The 2027 Medicare Advantage landscape: what changed
For 2027, 78 Medicare contracts leave the market and 2.28 million members have to choose a new plan, 1,205 plans redrew their counties, and the average deductible rose by almost a hundred dollars. These are the headline figures from the Livmor Landscape Report 2027, built from CMS's Landscape releases for 2026 and 2027 and September 2026 enrollment.
2027 at a glance
Contracts in 2027
654
down from 704 in 2026
Contracts exiting
78
2.28 million members must choose again
Contracts entering
28
down from 65 a year earlier
Contracts changed
307
plans, counties or names
Plans in 2027
5,884
down from 5,962
Plans that redrew counties
1,205
513 grew, 593 shrank, 99 both
Exits, entries and the members in between
Of the 704 contracts that sold Medicare Advantage or Part D plans in 2026, 78 do not return for 2027. CMS's September 2026 enrollment puts 2,281,108 members in those contracts across 288 plans; every one of them needs a new plan for January. Another 307 contracts continue with changes to their plans, counties or names, and 319 continue unchanged.
Only 28 contracts enter the market, against 65 a year earlier, and the number of parent organizations selling Medicare plans falls from 170 to 165. Among plan types, chronic-condition special needs plans are the one segment growing: 607 C-SNP plans for 2027, up from 433, while PPO plans fall from 1,598 to 1,430.
Sixty plans across 25 contracts have told CMS they will cap 2027 enrollment, with 554,877 seats between them. A capped plan can close to new members mid-year.
Where plans pulled back
1,205 plans changed their county service area between the two Landscape releases: 513 added counties, 593 removed counties, and 99 did both. Across 3,159 counties, 506 have at least a quarter fewer plans to choose from than in 2026; 26 counties are left without a general-enrollment plan, and 5 without any Medicare Advantage plan at all.
The sharpest state-level pullbacks, counted in plan-county offerings:
| State | 2026 | 2027 | Change |
|---|---|---|---|
| Minnesota | 1,576 | 1,000 | −36.5% |
| North Dakota | 804 | 547 | −32.0% |
| South Dakota | 943 | 645 | −31.6% |
The full report lists every plan that added or removed counties, state by state and county by county.
Costs moved up, premiums moved down
The average Medicare Advantage premium fell and more plans charge nothing, but deductibles and out-of-pocket limits rose. Of the 4,736 plans that continue from 2026 with comparable cost terms, 4,108 (87%) are worse on at least one of them, with a median deductible increase of $85 and a median out-of-pocket-limit increase of $600. Stand-alone Part D is a different story: the average premium climbs to $84.84 and no stand-alone drug plan is free in 2027.
| Measure | 2026 | 2027 |
|---|---|---|
| Average MA premium | $19.86 | $17.41 |
| Plans with a $0 premium | 58.6% | 70.7% |
| Average Part C deductible | $435 | $526 |
| Average in-network out-of-pocket limit | $6,208 | $6,835 |
| Part D out-of-pocket cap | $2,100 | $2,400 |
| Average stand-alone Part D premium | $62.86 | $84.84 |
| Stand-alone Part D plans with a $0 premium | 19.1% | 0% |
Averages are across all MA and MA-PD plans in each year's Landscape file; deductible averages cover plans that report one.
The full report is free
Every contract that is new, dropped, changed or unchanged; every plan that added or removed counties; enrollment caps; and the members affected, filterable by state and county. One sign-up also opens the Costs and Benefits Snapshot.
Source: CMS Medicare Advantage and Part D Landscape files for plan years 2026 and 2027; CMS monthly enrollment by plan and by county, September 2026. Livmor is not affiliated with the U.S. government or the federal Medicare program.