Where $0 Medicare Advantage plans are disappearing in 2027
We compared every general-audience Medicare Advantage plan in the CMS landscape files for 2026 and 2027, county by county. 74 counties that had at least one $0-premium plan this year have none for 2027. About 2.9 million people are in a plan that ends or stops covering their county, and 72% of the 3,107 counties with a plan have fewer to pick from. Open enrollment runs October 15 to December 7, 2026.
Key findings
- 74 counties lose all of their $0-premium plans. Minnesota (22) and North Dakota (22) account for 44 of them; the rest are in Idaho, Oklahoma, South Dakota, Montana, Colorado, Nebraska, Washington, and Utah. 67 of the 74 are nonmetro counties. In 61 of them no general-audience Medicare Advantage plan is offered at all for 2027; the other 13 still have plans, but every one charges a premium. About 40,000 people were in a Medicare Advantage plan in these counties in October 2026, and 98% of them are in a plan that ends or leaves the county. Only 5 counties gain a $0 option they didn’t have.
- About 2.9 million people are in a plan that ends or leaves their county. That’s 13.5% of the 21.5 million people in general-audience Medicare Advantage plans: their plan ends for 2027 or no longer covers their county. If they don’t pick a new plan, they go back to Original Medicare on January 1. Of the 16.5 million people in a $0-premium plan, about 2.0 million are in one that ends or leaves their county, and about 689,000 more are in one that stays but starts charging a premium where they live.
- The cheapest bad year costs more. CMS projects the average Medicare Advantage premium, weighted by enrollment and including Special Needs Plans, to fall 16.5% for 2027. But premiums are only part of the bill. Add a year of premiums to the out-of-pocket cap, and the lowest-cost plan with drug coverage in the typical county goes from $4,174 to $4,870. That worst-case cost rises in 2,325 of 3,032 counties and falls in 351.
- Higher out-of-pocket caps. The median in-network maximum out-of-pocket rose from $5,900 to $6,600. CMS raised the ceiling from $9,250 to $9,850, and 383 plans (10.8%) sit right at it, up from 336 (9.0%).
- Fewer plans almost everywhere, and the cuts hit PPOs. The number of plans fell from 3,753 to 3,553 (−5.3%), and $0-premium plans from 2,562 to 2,443 (−4.6%). PPO plans fell from 1,591 to 1,426, while HMO plans went from 2,139 to 2,115. 2,236 of 3,107 counties have fewer plans than in 2026; 547 have more. The typical nonmetro county goes from 22 plans to 18; the typical metro county from 33.5 to 30.
- Twelve parent companies stop selling general-audience Medicare Advantage plans, led by Group 1001 (Clear Spring Health), Molina Healthcare (Central Health Medicare Plan and others), and CHRISTUS Health (CHRISTUS Health Advantage); four of the twelve still offer Special Needs Plans. Four new ones enter. Among those that stay, Health Care Service Corporation shrinks the most, from 948 counties to 450; Devoted Health grows the most, from 999 to 1,341.
- More plans rated 4 stars, fewer at the top. The share of plans under a contract rated 4 stars or higher rose from 58.0% to 62.5%, but plans rated 4.5 or 5 stars fell from 1,241 to 806. These are counts of plans, not weighted by how many people are in them.
Counties losing every $0 plan
A $0 plan premium was available in 3,094 of the 3,105 counties with a general-audience plan in 2026. For 2027 that drops to 3,025 of 3,040. 67 of the 74 counties losing every $0 plan are nonmetro, by the USDA’s 2023 Rural-Urban Continuum Codes, and 62 are in the Upper Midwest and Plains (Minnesota, the Dakotas, Nebraska, Oklahoma and Montana).
Counties that lose every $0-premium plan in 2027, by state
General-audience Medicare Advantage plans. Hover or tab to a bar for the share of the state’s $0 counties.
Source: YourBestHealthPlans analysis of CMS CY2026 and CY2027 landscape files.
