Weiss Ratings says Medigap gains ground as Medicare Advantage growth slows in U.S.

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Medigap vs. Advantage enrollment

Highlights

Medigap enrollment rises 7.4% while Medicare Advantage grows only 1.7% in the 12 months to Q2 2026, according to Weiss Ratings.
Medigap premiums for H1 2026 climb 16.7% year-over-year to $9.45 billion, with premium per enrollee up roughly 8.7%; Medicare Advantage premiums rise 9.0% to $271.4 billion.
The number of Medicare Advantage insurers drops from 513 to 489 over two years, and Medigap providers decrease by eight, indicating shrinking market competition.

Enrollment trends and pricing shifts

As reported by Weiss Ratings, new findings released on October 30 show Medicare Supplement insurance, also known as Medigap, is gaining share as Medicare Advantage posts slower growth. The rating agency says Medicare Advantage enrollment rises 1.7% in the 12 months to the second quarter of 2026, while Medigap enrollment jumps 7.4%.

Weiss says Medicare Advantage added 1.16 million enrollees between the second quarter of 2024 and the second quarter of 2025, but only 474,955 in the following 12 months, a 59% slowdown in net additions. Medigap moves in the opposite direction, adding 359,641 enrollees in the first period and 457,980 in the second, lifting its share of combined enrollment in the two products from 17.7% to 18.8% over two years.

The premium data also points to diverging trends. Medigap premiums collected in the first half of 2026 rise 16.7% from a year earlier to $9.45 billion, outpacing enrollment growth and indicating a roughly 8.7% increase in premium per enrollee, while Medicare Advantage first-half premiums rise 9.0% to $271.4 billion on 1.7% enrollment growth.

Choice and insurer stability in focus

The competitive landscape is also narrowing. The number of companies offering Medicare Advantage falls from 513 to 489 over two years, including a net loss of 20 carriers in the latest 12 months, while Medigap loses eight carriers over the same period.

Weiss argues that fewer competitors can mean less choice for seniors and weaker pressure on insurers to contain prices and preserve benefits. Gavin Magor, the agency's director of ratings and research, says the slower growth in Medicare Advantage does not signal strong consumer confidence, particularly as plan availability, provider networks and benefits can change from year to year.

The distinction matters because the products operate differently. Medicare Advantage plans typically rely on provider networks and may require prior authorization in exchange for lower or zero premiums, while Medigap policies work with Original Medicare, allow access to any provider that accepts Medicare and cover much of the remaining out-of-pocket cost, but generally charge higher monthly premiums.

For seniors in the U.S., switching decisions can carry longer-term consequences. People who leave a Medicare Advantage plan for Medigap after their initial eligibility window can, in most states, face medical underwriting and may be denied coverage or charged more, making the choice harder to reverse.

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