The average Medicare beneficiary in Texas will have nine fewer Medicare Advantage drug plans to choose from in 2027 than in 2026, the biggest drop of any state, according to KFF’s count of plan options. Illinois and Ohio each lose eight, and Minnesota, New Mexico and Washington lose seven. Across the country the average beneficiary will see 28 of these plans, down from 32 a year earlier.
Anyone in a Medicare Advantage drug plan in one of those six states, and anyone elsewhere whose insurer is trimming its list, has until Dec. 7 to look again at what is on offer. A shorter list leaves fewer alternatives if the current plan raises its cost or drops a doctor or a drug. The question for each member is whether the plan they have is still the best of the ones left, or whether a switch for 2027 makes more sense.
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Six states lost the most plans, and Texas lost nine
KFF’s figures count the Medicare Advantage plans with drug coverage that are open to general enrollment, which are the plans the average beneficiary in each state could pick in 2026 and could pick in 2027. Texas is down nine, Illinois and Ohio eight apiece, and Minnesota, New Mexico and Washington seven apiece. KFF analysts Jeannie Fuglesten Biniek, Meredith Freed, Nancy Ochieng and Juliette Cubanski wrote the analysis, which uses federal plan data.
The picture is not a loss everywhere. Nine states have no change in the number of options, and four states gain plans. KFF lists them in a state-by-state figure rather than in its text.
Twenty-eight plans is down from 32, and from a high of 36
The 28 options for the average beneficiary in 2027 compare with 32 in 2026 and a peak of 36 in 2024. The number is still above the 27 options of 2021. Counting all Medicare Advantage plans, with or without drug coverage, the average falls to 35 in 2027 from 39.
Insurers and brokers could begin marketing 2027 plans on Oct. 1, and open enrollment started Oct. 15. A companion KFF analysis of insurer moves counts 498 county exits by Health Care Service Corporation and 359 by Centene, along with 228 by UnitedHealth Group, for 2027.
An average can hide a county with no plan at all
State averages cover a lot of ground. KFF finds 26 states and Puerto Rico where the average beneficiary has at least 20 plans, and Pennsylvania, Michigan and Ohio top 40. Nine states and the District of Columbia have fewer than 10 options, and Alaska has no general-enrollment drug plan at all. Lancaster County, Pennsylvania, has the most of any county with 66.
At the other end, 193 counties have no Medicare Advantage drug plan open to general enrollment in 2027, up from 123 in 2026, KFF reports in its county analysis. Those counties hold 638,000 beneficiaries. A resident of one of them is not looking at a shorter list but at an empty one.
Checking the shorter list before Dec. 7
Medicare.gov’s Plan Finder lists the plans sold in a ZIP code and compares them on premiums, costs and benefits, and Medicare says to enter every regular prescription for the best estimate. During open enrollment, from Oct. 15 to Dec. 7, a person can join, drop or switch a Medicare Advantage plan or a drug plan, and the plan must receive the request by Dec. 7, per Medicare’s enrollment rules. Coverage then starts Jan. 1.
The federal numbers are less alarming than the state counts. CMS says in its Sept. 28 release that about eight in 10 Medicare Advantage members can stay in their current plan with the same or a lower premium, and that more than 99% of beneficiaries nationwide can reach at least one Advantage plan. Members whose plan is being terminated, which KFF puts at 3.1 million people in Advantage drug plans, must choose new coverage.
Free help is available from 1-800-MEDICARE (1-800-633-4227) and from a State Health Insurance Assistance Program counselor, found at shiphelp.org. People already in an Advantage plan get a second chance from Jan. 1 to March 31 to switch plans or return to Original Medicare.
Does a shorter plan list change which plan fits the doctors and drugs on file?
When a state loses seven, eight or nine plans, the one a member keeps is rarely chosen against a full field. The plan that renews automatically is the one most members end up with, and few have a written reason for staying.
“The 2027 Medicare Open Enrollment Decision Kit” is a 55-page guide built around a cost calculator spreadsheet that compares plans on cost, drugs and doctors, so a member can keep, switch or wait with a reason on paper. It also includes the Open Enrollment calendar for the Oct. 15 to Dec. 7 window.
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.