In 65 of the 74 counties, every company that sold a $0 plan there in 2026 sells no general-audience plan there in 2027: the carrier left rather than adding a premium. The parent companies whose $0 plans were in these counties in 2026:
| Parent organization (CMS) | Plan brand | Affected counties with its $0 plan in 2026 | Of those, counties it leaves in 2027 |
|---|---|---|---|
| Blue Cross Blue Shield of Michigan Mutual Ins. Co. | NextBlue of North Dakota; Wellmark Advantage Health Plan | 25 | 25 |
| UnitedHealth Group, Inc. | UnitedHealthcare | 24 | 23 |
| Humana Inc. | Humana | 13 | 13 |
| Aware Integrated, Inc. | Blue Cross and Blue Shield of Minnesota | 8 | 8 |
| Medica Holding Company | Medica | 8 | 8 |
| CVS Health Corporation | Aetna Medicare | 5 | 5 |
| Health Care Service Corporation | Blue Cross and Blue Shield of IL, NM, OK, TX; Blue Cross and Blue Shield of Montana | 3 | 3 |
| Allina Health and Aetna Insurance Holding Company | Allina Health Aetna Medicare | 2 | 2 |
| Centene Corporation | Wellcare | 2 | 2 |
| HealthPartners, Inc. | HealthPartners | 2 | 2 |
| Intermountain Health Care, Inc. | Select Health | 1 | 1 |
A county can appear under more than one carrier. Parent organization names are as CMS reports them.
Other options remain in many of these counties. A Medicare Cost plan is still sold in 46 of the 74 counties, including 41 of the 61 with no general-audience Medicare Advantage plan left. Cost plans are a different kind of Medicare health plan: you can also see doctors outside the network under Original Medicare rules. None of them is $0; the cheapest premium CMS lists is $48 to $53 a month, depending on the county. Special Needs Plans are also sold in many of these counties for people who qualify, such as those with both Medicare and Medicaid. And Original Medicare, with or without a Medigap policy and a Part D drug plan, is available everywhere.
All 74 counties (10 states)
| County | $0 plans in 2026 | All plans 2026 → 2027 | MA enrollees, Oct. 2026 | Cost plan in 2027 |
|---|---|---|---|---|
| Alamosa, ColoradoNonmetro | 3 | 7 → 0 | 689 | No |
| Rio Grande, ColoradoNonmetro | 2 | 4 → 0 | 669 | No |
| Benewah, IdahoNonmetro | 2 | 3 → 0 | 262 | No |
| Blaine, IdahoNonmetro | 4 | 7 → 1 | 1,021 | No |
| Idaho, IdahoNonmetro | 2 | 4 → 0 | 617 | No |
| Latah, IdahoNonmetro | 2 | 4 → 2 | 1,089 | No |
| Lemhi, IdahoNonmetro | 2 | 3 → 0 | 156 | No |
| Lewis, IdahoNonmetro | 2 | 3 → 0 | 83 | No |
| Nez Perce, IdahoMetro | 2 | 4 → 2 | 1,339 | No |
| Aitkin, MinnesotaNonmetro | 2 | 5 → 0 | 521 | Yes, from $48 |
| Carlton, MinnesotaMetro | 1 | 3 → 0 | 394 | Yes, from $48 |
| Chippewa, MinnesotaNonmetro | 5 | 9 → 0 | 1,159 | Yes, from $53 |
| Cook, MinnesotaNonmetro | 1 | 4 → 0 | 83 | Yes, from $48 |
| Crow Wing, MinnesotaNonmetro | 5 | 9 → 0 | 10,861 | No |
| Goodhue, MinnesotaNonmetro | 1 | 2 → 0 | 328 | Yes, from $48 |
| Koochiching, MinnesotaNonmetro | 1 | 4 → 0 | 259 | Yes, from $48 |
