Health Care Service Corporation, known as HCSC, will stop offering Medicare Advantage drug plans in 498 counties for 2027 and add none, the largest county reduction of any insurer, according to KFF’s county-by-county analysis of federal plan files. Centene will leave 359 counties and enter 15. Separately, 193 counties holding 638,000 beneficiaries will have no Medicare Advantage drug plan open to general enrollment, up from 123 counties and 399,000 people in 2026.
Members of an HCSC or Centene plan in an exited county, and anyone who lives in one of the 193 counties, face a different choice than a simple plan swap. If no Advantage drug plan is left nearby, the options narrow to Original Medicare with a stand-alone drug plan and, for many people, a Medigap policy. Open enrollment ends Dec. 7, and the Medigap rights that come with a terminated plan run on their own clock.
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The insurers cutting the most counties
KFF analysts Meredith Freed, Jeannie Fuglesten Biniek, Nancy Ochieng and Juliette Cubanski counted every county where an insurer offered a Medicare Advantage drug plan in 2026 and compared it with the 2027 federal plan files. The counts below are counties exited and entered for general-enrollment plans that include drug coverage.
- HCSC: exiting 498, entering none
- Centene: exiting 359, entering 15
- UnitedHealth Group: exiting 228, entering 9
- CVS Health: exiting 186, entering 63
- Blue Cross Blue Shield of Michigan Mutual: exiting 177, entering 1
- Elevance Health: exiting 66, entering 10
- Humana: exiting 62, entering 4
- Devoted Health: entering 342, exiting none
The exits show up on the ground. KFF reports that HCSC no longer offers a drug plan in Miami-Dade County, Florida, and that four Minnesota counties, Brown, Lake of the Woods, Morrison and Renville, each lost three insurers that sold one in 2026.
Where the 193 counties with no drug plan are
The 193 counties are in 16 states plus U.S. territories other than Puerto Rico: Alaska, California, Colorado, Idaho, Kansas, Minnesota, Montana, Nebraska, Nevada, New Hampshire, North Dakota, Oklahoma, Oregon, South Dakota, Utah and Vermont. New Hampshire, North Dakota and Oklahoma are new to the list this year. No county in Alaska has a general-enrollment drug plan, and the state has about 110,000 beneficiaries.
In 187 of the counties there is no Medicare Advantage plan of any kind for general enrollment. The other six, Boyd County in Nebraska and Aurora, Beadle, Bon Homme, Brown and Charles Mix counties in South Dakota, have a Medicare Advantage plan without drug coverage. The 638,000 people involved are about 1% of all beneficiaries.
Medigap rights when an Advantage plan ends
People whose Medicare Advantage coverage is terminated get a special enrollment period and guaranteed-issue rights to buy a Medigap policy, KFF reports in its analysis of 4.3 million plan terminations. People whose plan is only being consolidated into another plan from the same insurer generally do not get those rights.
Medicare’s Medigap guide says a person in that position may buy Medigap Plan A, B, C, D, F or G sold in the state, though Plans C and F are closed to anyone new to Medicare on or after Jan. 1, 2020. The application can start 60 days before coverage ends, or by the date in the plan’s termination notice, and must come no more than 63 days after coverage ends. Medicare’s enrollment page says an Advantage member can also switch plans or return to Original Medicare from Jan. 1 to March 31.
Medicare.gov’s Plan Finder lists the plans still sold in a given ZIP code, and 1-800-MEDICARE (1-800-633-4227) answers questions around the clock. CMS has said more than 99% of beneficiaries nationally can reach at least one Advantage plan, a figure from its Sept. 28 release.
What the county count leaves out
KFF’s tally covers Medicare Advantage drug plans open to general enrollment. It leaves out special needs plans, employer group plans, PACE programs and plans without drug coverage, and it says it does not examine costs, benefits or other plan features. A county with no general-enrollment drug plan can still have a special needs plan for people who meet its criteria.
The county figures also say nothing about what members of an exiting plan pay next year, only where plans are sold. KFF says insurers’ choices reflect local market conditions, cost pressures, strategy shifts and profitability.
Will a Medicare Advantage drug plan still be sold in the member’s own county on Jan. 1?
For members in an exited county, the real choice is between another Advantage plan, if one is left, and Original Medicare with a Medigap policy. Medigap rights depend on the state and on the dates in the termination notice, and the order of the steps matters.
“The Medicare Money Bundle” holds eight Medicare guides in one download, including Medigap vs. Medicare Advantage, which covers Medigap rights, state rules and both paths priced. Open Enrollment in an Afternoon in the same bundle runs Plan Finder in one sitting and ends with a keep-or-switch answer.
This article was produced with AI assistance and edited for accuracy against the sources linked above.
David M. Keller is a finance writer based in Columbus, Ohio, covering personal finance and consumer-focused economic topics. He earned his degree in journalism from Ohio University and began his career reporting on local business and economic trends for a regional media outlet. Since then, he has contributed to a variety of online publications, focusing on clear, practical coverage of topics such as cost of living, debt, and everyday financial decision-making.
