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Nearly 3.2 million people in Medicare Advantage will need a new plan for 2027 as insurers discontinue coverage, according to an analysis of federal data. A separate analysis found 193 U.S. counties where no plan with drug coverage will be open to the general public.
The 3.2 million estimate comes from Medicare Market Insights and represents about 11% of people in individual Medicare Advantage plans, the private alternative to traditional Medicare.
The county count comes from KFF, a nonprofit health policy research group. Those counties are home to 638,000 beneficiaries, or 1% of everyone on Medicare, up from 399,000 people in 123 counties this year.
Open enrollment, the yearly window to change Medicare coverage, began Oct. 15 and ends Dec. 7. Nationally, choice remains broad. The Centers for Medicare & Medicaid Services (CMS) says more than 99% of beneficiaries will be able to choose at least one Medicare Advantage plan where they live, and 97% will have 10 or more to pick from.
What should you do if your Medicare Advantage plan is ending in 2027?
Start with the notice from your insurer. If it says your plan is being discontinued, you’ll need to choose new coverage before open enrollment closes Dec. 7.
Most people will have options. KFF says the average beneficiary can choose from 28 Medicare Advantage plans with drug coverage next year. Before you switch, check the plan’s doctor network, your prescriptions and your potential out-of-pocket costs.
Your two main paths are another Medicare Advantage plan or traditional Medicare. Here’s how they compare:
| Traditional Medicare | Medicare Advantage | |
|---|---|---|
| Who runs it | The federal government | Private insurance companies |
| Doctors and hospitals | Broader choice of providers | Narrower networks; some treatments need prior approval |
| Prescription drugs | Added through a separate Part D plan | Included in many plans |
| Availability | Every county | Varies by county |
Medicare Advantage plans can also offer lower premiums, a cap on out-of-pocket spending and extras such as dental, vision and hearing coverage.
Medicare.gov, 1-800-MEDICARE and your State Health Insurance Assistance Program can help you compare plans for free.
Where will there be no Medicare Advantage plans in 2027?
KFF found that the 193 counties without a Medicare Advantage drug plan for general enrollment are spread across U.S. territories other than Puerto Rico and these 16 states:
- Alaska
- California
- Colorado
- Idaho
- Kansas
- Minnesota
- Montana
- Nebraska
- Nevada
- New Hampshire
- North Dakota
- Oklahoma
- Oregon
- South Dakota
- Utah
- Vermont
Alaska is the most extreme case. No county in the state will have a plan open to general enrollment, which affects about 110,000 beneficiaries. New Hampshire, North Dakota and Oklahoma are new to the list this year.
In 187 of those counties, no Medicare Advantage plan of any kind will be open to the general public. The remaining six, in Nebraska and South Dakota, still have a plan without drug coverage. Traditional Medicare remains available everywhere.
Which insurers are pulling out of the most counties?
Some of the exits hit rural areas, such as four Minnesota counties where three insurers each are leaving. Others reach big markets, including Miami-Dade County, Florida, and Monroe County, New York, which includes Rochester.
Health Care Service Corporation is exiting the most counties, 498, followed by Centene (359), UnitedHealth Group (228) and Humana (62). KFF ties the pullback to cost pressures, local market conditions and insurers’ views on profitability.
Which US states are losing the most Medicare Advantage plans in 2027?
CMS state-by-state data show plan choices shrinking in 29 of the 51 places where individual Medicare Advantage plans are sold: 49 states, Washington, D.C., and Puerto Rico. The count is rising in 21 states and holding steady in Puerto Rico.
The national total barely moves, dipping from 5,553 plans to about 5,532. Florida is losing the most plans, going from 611 to 560, followed by Ohio (212 to 180) and Illinois (157 to 136).
In percentage terms, the steepest drops are in these states:
- Wyoming: 14 plans to 8, down about 43%
- Montana: 32 to 23, down 28%
- Maryland: 63 to 47, down about 25%
- Washington, D.C.: 20 to 15, down 25%
- Minnesota: 68 to 53, down 22%
Tennessee is adding the most plans, going from 132 to 155, followed by Missouri, Arizona and Alabama.