| Lake, MinnesotaNonmetro | 3 | 9 → 0 | 381 | Yes, from $48 |
| Lake of the Woods, MinnesotaNonmetro | 5 | 12 → 0 | 632 | No |
| Mahnomen, MinnesotaNonmetro | 5 | 10 → 2 | 379 | No |
| McLeod, MinnesotaNonmetro | 3 | 9 → 0 | 887 | Yes, from $48 |
| Meeker, MinnesotaNonmetro | 3 | 9 → 0 | 459 | Yes, from $48 |
| Mille Lacs, MinnesotaMetro | 3 | 8 → 0 | 745 | Yes, from $48 |
| Norman, MinnesotaNonmetro | 5 | 10 → 2 | 610 | Yes, from $53 |
| Pine, MinnesotaNonmetro | 1 | 2 → 0 | 502 | Yes, from $48 |
| Pipestone, MinnesotaNonmetro | 1 | 2 → 2 | 81 | Yes, from $48 |
| Polk, MinnesotaMetro | 5 | 10 → 2 | 2,456 | No |
| Red Lake, MinnesotaNonmetro | 5 | 10 → 2 | 545 | No |
| Rock, MinnesotaMetro | 1 | 2 → 2 | 234 | Yes, from $48 |
| Sibley, MinnesotaNonmetro | 3 | 7 → 0 | 563 | Yes, from $48 |
| Traverse, MinnesotaNonmetro | 2 | 6 → 2 | 45 | Yes, from $48 |
| Wadena, MinnesotaNonmetro | 5 | 9 → 0 | 1,944 | No |
| Custer, MontanaNonmetro | 4 | 6 → 0 | 347 | No |
| Hill, MontanaNonmetro | 4 | 6 → 0 | 214 | No |
| McCone, MontanaNonmetro | 2 | 4 → 0 | 12 | No |
| Rock, NebraskaNonmetro | 4 | 5 → 0 | 10 or fewer | Yes, from $53 |
| Sioux, NebraskaNonmetro | 3 | 3 → 0 | 12 | Yes, from $53 |
| Adams, North DakotaNonmetro | 1 | 3 → 0 | 16 | Yes, from $53 |
| Benson, North DakotaNonmetro | 2 | 7 → 0 | 64 | Yes, from $53 |
| Billings, North DakotaNonmetro | 1 | 3 → 0 | 10 or fewer | Yes, from $53 |
| Bottineau, North DakotaNonmetro | 1 | 3 → 0 | 75 | Yes, from $53 |
| Bowman, North DakotaNonmetro | 1 | 3 → 0 | 17 | Yes, from $53 |
| Burke, North DakotaNonmetro | 1 | 3 → 0 | 20 | Yes, from $53 |
| Cavalier, North DakotaNonmetro | 1 | 3 → 0 | 28 | Yes, from $53 |
| Divide, North DakotaNonmetro | 1 | 3 → 0 | 12 | Yes, from $53 |
| Dunn, North DakotaNonmetro | 1 | 3 → 0 | 30 | Yes, from $53 |
| Golden Valley, North DakotaNonmetro | 1 | 3 → 0 | 16 | Yes, from $53 |
| Hettinger, North DakotaNonmetro | 1 | 3 → 0 | 31 | Yes, from $53 |
| McKenzie, North DakotaNonmetro | 1 | 3 → 0 | 56 | Yes, from $53 |
| Mountrail, North DakotaNonmetro | 2 | 7 → 0 | 142 | Yes, from $53 |
| Pierce, North DakotaNonmetro | 1 | 3 → 0 | 58 | Yes, from $53 |
| Ramsey, North DakotaNonmetro | 3 | 9 → 2 | 251 | Yes, from $53 |
| Renville, North DakotaMetro | 1 | 3 → 0 | 47 | Yes, from $53 |
| Rolette, North DakotaNonmetro | 1 | 3 → 0 | 47 | Yes, from $53 |
| Slope, North DakotaNonmetro | 1 | 3 → 0 | 11 | Yes, from $53 |
| Stark, North DakotaNonmetro | 1 | 3 → 0 | 200 | Yes, from $53 |
| Towner, North DakotaNonmetro | 1 | 3 → 0 | 20 | Yes, from $53 |
| Ward, North DakotaMetro | 1 | 3 → 0 | 608 | Yes, from $53 |
| Williams, North DakotaNonmetro | 1 | 3 → 0 | 370 | Yes, from $53 |
| Beaver, OklahomaNonmetro | 5 | 7 → 0 | 93 | No |
| Cimarron, OklahomaNonmetro | 5 | 7 → 0 | 43 | No |
| Ellis, OklahomaNonmetro | 2 | 3 → 0 | 66 | No |
| Harmon, OklahomaNonmetro | 9 | 13 → 0 | 59 | No |
| Harper, OklahomaNonmetro | 2 | 3 → 0 | 38 | No |
| Roger Mills, OklahomaNonmetro | 5 | 7 → 0 | 76 | No |
