of that tells you: whether the plan you’d actually join is any good. That question only has a local answer.
We Tested It: Does One Company Win Everywhere for 2027?
“There is no national best plan” is easy to say and easy to doubt, so we tested it on the 2027 plans. From the CMS Landscape file for 2027, which lists every plan sold in every county, we took the shortlist most people start from: plans anyone can join (no special needs plans) that include drug coverage and charge no premium beyond Part B. Then, county by county, we asked which company sells the one with the lowest in-network out-of-pocket limit. That is the plan that protects you best in a bad year, and the closest thing a county has to an objective winner.
Of the 2,916 counties with at least one such plan, 176 were a tie between companies. In the other 2,740, the result looked like this:
| Parent company | Counties where it sells a $0 plan with drugs | Counties where it has the lowest limit | Share of all counties | Share of the counties it sells in |
|---|---|---|---|---|
| Humana | 2,477 | 813 | 29.7% | 35.0% |
| UnitedHealth Group | 2,055 | 463 | 16.9% | 24.0% |
| Elevance Health | 852 | 266 | 9.7% | 33.0% |
| Devoted Health | 1,341 | 212 | 7.7% | 16.9% |
| CVS Health (Aetna) | 1,896 | 193 | 7.0% | 10.9% |
| Centene | 1,358 | 110 | 4.0% | 8.9% |
Three things come out of that table. First, the most frequent winner wins less than a third of the time. Humana has the lowest limit in 29.7% of counties, which means that in seven counties out of ten a “best carrier” list that put Humana first would point you away from the most protective $0 plan on your own menu. Even where Humana sells, someone else wins about two times in three. Altogether, 47 different companies win at least one county.
Second, the winner does not stay put. We ran the same test on the 2026 plans. In the 2,587 counties with a clear winner in both years, the same company won both times in only 47.4% of them. More than half of counties have a different answer for 2027 than they had for 2026, which is one more reason the plan you chose last year deserves a fresh look now.
Third, the brand does not even settle it inside one county. Where a company sells two or more plans open to anyone in the same county, its own plans are a median $2,800 apart on the out-of-pocket limit, and in 71.4% of those cases the gap is $2,000 or more. Choosing the right company and then the wrong one of its plans can cost as much as choosing the wrong company.
None of this says the big insurers are bad, and the lowest limit is not the only thing that matters: your doctors and your prescriptions come first, as we set out below. It says that a ranking of companies answers a question nobody is actually facing. The question you face is which of the plans at your address fits you, and the step-by-step Plan Finder guide shows how to answer it in an afternoon.
How we counted: plan types HMO, HMO-POS, PPO, PFFS and MSA open to individual enrollment, special needs plans excluded, Part C premium of $0, drug coverage included. A county is a tie when two or more parent companies share the lowest limit. Full method and downloadable data on our methodology page.
The Numbers That Separate Plans in Your County
Once you’re comparing real plans rather than brands, the spread is wide — and it isn’t in the premium.
| What the range looks like in 2026 | |
|---|---|
| Plan premium | Often $0; the average is $14/month. HMOs average $12, local PPOs $18 |
| In-network out-of-pocket maximum | The legal ceiling is $9,250, but the enrollment-weighted average is $5,421. HMOs average $4,636, PPOs $6,592 |
| PPO combined limit | Up to $13,900 by law; $9,825 on average — a second, higher ceiling HMOs don’t have |
| Drug costs | Capped at $2,100 a year, separately from the medical maximum |
The premium range across plan types spans about $6 a month. The out-of-pocket range spans several thousand dollars. If you are going to spend your attention on one row of that table, it should not be the first one.
How to Choose, in Order
- Start with your address, not a carrier. Enter your ZIP code into the Medicare Plan Finder and see what’s actually sold to you. Everything before this step is background reading.
- Cut the list by out-of-pocket maximum. This is where thousands of dollars sit, and where two plans with identical premiums diverge most.
- Enter your medications by name and dose and compare total annual drug cost, not tier labels or advertised “$0 Tier 1” copays.
- Phone your doctors’ offices about the two or three plans still standing. CMS has acknowledged that Plan Finder’s provider directory can be wrong; the receptionist will not be.
- Check the star rating last, at contract level rather than carrier level, as a tie-breaker between plans that already fit.
- If you have a qualifying chronic condition or Medicaid, check whether a Special Needs Plan is available to you — that’s where the market has been putting its effort.
Frequently Asked Questions
So which carrier is best for 2026? There isn’t a national answer, and any article giving you one is describing an average of plans you mostly can’t buy. The best plan is whichever of the ones sold at your address caps your spending lowest, covers your doctors, and prices your medications well.
