The Data Is Unmistakable: More Medicare Members Than Ever Are Ready to Switch

Every year before AEP, researchers and health policy organizations track how many Medicare beneficiaries are likely to change their plan. This year, that number is the highest it has ever been — driven by a convergence of falling satisfaction, benefit reductions, rising out-of-pocket costs, prior authorization frustrations, and network instability that have been building for three consecutive enrollment cycles.

J.D. Power: MA Satisfaction Down 41 Points Over Two Years

The 2026 J.D. Power Medicare Advantage Study — based on nearly 15,000 Medicare Advantage member responses — found that overall member satisfaction now stands at 611 on a 1,000-point scale. That is down 12 points from 2025 and 41 points from 2024, per reporting by Kiplinger and TechTarget Healthcare.

The steepest two-year declines were in:

• Time and money savings: down 51 points
• Level of trust in the plan: down 49 points
• Coverage options meeting individual needs: down 47 points

The trust decline alone is a significant signal. When members no longer trust their plan to cover what they need when they need it, they start looking for alternatives — and the window to capture that search is AEP.

Deft Research: Record 21% of MA Members Considering Switching

Deft Research, which tracks Medicare member experience and switching behavior longitudinally, found that 21% of Medicare Advantage seniors are dissatisfied and considering switching heading into AEP 2026 — marking three consecutive records for MA switching intent in under a year, according to their 2026 AEP Gut Check Study. MA member loyalty declined by 6% over the same period, while the share of members at risk of switching grew by 4%.

During the last AEP, Deft recorded the largest single-year increase in MA switching ever observed — 23% of members switched, up from 16% in 2024 and 12% in 2022. Their research notes that “this fall’s AEP is expected to be highly active.”

2.9 Million Members Forced to Switch — Before They Even Chose To

The switching pressure in 2026 is not only voluntary. According to actuary research, approximately 2.9 million Medicare Advantage enrollees in non-employer HMO and PPO plans — roughly 10% of that population — were forced to find new coverage for 2026 after their plan exited their county, per actuary.info. That rate had averaged just over 1% annually from 2018 to 2024 before climbing to 6.9% in 2025 and hitting 10% in 2026.

For 2027, Humana alone is exiting MA markets covering 600,000 members, and Presbyterian Health Plan is exiting markets affecting approximately 30,000 subscribers. Millions more face network disruptions from health systems — including Naples Comprehensive Health dropping Cigna and Wellcare MA effective January 1 — that will force coverage decisions before the December 7 AEP deadline.

Why Are So Many Medicare Members Considering Switching?

Understanding the reasons behind switching intent is what separates a broker who loses a client to confusion from one who becomes a trusted long-term advisor. The data is consistent and clear.

1. Prior Authorization: Denied, Delayed, Overturned

The single biggest driver of Medicare Advantage dissatisfaction and switching is prior authorization — the insurance company requirement that certain medical services be approved before they are delivered.

According to a KFF analysis published in 2026, Medicare Advantage insurers denied 12% of standard prior authorization requests in 2025 — approximately one in eight. Among the most expensive types of post-acute care, denial rates were dramatically higher:

• Long-term acute care hospitals: 65% of requests denied
• Inpatient rehabilitation facilities: 54% of requests denied
• Skilled nursing facilities: 12% of requests denied

The most telling statistic: 67% of MA prior authorization denials that were appealed were ultimately overturned, per the same KFF analysis. A separate HHS Office of Inspector General report found that the three largest MA organizations denied requests for long-term acute care and inpatient rehabilitation at some of the highest rates in the program — yet most of those denials were reversed on appeal.

For members who experienced a denial that blocked or delayed their care, the intent to switch is significantly higher. University of Michigan research published in 2025 found that trouble getting needed care and dissatisfaction with care quality — not cost — were the primary drivers of leaving a Medicare Advantage plan entirely for Original Medicare, according to University of Michigan Health News. Members in poor health were more than twice as likely to report trouble accessing care — and those are precisely the members most likely to switch.

2. Benefit Reductions and Plan Changes

As carriers absorbed financial losses from high MA medical cost ratios, many reduced supplemental benefits — dental, vision, hearing, and OTC allowances — for 2026. What attracted a beneficiary to a plan two years ago may not exist at the same level today. KFF data show that the average Medicare beneficiary had 39 Medicare Advantage plans available in 2026 — down from 42 in 2025 — and fewer MA-PD options, per KFF’s plan landscape analysis. When a plan cuts benefits, loyalty evaporates.

3. Network Instability: Losing Trusted Doctors and Hospitals

At least 25 major health systems dropped Medicare Advantage contracts in 2026 alone — following 40 in 2025 and 32 in 2024 — per Becker’s Hospital Review tracking. Beneficiaries who received a letter telling them their hospital or doctor was no longer in their plan mid-year had, at most, 30 to 45 days notice under federal rules. Those members arrive at AEP motivated and ready to change.