| Texas, OklahomaNonmetro | 5 | 7 → 0 | 311 | No |
| Brule, South DakotaNonmetro | 2 | 3 → 0 | 12 | Yes, from $53 |
| Buffalo, South DakotaNonmetro | 2 | 3 → 0 | 10 or fewer | Yes, from $53 |
| Edmunds, South DakotaNonmetro | 1 | 2 → 0 | 45 | Yes, from $53 |
| Gregory, South DakotaNonmetro | 2 | 3 → 0 | 13 | Yes, from $53 |
| Jerauld, South DakotaNonmetro | 3 | 5 → 0 | 13 | Yes, from $53 |
| McPherson, South DakotaNonmetro | 1 | 2 → 0 | 14 | Yes, from $53 |
| Wayne, UtahNonmetro | 1 | 1 → 0 | 158 | No |
| Clallam, WashingtonNonmetro | 6 | 9 → 1 | 3,607 | No |
| Grays Harbor, WashingtonNonmetro | 3 | 7 → 4 | 2,670 | No |
Download: county list (CSV)
Look up your county
Type a county to see what changes there for 2027. The map colors every county by what happens to its $0-premium plans; select a county on the map to see its numbers.
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What happens to $0-premium plans in each county, 2026 to 2027
Puerto Rico isn’t drawn; use the lookup. The same data is in the county CSV. Source: YourBestHealthPlans analysis of CMS CY2026 and CY2027 landscape files.
Who is affected
We matched each plan’s October 2026 enrollment, county by county, to CMS’s 2027 plan crosswalk, which says whether each plan renews, merges into another plan, shrinks its service area or ends. A person counts as affected if their plan ends, or if the plan it becomes isn’t sold in their county in 2027.
| Area | Counties | Lose every $0 plan | Lose every plan | Fewer plans | Plans in the typical county | Enrollees in a plan that ends or leaves |
|---|---|---|---|---|---|---|
| Nonmetro | 1,861 | 67 | 63 | 1,351 (73%) | 22 → 18 | 615,000 of 3.1 million (19.9%) |
| Metro | 1,238 | 7 | 4 | 877 (71%) | 33.5 → 30 | 2.2 million of 18.2 million (12.1%) |
Metro = USDA 2023 Rural-Urban Continuum Codes 1–3; nonmetro = 4–9. Connecticut’s 8 counties have no 2023 code because USDA now uses its planning regions, so they’re left out of this table. Enrollment is CMS’s October 2026 count; CMS hides plan-county cells of 10 or fewer people, so these are slight undercounts.
Out-of-pocket caps are going up
Every Medicare Advantage plan has to cap what you pay for covered in-network care in a year. For 2027 CMS lets plans set that cap as high as $9,850, up from $9,250. A $0 premium doesn’t make a plan cheap in a bad year: the cap is the number to compare.
| All general-audience plans | 2026 | 2027 |
|---|---|---|
| Plans | 3,753 | 3,553 |
| $0-premium plans | 2,562 (68.3%) | 2,443 (68.8%) |
| Median in-network out-of-pocket cap | $5,900 | $6,600 |
| Highest cap CMS allows | $9,250 | $9,850 |
| Plans at the highest cap | 336 (9.0%) | 383 (10.8%) |
| Counties with a plan | 3,105 | 3,040 |
| Plans in the median county | 26 | 24 |
Carrier exits and entries
Twelve parent organizations that sold general-audience Medicare Advantage plans in 2026 have none in the 2027 file. Four appear for the first time.
