While the recent annual declines in total Medicare supplement policyholders are expected to continue over the near term, it is anticipated that the market will return to an annual growth position by 2026. This return to growth coincides with the continued increases in the Medicare eligible population as well as uncertainty around the Medicare Advantage market.

Despite the recent headwinds, Medicare supplement coverage will continue to be a popular choice amongst beneficiaries for its consistent benefits and lack of provider networks. As the Medicare-eligible population continues to grow, there will be ample opportunity for carriers, reinsurers, agents, and product administrators to capitalize on the opportunity and provide this important coverage to beneficiaries.

As of year-end 2023, the number of in force Medicare supplement policies was over 14.15 million, which was a decrease of approximately 178,000 policies (1.2%) from 2022. It is anticipated that this slide will continue through 2025 until returning to growth in 2026.

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Despite the decrease of in force policies, Medicare supplement earned premium grew by over $618 million (1.7%) in 2023. This aspect of the Medicare supplement market is expected to continue to grow with over $47 billion of total earned premium being realized in 2033.

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An important component embedded within the total earned premium projection is new business premium. The estimated 2023 new business premium was $4.0 billion, which was a decrease of $100 million (2.4%) from 2022. While this downward trend is projected to continue through 2025, it is estimated that new business premium will return to current levels and grow to $4.65 billion in 2033.

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