By Petra Brock, Senior Research Manager
The Medicare Advantage (MA) market has seen massive membership growth, now accounting for more than half—51%—of all eligible Medicare beneficiaries.1 And although plans are projecting a decline in MA membership in 2026 of around 900,000 members, the Centers for Medicare & Medicaid Services (CMS) expects MA enrollment to be more robust and stable.2
As the MA market has grown, so has the market of special needs plans (SNPs). Today, slightly more than 1 in 5 MA beneficiaries are enrolled in a SNP.3 And while the vast majority of SNP beneficiaries are enrolled in Dual Eligible Special Needs Plans (D-SNPs), over the last year in particular, enrollment in SNPs that serve individuals with certain chronic conditions—C-SNPs—has skyrocketed. Between the declared end of the COVID-19 pandemic to September of this year, C-SNP enrollment has tripled from just shy of half a million members to 1.4 million members. Comparatively, membership in C-SNP grew at a much more conservative 28% during the COVID years, from slightly less than 400,000 at the start of the pandemic to almost 500,000 at its declared end.3
In 2023, more than 90% of seniors aged 65 and older reported having at least one chronic condition, with 79% reporting having two or more.4 Although the chronic conditions included in this study weren’t identical to the list of chronic conditions covered by C-SNPs (see Table 1, below), it does illustrate the high prevalence of chronic conditions among the senior population. Specifically in terms of some of the chronic conditions covered by C-SNPs, the prevalence of diagnosed heart disease in 2020 was 18% among seniors,5 while in 2023, the reported prevalence of chronic obstructive pulmonary disease (COPD) was 19%6 and the prevalence of diabetes was 27%7 among seniors. Obviously, there is tremendous growth potential in the C-SNP market. Yet, despite the recent spike in the market’s membership, membership is still only 4% of the entire Medicare Advantage landscape. This raises the question: Why?
One potential answer could be the relatively small number of plans specifically designed for people with chronic conditions. For the 2026 plan year, a total of 5,556 Medicare Advantage plans will be available nationally. Of those, 562 are plans specifically designed for beneficiaries with chronic conditions—10.1% of all available MA plans.8 Complicating this matter further is that the number of available C-SNPs vary by state, with some states offering no C-SNPs at all while others offering vast numbers—including Florida, which will offer a whopping 114 C-SNPs in 2026.8
An additional factor in low C-SNP membership could be the type of chronic conditions currently covered by C-SNPs. The vast majority of C-SNPs focus on just three conditions—either alone or in combination with other conditions. Of the 562 C-SNPs available nationally in 2026, 86% are designed to address chronic heart failure, 86% address cardiovascular disorders, while 87% address diabetes mellitus. Other chronic conditions covered by C-SNPs include chronic kidney disease (offered by 6% of all 562 C-SNPs), chronic lung failure (6%), chronic mental health (1%), as well as dementia, HIV/AIDS, and chronic alcohol/drug dependence (one plan each). Currently, no C-SNPs have been designed to directly address cancer, severe hematologic disorders, end-stage liver disease, or stroke.8 Obviously, expanding the number of health plans is critical; however, it would probably be best to focus on conditions that can more easily be controlled and that would impact a larger proportion of seniors.
Further hampering uptake of C-SNPs is a lack of familiarity of these types of plans. Deft’s 2025 Dual Eligible Acquisition Study found that just 24% of Dual Eligible beneficiaries in some type of Medicare coverage were aware of C-SNPs; among beneficiaries in Medicare Advantage coverage specifically, only 28% said they had heard of C-SNPs. As seen in Deft’s 2025 Dual Eligible Retention Study, after being told what a C-SNP offers, only 29% of Dual Eligible beneficiaries said they would be very or extremely likely to consider switching to such a plan even if it were tailored to their chronic condition. However, appeal did increase as members became more polychronic, although it required having five chronic conditions or more for high likelihood of switching to reach 45%.
KPIs vary substantially by type of plan, with members in SNPs giving both higher plan ratings as well as being more likely to recommend their plans. As Deft’s 2025 Dual Eligible Retention Study reported, C-SNP beneficiaries were much more likely to give high plan ratings and high NPS scores than their counterparts in non-SNPs and were just as likely to report planning to stay in their chronic needs plans as other MA members (see Figure 1 below).
There is good potential for growth in the C-SNP space, particularly given the large percentage of seniors living with the type of chronic conditions covered by these types of plans. Growth may be thwarted by the relatively low percentage of C-SNPs currently available, particularly in some states, as well as the type of chronic conditions currently included in available C-SNPs. In addition, low familiarity with the product is also likely stifling growth. However, all these issues can be addressed. Education about this specific plan type is vital. In addition, focusing on the potentially improved wellness these plans provide, rather than the specifics of the diseases, may also make C-SNPs more appealing. Ultimately, though, making the availability of this product more widely known, particularly among those seniors currently impacted by the type of conditions that are covered, could mean not just a steady increase in membership but also more seniors obtaining assistance managing their chronic conditions and ultimately better health outcomes.
1 Deft analysis of CMS’ Medicare Monthly Enrollment, May 2025.
2 CMS. Medicare Advantage and Medicare Prescription Drug Programs Expected to Remain Stable in 2026. September 26, 2025.
3 Deft’s MA Growth Tracker, an analysis of CMS’ Monthly Enrollment by Contract/Plan/State/County file.
4 Watson, KB et al. Trends in Multiple Chronic Conditions Among US Adults, By Life Stage, Behavioral Risk Factor Surveillance System, 2013–2023, April 17, 2025.
5 CDC. QuickStats: Percentage of Adults Aged ≥18 Years with Diagnosed Heart Disease, by Urbanization Level and Age Group—National Health Interview Survey, United States, 2020. June 10, 2022.
6 Weeks, J.D. and Elgaddal, N. Chronic obstructive pulmonary disease in adults age 18 and older: United States, 2023. May 2025.
7 Gwira, J.A. et al. Prevalence of total, diagnosed, and undiagnosed diabetes in adults: United States, August 2021–August 2023. November 2024.
8 Deft analysis of the 2026 CMS Landscape and Crosswalk data.