4. New Member Confusion and Unmet Expectations

J.D. Power found that only 38% of first-year Medicare Advantage members feel their service expectations are met. New enrollees frequently struggle with understanding their benefits, locating in-network providers, navigating prior authorization, and managing deductibles. That gap between expectation and reality in year one creates a predictable wave of switching intent by the following AEP.

5. ACA Marketplace Members: Cost Shock After Subsidy Expiration

The end of enhanced ACA premium tax credits hit Marketplace enrollees hard in 2026. A KFF follow-up survey of 2025 ACA Marketplace enrollees found that 63% said they felt “worried” and 52% said they felt “angry” while evaluating coverage options for 2026. Nearly half (46%) said the process made them feel “confused.” Of those who had Marketplace insurance in 2025, 50% either switched plans or obtained coverage elsewhere in 2026, while 9% said they are now uninsured. The emotional and financial volatility in the under-65 market creates significant opportunity for proactive brokers who can simplify the decision.

What This Means for the Medicare Advantage Enrollment Outlook

The cumulative effect of falling satisfaction and rising switching intent has already begun to show up in enrollment figures. CMS projects MA enrollment will fall from 34.9 million in 2025 to approximately 34 million in 2026 — the first projected decline in MA enrollment in years — per Healthcare Dive. That represents MA’s share of the Medicare population dropping from approximately 50% in 2025 to an estimated 48% in 2026.

Meanwhile, KFF data show 56.1 million people are enrolled in Medicare Part D as of February 2026 — with the MA-PD share holding at 56% despite enrollment declines in the broader MA market. The data tells a clear story: members are not leaving Medicare. They are reconsidering which type of Medicare coverage best serves them.

For brokers, this is the most important distinction. A client who is dissatisfied with their Medicare Advantage plan is not lost — they are looking for guidance. The broker who understands what is driving their dissatisfaction and can frame both the MA and Medigap options clearly is positioned to retain and potentially upgrade that client relationship for years.

The Broker’s AEP 2026 Playbook: How to Win Switching Clients

Record switching intent only creates opportunity for brokers who are prepared. Here is the practical framework for capturing this AEP’s momentum.

Step 1: Contact Your Existing Book Before October 15 — Not After

The research is consistent: Medicare members who are going to switch have usually made the emotional decision before AEP opens. They are looking for someone to confirm and execute the decision — not someone to convince them. Brokers who reach clients in September and early October with a proactive review invitation are the ones who get the call. Brokers who wait for AEP to start are chasing leads that someone else already converted.

Your outreach message does not need to be complicated: “AEP opens October 15. Before I recommend any changes to your plan, I want to make sure your doctors are still in-network and your plan still makes sense for 2027. Let’s set up a quick review.”

Step 2: Know Who Is Most Likely to Switch — And Reach Them Specifically

Based on the data, the highest-probability switching clients in your book are:

• Members enrolled in any plan that is exiting their county for 2027 — Humana’s 600,000, Presbyterian’s 30,000, or any local carrier
• Members in Cigna/Healthspring or Wellcare MA who use NCH or another system that is dropping those networks (Southwest Florida brokers: this is urgent)
• Members in plans with benefit reductions for 2027 — dental or vision cuts, OTC reduction, premium increases
• Any client who experienced a prior authorization denial in the past 12 months
• First-year MA members — only 38% feel their expectations are being met
• ACA Marketplace clients whose 2026 premiums increased significantly due to subsidy changes

Step 3: Lead the Medigap Conversation — Especially for the Right Clients

The data from the University of Michigan study points directly to the profile of the ideal Medigap candidate: a member who has had difficulty getting needed care, who has experienced prior authorization delays, who has chronic or complex health needs, or whose preferred providers are leaving MA networks. For these clients, the premium increase of Plan G or Plan N is predictable and often offset by avoided surprise costs and restored access to care they trust.

The guaranteed issue conversation also matters now. Members in exiting MA plans may have a guaranteed issue right to enroll in Medigap without underwriting — but that right is time-limited. Brokers who surface this window early get the business. Brokers who mention it after the window closes have a frustrated client with fewer options.

Step 4: Serve the Forgotten ACA Client

While Medicare gets most of the attention during enrollment season, the under-65 ACA Marketplace is equally dislocated heading into 2027. KFF data show 63% of 2025 Marketplace enrollees felt worried, 52% felt angry, and 46% felt confused during their 2026 coverage search. These clients need a broker who can simplify the decision — not a website with 47 filter options.

For brokers who also handle ACA plans: the cross-sell conversation is real. A Medicare client with an under-65 family member — a spouse, adult child, or aging parent — is a multi-product household waiting for a broker who asks the right question.

Step 5: Get AHIP-Certified Before AEP Opens

None of this client work is possible if you are not certified to sell Medicare Advantage plans for the new plan year. AHIP certification for 2027 is required before writing any AEP business. Affordable Care Agents provides access to AHIP certification at a reduced rate through our OIM partner portal — available now at ahipmedicaretraining.com/clients/oim. Do not wait until October 14.

Frequently Asked Questions: Health Insurance Switching and AEP 2026