Goodsurance

Enrollment & timing

HMOs Captured Four of Every Five New Medicare Advantage Members Added in July

Monthly enrollment data published by CMS shows health-maintenance organizations gaining ground this summer while preferred-provider networks barely moved, part of a broader market realignment as carriers pull back on PPO products that proved costly.

By the Goodsurance editorial teamJuly 18, 2026

CMS Medicare Advantage and Part D contract-and-enrollment data for July 2026 shows total Medicare Advantage enrollment reached approximately 36.2 million, a gain of about 59,000 members from June. Within that gain, health-maintenance organizations accounted for roughly 47,000 new enrollees, or about 80 percent of the monthly increase. Local preferred-provider organizations added only about 11,000. From February through July 2026, HMOs absorbed 313,000 new members compared with 62,000 for PPOs.

Special-needs plans continued to lead growth across both plan types, reaching 8.4 million enrollees in July, or about 23 percent of all Medicare Advantage membership. Chronic-condition special-needs plans, which serve people with diagnoses such as diabetes or heart failure, saw especially fast growth, with enrollment roughly 45 percent higher in 2026 than in 2025, according to KFF analysis.

HMOs captured 4 out of 5 new Medicare Advantage members in July. Here is what that shift means for your network choices.

The tilt toward HMOs reflects a pattern playing out across the market in 2026: many carriers that expanded PPO offerings during the enrollment surge of the early 2020s have been consolidating or exiting PPO contracts that proved financially difficult to sustain as medical costs rose. PPO plans typically allow enrollees to see out-of-network providers, usually at higher cost-sharing, whereas HMOs generally require referrals and restrict coverage to a defined provider network.

For beneficiaries weighing a plan change during a qualifying special-enrollment period, the shift means fewer PPO options in some counties. CMS publishes the enrollment data each month, typically by the fifteenth.

In plain words

Medicare's private insurance option, called Medicare Advantage, had about 36.2 million members in July 2026. Most people who joined in July chose HMO plans, not PPO plans. HMO plans limit you to a set group of doctors and usually require a referral to see a specialist. PPO plans let you see more doctors but often cost more. Plans designed for people with chronic conditions or low incomes are growing the fastest and now cover about one in four Medicare Advantage members.

Understand the basics first

Source: CMS
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