Sixty-seven counties in 11 states will have no general-enrollment Medicare Advantage plan left for 2027, according to a MoneyGeek analysis of CMS files published Oct. 27. North Dakota has 21 of them, Minnesota 15, Oklahoma seven, South Dakota six and Colorado five. Medicare open enrollment ends Dec. 7, and people in those counties who now have Advantage coverage have to choose another path.
Which counties lose every general-enrollment plan?
The five states at the top of MoneyGeek’s list are joined by Idaho with four counties, Montana with three, Nebraska and New Hampshire with two each, and California and Utah with one apiece. That adds up to 67. In North Dakota, MoneyGeek says every one of the 21 counties loses NextBlue of North Dakota, the only general-enrollment plan there.
Other names on the list include Texas County in western Oklahoma, where UnitedHealthcare leaves; Alamosa and Rio Grande counties in Colorado, where Humana leaves; Eagle, Phillips and Yuma in Colorado, where UnitedHealthcare leaves; and Lake County, California, which loses its only general-enrollment option as UnitedHealthcare exits. Nebraska’s two are Rock County, where Aetna leaves, and Sioux County, where Humana leaves.
MoneyGeek defines general-enrollment plans as individual Advantage plans that are not limited to people with Medicaid, certain chronic conditions or institutional care. Its count leaves out special needs plans, cost plans, stand-alone drug plans and employer plans, so a county on the list can still have one of those.
The question for anyone living in one of these counties is concrete: does the plan they have now appear anywhere in their county for 2027, and if not, which of the remaining routes fits their doctors and prescriptions by Dec. 7?
Stay ahead of government payment news: Miss an enrollment or claim deadline and the money can be gone. Join the Retirement Money Brief and we’ll send you our 2026 Government Check Reality Tracker as a welcome gift.
Get the Brief + the check tracker →
We may earn a commission from links on this page.
How many people live in these 67 counties?
Fewer than most readers might expect. MoneyGeek estimates about 31,191 to 32,151 members are in the 67 counties, a range because CMS hides enrollment counts of 10 or fewer. Sixty-three of the 67 counties are rural. Counting earlier losses too, MoneyGeek says 181 counties have no general-enrollment plan for 2027, up from 116 in 2026.
The largest single pocket is Crow Wing County, Minnesota, where MoneyGeek counts 10,861 members after Blue Cross and Blue Shield of Minnesota and Medica leave. Wadena County, Minnesota, has 1,944, Lake County, California, 1,063, and in North Dakota, Ward County has 608 and Williams County 370.
Minnesota’s attorney general backs up the state count. In a Nov. 2 alert, Attorney General Keith Ellison said 15 counties will have no Medicare Advantage plans in 2027: Aitkin, Carlton, Chippewa, Cook, Goodhue, Koochiching, Lake, McLeod, Meeker, Mille Lacs, Pine, Rice, Sibley, Stevens and Yellow Medicine. The office lists Crow Wing, Lake of the Woods and Wadena counties as having neither Advantage nor Medicare cost plans.
Ellison urged people to review their options well before Dec. 7. His office points people to Minnesota Aging Pathways at 800-333-2433, which estimates nearly 400,000 Minnesotans are affected, about one-third of the 1.2 million on Medicare.
What is left when the Advantage plans go?
Original Medicare is the fallback, with a separate drug plan added. Medicare.gov says that people who move to Original Medicare may need to enroll separately in a drug plan and could consider buying Medigap, which is extra insurance from a private company that covers a share of Original Medicare costs.
The timing is set by a special enrollment period. Ohio’s Department of Insurance, describing the federal rule in a Nov. 2 bulletin, says people whose Advantage plan is ending automatically qualify to enroll in a new Advantage plan or a Part D plan from Dec. 8 through the end of February. MoneyGeek gives the dates as Dec. 8 through Feb. 28 and says requests received Dec. 8 to Dec. 31 take effect Jan. 1.
The Medigap window is tighter. Medicare.gov says the guaranteed-issue right lets a person apply for Plan A, B, C, D, F, G, K or L starting 60 days before the Advantage coverage ends and no more than 63 days after. MoneyGeek puts the federal window at Nov. 1, 2026, through March 4, 2027. Ohio’s bulletin adds that the protection holds even for people with health conditions.
State rules can widen that. MoneyGeek notes that Connecticut and New York let people buy Medigap year-round, and that Massachusetts, Maine, Rhode Island, Delaware and Minnesota have their own windows. None of those windows is automatic. A person has to apply, and the Medigap policy cannot start until the Advantage plan ends.
Could New Hampshire’s list change?
It may. New Hampshire is one of the 11 states, with two counties on MoneyGeek’s list. Separately, InsuranceNewsNet reported on Oct. 21 that Gov. Kelly Ayotte said she had convinced the Trump administration to work on keeping Medicare Advantage coverage in Coos and Carroll counties through 2027, a day after insurers said no plans would be offered in Coos County.
“I thank Administrator Oz and CMS for working with us to ensure Medicare Advantage coverage in Coos and Carroll Counties,” Ayotte said, and she advised affected seniors to make no decisions until more information is available. The report says CVS Health and BMC Health Systems are leaving the state entirely, together covering about 14,000 residents, and that Carroll County’s one remaining insurer offers coverage only to seniors with special needs.
The governor’s statement does not name an insurer or plan that would provide the coverage. Until one is announced, the Dec. 7 date still applies to people in those counties.
Is your county one of the 67?
With no general-enrollment plan left in a county, there is no Advantage plan to switch into, and a member who lets the date pass can end up on Original Medicare with no drug plan and a Medigap window already running. The Medigap application window closes 63 days after the Advantage coverage ends.
The Medicare Money Bundle includes Medigap vs. Medicare Advantage, a guide to Medigap rights, state rules and both paths priced. It is part of a 102-page download of eight Medicare guides that also includes Open Enrollment in an Afternoon.
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.