| Leaving | Plan brand | Plans in 2026 | Counties in 2026 |
|---|---|---|---|
| Group 1001 | Clear Spring Health | 6 | 138 |
| Molina Healthcare, Inc. | Central Health Medicare Plan; ConnectiCare; Molina Healthcare of California; Molina Healthcare of Illinois | 17 | 75 |
| CHRISTUS Health | CHRISTUS Health Advantage | 8 | 44 |
| Aspirus, Inc. | Aspirus Health Plan | 2 | 21 |
| Horizon Mutual Holdings, Inc | Braven Health | 10 | 21 |
| Providence St Joseph Health | Providence Medicare Advantage Plans | 7 | 13 |
| BMC Health System, Inc. | WellSense Health Plan | 4 | 10 |
| Elderplan, Inc. | Elderplan | 2 | 8 |
| Presbyterian Healthcare Services | Presbyterian Health Plan | 4 | 8 |
| Memorial Hermann Health System | Memorial Hermann Health Plan | 2 | 6 |
| Central Mass Health Holding LLC | Mass Advantage | 4 | 1 |
| Sharp Healthcare | Sharp Health Plan | 4 | 1 |
| Entering | Plan brand | Plans in 2027 | Counties in 2027 |
|---|---|---|---|
| Muscogee Creek Nation | Native Advantage | 1 | 11 |
| St. Luke's Health System, Inc. | St. Luke's Health Plan | 3 | 7 |
| MultiCare Health Systems | MultiCare Health Plan Medicare Advantage Evergreen Plans | 2 | 3 |
| MedCare Partners Holding, LLC | MedCare Partners Health Plan of Texas | 1 | 1 |
Bigger carriers that stay are pulling back too. The largest changes in county footprint:
| Parent organization (CMS) | Counties 2026 → 2027 | Plans 2026 → 2027 |
|---|---|---|
| Health Care Service Corporation | 948 → 450 | 232 → 149 |
| Centene Corporation | 1,731 → 1,387 | 187 → 110 |
| Blue Cross Blue Shield of Michigan Mutual Ins. Co. | 299 → 106 | 58 → 43 |
| UnitedHealth Group, Inc. | 2,597 → 2,457 | 524 → 490 |
| CVS Health Corporation | 2,083 → 1,960 | 483 → 464 |
| Humana Inc. | 2,655 → 2,598 | 653 → 621 |
| Elevance Health, Inc. | 1,030 → 974 | 170 → 164 |
| Blue Cross Blue Shield of Kansas | 51 → 6 | 5 → 4 |
| Devoted Health, Inc. | 999 → 1,341 | 241 → 407 |
| Singh Holdings LLC | 71 → 116 | 1 → 4 |
| Lumeris Group Holdings Corporation | 72 → 94 | 13 → 14 |
Counties here are counties where the parent sells at least one general-audience plan. The first 8 rows are the biggest losses, the last 3 the biggest gains.
Star ratings
CMS rates each Medicare Advantage contract from 1 to 5 stars on quality and member experience, and every plan under a contract shares its rating. The 2027 ratings, released in October 2026, are the ones shown during this enrollment period.
Medicare Advantage plans by overall star rating, 2026 vs. 2027
Number of general-audience plans. Source: CMS 2026 and 2027 Star Ratings data tables; CMS landscape files.
Star rating table
| Overall rating | Plans 2026 | Plans 2027 |
|---|---|---|
| 2.0 stars | 3 (0.1%) | 2 (0.1%) |
| 2.5 stars | 43 (1.1%) | 49 (1.4%) |
| 3.0 stars | 405 (10.8%) | 402 (11.3%) |
| 3.5 stars | 949 (25.3%) | 681 (19.2%) |
| 4.0 stars | 937 (25.0%) | 1,416 (39.9%) |
| 4.5 stars | 1,132 (30.2%) | 756 (21.3%) |
| 5.0 stars | 109 (2.9%) | 50 (1.4%) |
| Plan too new to be measured | 107 (2.9%) | 140 (3.9%) |
| Not enough data | 68 (1.8%) | 57 (1.6%) |
State by state
Plans are counted once per state they’re sold in. Median cap = median in-network maximum out-of-pocket across the state’s plans.
