“We looked strategically across all of our geographies to determine where we will be best positioned for long-term success.” That is how Stephen Harris, president of government markets at Health Care Service Corp., describes a decision that cuts the company’s Medicare Advantage map from 948 counties to 478 for 2027.
HCSC is the parent of Blue Cross and Blue Shield in Illinois, Montana, New Mexico, Oklahoma and Texas. About 127,000 of its roughly 800,000 Medicare Advantage members are affected, and the company says a little over half of them can choose another HCSC plan in their county.
What HCSC says it is keeping
Harris told Becker’s Payer Issues that HCSC will offer Medicare Advantage in 478 counties across 24 states in 2027. In 2026 it sold plans in 948 counties across 30 states and Washington, D.C. It is dropping Blue-branded plans in Texas and Oklahoma, leaving Montana and narrowing its Illinois service area.
New Mexico moves the other way. HCSC is expanding its Blue-branded plan there to all 33 counties ahead of the state’s planned 2028 shift to fully integrated dual-eligible special needs plans. The company will build its future lineup around HMO plans, especially the HealthSpring plans it bought from Cigna.
HCSC runs Blue Cross and Blue Shield plans in Illinois, Montana, New Mexico, Oklahoma and Texas, according to Wikipedia. Illinois is the one state on that list where the company is narrowing rather than leaving, and the Becker’s report does not say which Illinois counties lose the plans.
Why a big insurer shrinks
Harris said the choices weighed provider partnerships, network adequacy, membership concentration in small markets, member product needs and utilization. HCSC also compared its medical cost trend with what Medicare pays in each region. The company posted a net loss of more than $1.9 billion in 2025, against net income of $659 million the year before.
Members of a Blue Cross Medicare Advantage plan in Texas, Oklahoma, Montana or Illinois should find out whether their county is still on the map. The question is whether the plan is leaving their county, and if so, what replaces it before December 7. The insurer’s notice and Medicare’s Plan Finder show which plans are listed for a ZIP code.
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HCSC paid $3.3 billion for Cigna’s Medicare business less than two years ago. Harris said the company is “at or ahead of most of the targets we set before the deal closed” and is optimistic about “a period of stabilization” into 2028. For members, the practical result is smaller maps and fewer same-county alternatives.
Two counts of the same map
HCSC’s own count is 478 counties. Becker’s county ranking, built on the data CMS released September 28, puts the figure at 450 and lists a 52.5% decline. That table covers individual Medicare Advantage and Medicare Advantage drug plans and leaves out special needs plans, cost plans and stand-alone drug plans.
KFF’s county analysis counts 498 county exits and no entries for HCSC, the most of any insurer it lists. It notes that Miami-Dade County, Florida, is among the places where HCSC no longer offers Medicare Advantage drug plans. That exit count equals 948 minus the 450 in the Becker’s table.
Texas: Blue Cross leaves Medicare Advantage entirely
In Texas, Blue Cross and Blue Shield of Texas says it will “no longer offer Medicare Advantage plans in Texas in 2027,” 24/7 Wall St. reported on October 15. Coverage under those plans ends December 31, 2026. The article says the nonrenewal notice is the member’s proof of the Medigap right, and that members can apply in November and ask for the policy to start the day the Advantage plan ends, so there is no overlap and no lapse.
The report counts that window as running 63 days past the end of coverage, which lands on March 4, 2027. Medicare’s Medigap page says people whose plan will no longer cover where they live can buy any Medigap policy sold in their state, applying no more than 63 days after coverage ends.
The December 7 clock and the March 4 clock
Medicare’s joining a plan page puts open enrollment at October 15 to December 7, with coverage starting January 1. Those dates serve people picking a new Medicare Advantage plan. The March 4 window matters mainly to Texans heading to Original Medicare with a Medigap policy.
The company has not published how many Texas members hold the plans that end. HCSC says 127,000 members are affected across its footprint, and Becker’s reports that just over half can move to another HCSC plan in the same county. A Blue Cross member’s own county decides which group applies.
That leaves one question the numbers cannot answer for any single household: is my Blue Cross plan leaving my county, and what do I pick before the deadline? The notice in the mailbox, with the end date on it, is the document that decides the next move.
Is your Blue Cross Medicare Advantage plan leaving your county?
HCSC says 127,000 members are affected, and a notice that arrives in the mail ends coverage on December 31 whether or not a replacement has been chosen. In Texas, the Medigap window that follows closes March 4, 2027.
The 2027 Medicare Open Enrollment Decision Kit includes a cost calculator spreadsheet that compares plans on cost, drugs and doctors, plus a prescription-by-plan comparison. It also carries the Medigap guaranteed-issue rights that apply when a Medicare Advantage plan leaves, with a call script.
Compare Blue Cross replacements and Medigap costs in a Decision Kit calculator →
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This article was produced with the assistance of AI and reviewed by the editorial team.
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.
