Medicare’s annual open enrollment period is underway, and for millions of older Americans enrolled in privately run Medicare Advantage plans, this year’s decision may not be optional. Insurers are dropping plans in many parts of the country for 2027, leaving enrollees in some areas with far fewer choices and, in some counties, none at all.
Open enrollment began October 15 and runs through December 7, with new coverage taking effect January 1, 2027.
Who is affected
Medicare Advantage lets private insurers administer Medicare benefits for people who choose it over traditional Medicare, which the federal government runs directly. About 35 million people are enrolled, more than half of the roughly 70 million Americans in Medicare, according to NPR. The plans are popular because they often cover extras such as vision and dental care, frequently with lower premiums, and many include Part D prescription drug coverage.
Unlike traditional Medicare, however, insurers can decide where to sell their plans and can leave markets that are not profitable. Research published in JAMA found that about 2.9 million seniors were in Medicare Advantage plans that closed last year, NPR reported. For 2027, an analysis of insurer announcements by the podcast An Arm and a Leg found at least 2 million people will be affected, and other early estimates range from 3.2 million to 5 million.
An analysis of federal data by the health policy research group KFF found that 193 counties, most of them rural, will have no Medicare Advantage plans offered, up from about 120 last year, according to NPR. Several large metro areas are also seeing steep cuts. Dallas, Minneapolis, Seattle, Houston and Portland each have between a quarter and a third fewer plans for 2027.
Nationally, the average Medicare beneficiary can choose from 35 Medicare Advantage plans in 2027, compared with 39 in 2026, according to a KFF analysis cited by ABC News.
What happens if a plan ends
Insurers closing plans were expected to mail notices to members during the first week of October, NPR reported. Enrollees can also check their plan’s status for next year by logging in to their account on Medicare.gov.
People whose plan is ending and who do not pick a new one will either be assigned by the insurer to another Medicare Advantage plan or enrolled by the government in traditional Medicare, without a supplemental or drug plan. Those who switch from a closing Medicare Advantage plan to traditional Medicare can buy a Medigap supplemental policy without the usual restrictions, which may help people whose pre-existing conditions previously kept them out of that market.
Enrollees whose plans are closing qualify for a special enrollment period that runs until February 28, 2027. To have new coverage start on January 1, they need to enroll by December 31.
New wrinkles this year
Insurers can now cap enrollment in some of the Medicare Advantage plans they do offer, NPR reported, meaning a preferred plan could fill up before a late shopper signs on. Companies are required to accept members on a first-come, first-served basis and may not select customers based on health, age or demographics.
Drug coverage costs are also shifting. ABC News reported that the Trump administration is ending the Part D Premium Stabilization Demonstration, a temporary subsidy program that held down premiums for stand-alone prescription drug plans, at the end of the year. The standard Part D deductible will rise from $615 to $700.
“Without these extra subsidies in place for 2027, some Part D stand-alone drug plan enrollees could face a larger premium increase for drug coverage next year than in recent years, though plan-specific premium amounts are not yet known,” said Juliette Cubanski of KFF.
Dr. Mehmet Oz, administrator of the Centers for Medicare & Medicaid Services, has said the subsidy program benefited insurance companies. “Every Medicare beneficiary still has access to low-cost plans, and we will continue to lower prescription drug prices for every American patient,” he wrote on X in July.
Where to get help
Every state has a free, federally mandated State Health Insurance Assistance Program, known as a SHIP, whose counselors must give unbiased information on all options, NPR reported. A state directory is available at shiphelp.org. The nonprofit Medicare Rights Center also runs a national helpline.
Medicare’s online Plan Finder lets beneficiaries compare options, but its lists of covered doctors and drugs can contain errors, so enrollees should confirm details with their doctor’s office or a counselor. NPR also advised caution about sharing personal information with online services, some of which sell contact details.
“I think people need to be paying attention to not just the premium, but also things like the deductible and the caps because that could significantly impact their out-of-pocket costs,” Timothy McBride, a health policy analyst at Washington University in St. Louis, told ABC News.