| State | Plans 2026 → 2027 | $0 plans 2026 → 2027 | Counties losing every $0 plan | Median cap 2026 → 2027 | At the max cap, 2027 |
|---|---|---|---|---|---|
| Alabama | 63 → 65 | 44 → 45 | 0 | $5,900 → $6,500 | 9.2% |
| Arizona | 84 → 90 | 73 → 80 | 0 | $4,900 → $5,450 | 0% |
| Arkansas | 56 → 54 | 43 → 45 | 0 | $6,700 → $6,750 | 7.4% |
| California | 272 → 259 | 185 → 176 | 0 | $2,900 → $2,900 | 0.8% |
| Colorado | 71 → 65 | 54 → 55 | 2 | $5,400 → $6,050 | 4.6% |
| Connecticut | 31 → 27 | 21 → 15 | 0 | $6,750 → $7,150 | 14.8% |
| Delaware | 24 → 24 | 17 → 15 | 0 | $6,725 → $7,150 | 20.8% |
| District of Columbia | 16 → 11 | 8 → 5 | 0 | $6,750 → $7,150 | 0% |
| Florida | 325 → 308 | 294 → 288 | 0 | $3,900 → $4,200 | 1.3% |
| Georgia | 107 → 99 | 84 → 80 | 0 | $9,250 → $9,850 | 53.5% |
| Hawaii | 35 → 37 | 18 → 19 | 0 | $6,700 → $7,150 | 0% |
| Idaho | 36 → 33 | 17 → 11 | 7 | $6,250 → $6,700 | 0% |
| Illinois | 124 → 106 | 96 → 81 | 0 | $4,800 → $5,200 | 7.5% |
| Indiana | 94 → 98 | 68 → 72 | 0 | $5,900 → $6,750 | 15.3% |
| Iowa | 45 → 41 | 28 → 25 | 0 | $5,000 → $6,500 | 4.9% |
| Kansas | 68 → 60 | 53 → 49 | 0 | $5,000 → $5,500 | 5% |
| Kentucky | 79 → 80 | 60 → 55 | 0 | $6,500 → $6,925 | 11.3% |
| Louisiana | 71 → 70 | 53 → 53 | 0 | $4,900 → $6,300 | 4.3% |
| Maine | 36 → 32 | 19 → 14 | 0 | $6,775 → $7,150 | 12.5% |
| Maryland | 38 → 30 | 16 → 14 | 0 | $7,500 → $7,500 | 3.3% |
| Massachusetts | 84 → 79 | 30 → 29 | 0 | $5,000 → $6,000 | 6.3% |
| Michigan | 148 → 131 | 68 → 63 | 0 | $5,100 → $6,000 | 9.2% |
| Minnesota | 55 → 40 | 19 → 14 | 22 | $5,000 → $6,900 | 12.5% |
| Mississippi | 49 → 51 | 39 → 40 | 0 | $6,000 → $6,900 | 13.7% |
| Missouri | 109 → 113 | 89 → 91 | 0 | $4,500 → $5,500 | 2.7% |
| Montana | 28 → 19 | 15 → 8 | 3 | $6,600 → $6,750 | 0% |
| Nebraska | 33 → 30 | 24 → 22 | 2 | $5,000 → $7,000 | 3.3% |
| Nevada | 64 → 58 | 56 → 49 | 0 | $2,975 → $3,950 | 0% |
| New Hampshire | 17 → 15 | 10 → 9 | 0 | $6,550 → $7,150 | 6.7% |
| New Jersey | 72 → 56 | 43 → 33 | 0 | $8,875 → $9,750 | 50% |
| New Mexico | 50 → 39 | 37 → 32 | 0 | $4,900 → $5,900 | 2.6% |
| New York | 147 → 145 | 62 → 59 | 0 | $8,900 → $9,750 | 49.7% |
| North Carolina | 122 → 120 | 88 → 96 | 0 | $6,250 → $6,950 | 27.5% |
| North Dakota | 15 → 12 | 7 → 5 | 22 | $6,500 → $6,825 | 0% |
| Ohio | 155 → 134 | 95 → 83 | 0 | $5,300 → $5,900 | 2.2% |
| Oklahoma | 56 → 52 | 41 → 37 | 7 | $5,700 → $6,050 | 5.8% |
| Oregon | 80 → 69 | 47 → 42 | 0 | $6,250 → $7,100 | 2.9% |
| Pennsylvania | 273 → 267 | 137 → 134 | 0 | $6,600 → $7,100 | 10.1% |
| Puerto Rico | 31 → 32 | 30 → 32 | 0 | $3,400 → $3,400 | 0% |
| Rhode Island | 14 → 13 | 9 → 7 | 0 | $5,825 → $6,750 | 0% |
| South Carolina | 69 → 68 | 50 → 51 | 0 | $8,200 → $9,250 | 42.6% |
| South Dakota | 13 → 15 | 6 → 5 | 6 | $5,500 → $7,150 | 0% |
| Tennessee | 93 → 105 | 64 → 75 | 0 | $5,100 → $6,200 | 6.7% |
| Texas | 272 → 228 | 220 → 183 | 0 | $5,925 → $6,500 | 7% |
| Utah | 38 → 33 | 28 → 24 | 1 | $5,800 → $6,700 | 3% |
| Vermont | 3 → 5 | 3 → 3 | 0 | $6,500 → $7,150 | 20% |
| Virginia | 103 → 106 | 70 → 78 | 0 | $6,750 → $7,150 | 26.4% |
| Washington | 89 → 71 | 52 → 43 | 2 | $6,600 → $6,750 | 5.6% |
| West Virginia | 55 → 51 | 35 → 30 | 0 | $6,900 → $7,150 | 15.7% |
