Take a closer look at this interactive map, which shows the counties that have fewer Medicare Advantage insurers in 2026 than at any time during the previous five years. Note how parts of New England, the Upper Midwest and large areas in the West lost insurers.
Insurance companies rely on internal metrics to evaluate their geographic footprints, but they also react to what their competitors do. Company entrances and exits do not follow any trends when it comes to historical Medicare spending or federal payments. For 2026, insurers generally expanded in counties that had lower Medicare Advantage enrollment than the state average.
2022
2023
2024
2025
2026
The number of Medicare Advantage insurers varies by county
1 insurer
2 insurer
3 insurer
4 insurer
5+ insurers
No data
Counties with no insurers, 2026
Never had an insurer
Had at least one insurer in 2022, lost all by 2026
No insurers in 2022, gained then lost all by 2026
Only had one insurer
More than one insurer pre-2026, only one in 2026
No insurer in 2022, mixed results 2023-2025, one insurer 2026
Counties with one insurer, 2026
At least one insurer in 2026, but had none at some point 2022-2025
At least one insurer for all years examined
All others
Areas of biggest loss
The top five insurance companies are primarily responsible for the decrease in the availability of Medicare Advantage policies. Since 2024, these insurers’ exits have left 52 counties with no Medicare Advantage plans available. Still, they collectively account for 55% of all plans for 2026.
Total number of counties where the "Big Five" sold Medicare Advantage plans
Fewer counties served by largest insurers
0
1,000
2,000
3,000
4,000
5,000
2022
2023
2026
2024
2025
7,975
8,658
8,425
9,017
9,034
6,000
9,000
7,000
8,000
Aetna
Elevance Health
Humana
Kaiser Foundation Health Plan
UnitedHealthcare
Medicare Advantage enrollment climbs
Medicare Advantage plan availability peaked in 2024. That same year, the Centers for Medicare and Medicaid Services implemented a challenging new payment structure. Insurers have been dropping counties since.
Source: KFF
11
12
13
14
15
16
28
31
33
17
18
20
22
24
26
'10
'11
'12
'13
'14
'15
'22
'23
'24
'16
'17
'18
'19
'20
'21
2022
2023
2024
2025
2022
2023
2024
2025
Play
Pause
Watch the change over time
Total Medicare Advantage Enrollment, 2007-2025 (millions)
Source: Modern Healthcare analysis of Centers for Medicare and Medicaid Services data
Source: Modern Healthcare analysis of Centers for Medicare and Medicaid Services data
Source: Modern Healthcare analysis of Centers for Medicare and Medicaid Services data
'07
'08
'09
'25
8
9
10
34
1,840
1,978
2,227
2,248
2,103
983
1,105
1,067
1,090
952
2,659
2,782
2,828
2,770
2,655
116
116
118
118
118
2,377
2,677
2,777
2,808
2,597
2026
2026