Why did my plan disappear or change for 2026? The number of plans fell 9% — 346 fewer than in 2025 — as carriers withdrew from counties and products that weren’t working for them. This happened while payments to plans rose over 5%, so it reflects strategy rather than shortage.
Does a carrier’s high star rating mean my plan is highly rated? Not necessarily. Ratings are assigned to contracts, not companies, and one insurer can hold contracts with very different scores. Check the contract behind your specific plan.
How many plans will I actually have to choose from? About 39 on average in 2026, down from 42 in 2025, of which around 32 include prescription drug coverage. Enough that filtering properly matters more than picking a brand.
When can I switch plans? During the Annual Enrollment Period (October 15 – December 7), or once during the Medicare Advantage Open Enrollment Period (January 1 – March 31) if you’re already in a Medicare Advantage plan.
Bottom Line
The honest answer to “which is the best Medicare Advantage plan for 2026” is that the question has no national answer, and the articles that give one are answering an easier question instead.
What the 2026 data does tell you is worth carrying. There are 9% fewer plans than last year, so check whether yours changed. The market’s growth is concentrated almost entirely in Special Needs Plans, so check whether you qualify for one. And the spread between plans is in the out-of-pocket maximum, not the premium — which means the comparison that decides your year is the one most people skip.
Compare the exact plans available in your ZIP code using the official Medicare Plan Finder, or speak with your local State Health Insurance Assistance Program (SHIP) for free, unbiased guidance.
Sources
- Medicare Advantage 2026 Spotlight: A First Look at Plan Offerings — KFF. Source for the 3,373 plans available and the 9% decrease of 346 plans, the 39 average options versus 42 in 2025, the 32 MA-PD plans versus 34, and the HMO and PPO shares.
- Medicare Advantage in 2026: Enrollment Update and Key Trends — KFF. Source for 35.2 million enrollees out of 64.2 million beneficiaries (55%), the 3% growth versus 4% the prior year, SNPs accounting for 85% of net growth, the 8.2 million SNP enrollees and the 45% rise in chronic-condition plan enrollment.
- Medicare Advantage in 2026: Premiums, Out-of-Pocket Limits, Supplemental Benefits and Prior Authorization — KFF. Source for the $9,250 and $13,900 statutory out-of-pocket limits, the $5,421 average, the $4,636 HMO and $6,592 PPO averages, the $9,825 average combined PPO limit, and the $12 and $18 average premiums by plan type.
- Medicare Advantage and Medicare Prescription Drug Programs Expected to Remain Stable in 2026 — Centers for Medicare & Medicaid Services. Source for the $14.00 average Medicare Advantage premium in 2026 and the $16.40 figure for 2025.
- 2026 Medicare Advantage and Part D Rate Announcement — Centers for Medicare & Medicaid Services. Source for the projected 5.06% increase, or over $25 billion, in payments to Medicare Advantage plans for 2026.
- 2026 Star Ratings Fact Sheet — Centers for Medicare & Medicaid Services. Source for the 3.98 enrollment-weighted average star rating.
- Final CY 2026 Part D Redesign Program Instructions — Centers for Medicare & Medicaid Services. Source for the $2,100 annual out-of-pocket cap on prescription drugs.
- CY2027 Landscape file (September 2026) and CY2026 Landscape file — Centers for Medicare & Medicaid Services. Source for our county-by-county test: premiums, drug coverage, in-network out-of-pocket limits and parent company of every plan in every county, 2026 and 2027.
The 2026 figures on this page were checked against the sources above on September 16, 2026. The 2027 county test comes from our own count of the CMS Landscape files, made on October 18, 2026.
Update history
- September 2, 2026 — First published.
- October 18, 2026 — Added our county-by-county test of the 2027 plans: which company sells the lowest out-of-pocket limit among $0-premium plans with drug coverage, how often that changed from 2026, and how far apart one company’s own plans are in the same county. Title updated to 2027.
Disclaimer: Figures mentioned in this article reflect 2026 data from the Centers for Medicare & Medicaid Services (CMS) and KFF analysis, and vary by state, county and plan. Always confirm current details directly with Medicare.gov, 1-800-MEDICARE, or a licensed agent before making a decision.
Unai Sampedro founded and edits Medicare Plan Compass. He is not a licensed insurance agent or broker and takes no commission from any insurer; the site is funded by advertising. Articles are written from CMS and Medicare.gov documents and reviewed each year when new figures are published. Nothing here is personalized advice: the goal is to explain the rules in plain language so readers can ask better questions before they speak to someone who can advise them.