| Wisconsin | 82 → 75 | 47 → 42 | 0 | $5,000 → $5,500 | 2.7% |
| Wyoming | 13 → 8 | 7 → 4 | 0 | $6,750 → $7,075 | 12.5% |
Download: every county (CSV) · state summary (CSV) · counties losing every $0 plan (CSV) · headline numbers (JSON)
Is your plan leaving? If your plan won’t be offered in 2027, it must send you a notice, and you get a Special Enrollment Period to pick a new plan. You can also switch during open enrollment, October 15 to December 7, 2026. Compare what’s left in your county in our state rankings or the Medicare Plan Finder. Free one-on-one help: your State Health Insurance Assistance Program.
Going back to Original Medicare? When your Medicare Advantage plan leaves your area, federal law gives you a guaranteed-issue right to buy certain Medigap policies without health questions, from 60 days before your plan coverage ends to 63 days after. Some states give more rights. Medigap guaranteed-issue rights by state.
How our numbers compare
Other analyses of the same CMS files count different things. Here’s how ours line up, so you can use them side by side.
| Measure | Published | Ours | Why they differ |
|---|---|---|---|
| Medicare Advantage plans, 2026 | 5,553 (CMS) | 5,553 with Special Needs Plans; 3,753 without | Same count. This study leaves out the 1,800 Special Needs Plans, which only some people can join. |
| Medicare Advantage plans, 2027 | about 5,532 (CMS) | 5,522 with Special Needs Plans; 3,553 without | CMS gave an approximate figure; ours is counted from the 2027 landscape file. |
| Counties with no general-audience drug plan | 123 → 193 (KFF) | 63 → 133 | Same rise of 70. Ours covers only the 3,167 counties listed in the CMS file; KFF’s also covers counties with no plan of any kind, such as Alaska’s. The gap is the same 60 counties in both years. |
| Counties carriers leave and enter (drug plans) | KFF | Identical for all six carriers below | Health Care Service Corporation: 498 out, 0 in; UnitedHealth Group: 228 out, 9 in; Humana: 62 out, 4 in; Centene Corporation: 359 out, 15 in; CVS Health Corporation: 186 out, 63 in; Devoted Health: 0 out, 342 in. |
| Average premium | $14.37 → $12.00 (CMS) | Not computed | CMS weights by projected enrollment and includes Special Needs Plans. We report the worst-case year instead. |
CMS: Medicare Advantage and Medicare Prescription Drug Programs Expected to Remain Stable in 2027, September 28, 2026. KFF: Medicare Advantage Plan Availability Varies Widely by County for 2027, October 9, 2026. Both read October 18, 2026.
Methodology
Data. CMS Medicare Advantage and Prescription Drug Plan Landscape files for contract years 2026 (CY2026_Landscape_202609.csv, data last updated September 2, 2026) and 2027 (CY2027_Landscape_202609.csv, released September 2026, revised September 30, 2026). Star ratings: CMS 2026 Star Ratings data tables (summary ratings as revised July 22, 2026, which match the 2026 ratings in the landscape file) and 2027 Star Ratings data tables (October 8, 2026). Enrollment: CMS Monthly Enrollment by Contract/Plan/State/County, October 2026. Plan changes: CMS 2027 Part C and D Plan Crosswalk (October 1, 2026 file). Metro and nonmetro: USDA Economic Research Service 2023 Rural-Urban Continuum Codes.
