UnitedHealth Group received the largest total Medicare Advantage bonus payments in 2026, pulling in $3.9 billion as total program spending reached $13.4 billion across all MA plans, according to a KFF analysis published July 1.
The $13.4 billion in quality bonus spending represents 2.3% of the $574 billion in projected 2026 MA payments. The share of all MA enrollees in bonus-eligible plans fell to 68% in 2026, down from 75% in 2025 and the lowest since 2018, after qualifying contracts dropped to 209 from 261.
Payers ranked by Medicare Advantage bonus payments in 2026:
UnitedHealth Group
Total enrollees: 9.2 million
Total bonus: $3.9 billion
Average bonus per enrollee: $423
Share of enrollees in plans with bonuses: 78%
CVS Health
Total enrollees: 4.1 million
Total bonus: $2 billion
Average bonus per enrollee: $491
Share of enrollees in plans with bonuses: 86%
Humana
Total enrollees: 7 million
Total bonus: $1.5 billion
Average bonus per enrollee: $214
Share of enrollees in plans with bonuses: 40%
Kaiser Foundation Health Plans
Total enrollees: 2 million
Total bonus: $1.2 billion
Average bonus per enrollee: $577
Share of enrollees in plans with bonuses: 100%
Elevance Health
Total enrollees: 1.9 million
Total bonus: $462 million
Average bonus per enrollee: $246
Share of enrollees in plans with bonuses: 51%
Health Care Service Corp.
Total enrollees: 900,000
Total bonus: $323.8 million
Average bonus per enrollee: $376
Share of enrollees in plans with bonuses: 66%
Centene
Total enrollees: 900,000
Total bonus: $21.5 million
Average bonus per enrollee: $23
Share of enrollees in plans with bonuses: 6%
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