2026 Medicare Advantage: Key Changes for DME Suppliers

Published in Member Communities on October 27, 2025

By Tyler Coulander, Market Strategy Manager, VGM & Associates

As the Medicare Advantage (MA) landscape undergoes significant transformation, durable medical equipment (DME) suppliers need to have a keen awareness of the most recent trends within this space. Major insurers are scaling back, and enrollment in MA plans is now projected to decline. This makes 2026 a pivotal year for anyone serving the Medicare population—including those in the DME space.

Several of the largest Medicare Advantage insurers are pulling back their geographic footprints in 2026. UnitedHealthcare is exiting 109 counties, impacting roughly 180,000 enrollees. Aetna is reducing its presence by 100 counties, and Humana is scaling back to 85% of U.S. counties, down from 89%^[1]. In Minnesota, UCare is exiting the MA market entirely^[2].

For the first time in 20 years, Medicare Advantage enrollment is expected to decline—from 35 million in 2025 to 34 million in 2026, according to CMS projections^[3]. While the drop may seem modest, it reflects a broader recalibration in the MA market. For DME providers, this could mean fewer patients covered under MA plans, which often have different authorization and billing requirements than traditional Medicare.

This shift may also influence how suppliers allocate resources between MA and Medicare Fee-for-Service (FFS), especially in regions where plan exits are concentrated.

It is worth noting that the recent release of this information from CMS shows a significant change from the latest Congressional Budget Office projections, which showed an increase in Medicare enrollment through 2034 at the time of their completed analysis.

Monitoring these developments will be critical for industry stakeholders to truly understand what direction Medicare enrollment is headed over the next several years. As we evaluate enrollment data over the next several years, we will be able to better understand the direction of Medicare Advantage.

Here are a few key actions DME suppliers should consider as they prepare for the 2026 changes:

Understand your payer mix: Identify which MA plans are exiting your service areas and assess the impact on your referral volume.
Strengthen relationships with traditional Medicare providers: With enrollment shifting, Medicare FFS may become a more important revenue stream.
Educate your referral partners: Help physicians and case managers understand how plan changes may affect DME access and coverage for their patients.

The Medicare Advantage market is entering a new era—one marked by regulation and recalibration. For DME suppliers, these changes present both challenges and opportunities. By staying informed and adapting proactively, suppliers can continue to serve patients effectively while navigating a more complex payer environment.