Plans counted. General-audience Medicare Advantage plans with and without drug coverage (HMO, HMO-POS, PPO, regional PPO, PFFS and MSA). Special Needs Plans, Cost plans, PACE and employer group plans are excluded; employer plans are not in the landscape file. Each CMS contract-plan-segment ID is one plan. Nationwide counts are unique plans; state counts count a plan once in each state where it’s sold. Plans under CMS sanction are included because they appear in the file.
Definitions. A $0-premium plan has a combined monthly plan premium (Part C plus Part D) of $0; the Part B premium is still owed. A county “loses every $0 plan” if at least one $0-premium plan was offered there in 2026 and none is in 2027. Out-of-pocket cap is the in-network maximum out-of-pocket amount; plans “at the maximum” equal the CMS mandatory limit for that year ($9,250 for 2026, $9,850 for 2027). Carrier exits and entries compare parent organization names as CMS reports them; no parent organization that kept a contract changed its name between the files. Star bands use the contract’s overall rating. The worst-case year is 12 months of premiums plus the in-network out-of-pocket cap, the same measure our rankings use; for each county we take the lowest among plans with drug coverage, and the “typical county” is the median across the 3,032 counties with such a plan in both years. County counts cover the 3,107 counties with a general-audience plan in either year.
People affected. October 2026 enrollment in general-audience plans (no Special Needs Plans, employer plans, Cost plans or PACE), by plan and county. Each plan is followed through the 2027 crosswalk; a person counts as affected if the plan is terminated or if the plan it continues as has no 2027 segment in their county. “Starts charging a premium” compares the plan’s 2026 premium in the county with the lowest premium of its 2027 plan there. CMS hides cells of 10 or fewer people, so totals are slight undercounts; enrollees living outside their plan’s 2026 service area (usually people who moved) are left out.
Checks. Every number on this page is computed from the data when the site is built. The headline numbers were recomputed independently from the raw CMS CSV files and matched.
Limits. County counts are not weighted by population; the enrollment figures above are the people-weighted view. A $0 plan that leaves a county may be replaced by a plan with a small premium and a lower cap; this study counts plans and does not judge their value. Plans can still change before January 1. Check your plan’s Annual Notice of Change for its exact 2027 terms.
Cite or republish
Journalists, researchers and SHIP counselors are welcome to use these numbers and charts. Please credit and link to this page:
YourBestHealthPlans analysis of CMS CY2026 and CY2027 Medicare Advantage landscape files, https://yourbesthealthplans.com/medicare-advantage-2027-changes/
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<p>Source: <a href="https://yourbesthealthplans.com/medicare-advantage-2027-changes/">YourBestHealthPlans analysis of CMS Medicare Advantage landscape files, 2026–2027</a></p>
Data files: every county (CSV), state summary CSV, counties losing every $0 plan (CSV), headline numbers JSON. Questions or a specific county or carrier cut: contact the YourBest Editorial Team.
Sources
- CMS, CY 2026 and CY 2027 Medicare Advantage and Prescription Drug Plan Landscape files, cms.gov (accessed October 17, 2026).
- CMS, 2026 and 2027 Part C and D Star Ratings data tables, cms.gov (accessed October 17, 2026).
- CMS, CY 2026 MOOP and cost-sharing limit calculations, cms.gov; CMS, final CY 2027 Part C MOOP limits (Part C bid guidance). The highest in-network cap in each year’s landscape file matches: $9,250 and $9,850.
- CMS, Monthly Enrollment by Contract/Plan/State/County, October 2026, and 2027 Part C and D Plan Crosswalk, cms.gov (accessed October 18, 2026).
- USDA Economic Research Service, 2023 Rural-Urban Continuum Codes, ers.usda.gov (accessed October 18, 2026).
- County map shapes: U.S. Census Bureau cartographic boundaries via the us-atlas project.
Educational information, not a recommendation to join any plan. We are not an insurance agent or broker, and we are not connected with or endorsed by the U.S. government or the federal Medicare program. · Advertiser disclosure