Mark Farrah Associates Noted Record Lows and Highs for Medicare Advantage and PDPs

PITTSBURGH: Mark Farrah Associates, www.markfarrah.com, assessed Medicare Advantage (MA), including MA with a Prescription Drug Plan (MA-PD), and stand-alone Prescription Drug Plan (PDP) performance, market share and market penetration by state as of April 1, 2026. Based on the Centers for Medicare & Medicaid Services (CMS) enrollment data and aggregated by Mark Farrah Associates (MFA) in Medicare Business Online™, total MA membership stood at 35.5 million and Medicare stand-alone PDPs covered 24.9 million members. Medicare Advantage (MA) market penetration remains strong; however, the growth rate has slowed to a record low, of 2.4%; while Prescription Drug Plan (PDP) enrollment soared to its highest growth rate level since 2013.

Key highlights include:

• Six of the top ten MA companies, each with more than 400,000 members in this segment, realized year-over-year declines, with an overall net gain of 1.5%; however, 78.2% of MA enrollees continue to opt for one of these top insurers.
• Two trends that also impacted MA plans’ growth in 2026 were in MA plans without prescription drug coverage and Special Needs Plans (SNPs). More than 23% of MA members are now in SNPs. The growth in MA plans with no prescription drug (no RX) coverage is related to a trend by some insurance carriers to split employer-based MA-PD plans into medical and stand-alone prescription drug plans (PDPs) in 2026.
• Stand-alone prescription drug plans’ (PDPs’), also referred to as Medicare Part D plans, enrollment increased by roughly 1.8 million enrollees, 7.8%, from April 2025. This is the highest increase in PDP members and year-over-year growth rates since 2013.
• Texas experienced the most sizeable year-over-year increase, gaining approximately 95,000 MA members.
• North Carolina had the largest year-over-year aggregate increase for PDP membership with over 189,000 more enrollees.

Many companies conduct their post-OEP (Open Enrollment Period) competitive assessments by using tools such as Mark Farrah Associates’ (MFA) Medicare Business Online™ and Health Coverage Portal™ to evaluate any changes in their market standings.

To read the FREE full text of “Record Growth Rates for Medicare Advantage Plans (Lowest) & PDPs (Highest)", visit the Analysis Briefs library on Mark Farrah Associates' website.

About Mark Farrah Associates (MFA)

Mark Farrah Associates (MFA) is a leading data aggregator and publisher providing health plan market data and analysis tools for the healthcare industry. MFA’s Medicare Business Online™ (MBO) product simplifies the tracking of monthly Medicare Advantage and PDP enrollment by competitor. The Medicare Benefits Analyzer™ presents benefit copay comparisons across hundreds of benefit attributes by plan as reported in the Plan Finder on Medicare.gov. MFA also offers Med Supp market data enrollment and financial insights for companies interested in Medicare Supplement business. Committed to simplifying analysis of health insurance business, our products also include: Health Coverage Portal™, County Health Coverage™, Health Plans USA™ and 5500 Employer Health Plus. Follow us on LinkedIn!

Fonte: Business Wire