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Medicare Advantage

Special Needs Plans Now Enroll Nearly 1 in 4 Medicare Advantage Members, KFF Reports

A KFF analysis of 2026 Medicare Advantage enrollment finds that plans tailored to people with chronic illnesses or limited incomes have grown sharply and now represent nearly one quarter of all Medicare Advantage membership.

By the Goodsurance editorial teamSeptember 7, 2026

Special needs plans, a form of Medicare Advantage that restricts enrollment to people who meet specific health or income criteria, account for 23 percent of all Medicare Advantage enrollment in 2026, according to a KFF analysis published in July 2026. About 8.2 million people are enrolled in a special needs plan, an increase of more than 900,000 from 2025. Special needs plan growth drove 85 percent of the net increase in Medicare Advantage enrollment between 2025 and 2026. Total Medicare Advantage enrollment stands at 35.1 million, representing just over half of all eligible Medicare beneficiaries.

Three types of special needs plans exist. Dual-eligible special needs plans, known as D-SNPs, serve people who qualify for both Medicare and Medicaid and represent about 78 percent of all special needs plan enrollment. Chronic-condition special needs plans, known as C-SNPs, serve people with severe or disabling conditions such as diabetes and cardiovascular disease. C-SNP enrollment grew 45 percent from 2025 to 2026, reaching about 1.7 million enrollees, and nearly 97 percent of C-SNP plans focus on diabetes or cardiovascular conditions. Institutional special needs plans serve people in nursing homes or similar long-term care settings.

With the 2027 annual enrollment period opening October 15, people who qualify for a special needs plan may find it worth checking whether one is available in their area.

Nearly 1 in 4 Medicare Advantage members are now in a special needs plan. Find out what they are, who qualifies, and why enrollment keeps growing.

In plain words

A type of Medicare Advantage plan called a special needs plan has grown a lot this year. About 1 in 4 Medicare Advantage members now belong to one. These plans are only for certain people, such as those who have both Medicare and Medicaid, or those with serious health conditions like diabetes or heart disease. About 8.2 million people are in these plans now, up from about 7.3 million last year. If you have a qualifying condition, a special needs plan may be available near you. Open enrollment starts October 15.

Understand the basics first

Source: KFF
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