638,000 Medicare Beneficiaries in 193 Counties Will Have No General Medicare Advantage Drug Plan for 2027

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The seller has not agreed to a recall or refund. A Recalled Teething Toy Broke the Pattern Parents Were Told to Look ForA newly recalled pull-string teething toy has a different model number and design from earlier recalls, and one choking incident has been reported. Trying to Lower Blood Sugar, Cholesterol or Blood Pressure? Different Workouts Suited Different MarkersA pooled analysis of 53 trials found that different exercise types helped different metabolic markers. Most of the evidence was low certainty. Joe Raedle | Getty Images Share on Twitter Share on Facebook Share on Pocket About 638,000 people with Medicare live in 193 counties where no general-enrollment Medicare Advantage plan with drug coverage will be offered in 2027, according to a new KFF analysis. That is up from 123 counties and 399,000 beneficiaries in 2026, an increase of 239,000 people.

The affected counties are spread across 16 states and the U.S. territories other than Puerto Rico. New Hampshire, North Dakota, and Oklahoma joined the list for 2027. Alaska has no general-enrollment Medicare Advantage drug plan in any county, affecting about 110,000 beneficiaries.

For enrollees whose plan is disappearing, the change forces a decision before coverage starts Jan. 1. Medicare open enrollment runs Oct. 15 through Dec. 7, and people who lose a plan will need to compare drug coverage, doctors, and costs rather than wait for an automatic switch.

The 16 states with at least one county lacking a Medicare Advantage drug plan are Alaska, California, Colorado, Idaho, Kansas, Minnesota, Montana, Nebraska, Nevada, New Hampshire, North Dakota, Oklahoma, Oregon, South Dakota, Utah, and Vermont, KFF found. In six counties in Nebraska and South Dakota, a Medicare Advantage plan without drug coverage is available, and some counties offer cost plans or special needs plans for eligible people.

Choices are narrowing elsewhere too. The share of beneficiaries with more than 40 Medicare Advantage drug plans fell from 27% in 2026 to 20% in 2027. The average beneficiary will still have 28 plans to choose from, and Lancaster County, Pennsylvania, tops the country with 66 options.

Several large insurers are pulling back. Health Care Service Corporation is leaving 498 counties, Centene 359, UnitedHealth Group 228, CVS Health 186, and Blue Cross Blue Shield of Michigan 177, though some of these companies are also entering other counties. Devoted Health is the largest expansion, entering 342 counties, while Group 1001, which operates as Clear Spring Health, and Molina are leaving the general Medicare Advantage drug plan market.

For enrollees in newly affected states, the change can be abrupt. A beneficiary in North Dakota or Oklahoma who had a general Medicare Advantage drug plan this year may find no comparable option in their county for 2027 and will need to choose a different path.

The Centers for Medicare & Medicaid Services says the program overall remains stable. CMS projects more than 99% of beneficiaries will have access to at least one Medicare Advantage plan, with about 5,532 plans nationally, down from 5,553. KFF’s county-level figures show how that national picture can hide local gaps.

Having no Medicare Advantage drug plan in a county does not mean losing Medicare. Beneficiaries there can use Traditional Medicare for hospital and doctor coverage and add a stand-alone Part D drug plan. Many also buy a Medicare supplement, or Medigap, policy to help with deductibles and coinsurance.

Stand-alone drug plan options are thinning as well. A separate KFF review of Part D plans found the average beneficiary will have nine stand-alone plans in 2027, down from 11, and total plans fall from 360 to 316. No zero-premium stand-alone plan will be available to people who do not qualify for low-income help.

Premium changes vary widely. CMS estimates the average stand-alone drug plan premium will rise from about $35 to $36 a month, but KFF found AARP Medicare Rx Preferred enrollees face increases of $50 or more in every state. About 4 million stand-alone plan enrollees who paid no premium in 2026 will pay something in 2027 whether they stay or switch.

Lower premiums can come with trade-offs. KFF advises checking each plan’s list of covered drugs, drug tiers, deductibles, and cost-sharing, since a cheaper plan may cover fewer medicines or charge more at the pharmacy. Centene’s Wellcare Value Script and Wellcare Classic are the lowest-premium plans, at about $5.30 a month in 45 states and $7.30 a month in 33 states, KFF found.

People whose Medicare Advantage plan leaves their area generally get a special enrollment period to choose new coverage, which can extend past Dec. 7. Those who switch to Traditional Medicare may also have a guaranteed right to buy certain Medigap policies for a limited time without medical underwriting, which matters because Medigap insurers can otherwise deny or charge more based on health.

The people most affected are those living in the 193 counties, along with enrollees whose current insurer is exiting even where other plans remain. Older adults on several prescriptions, people with chronic conditions, and caregivers managing a parent’s coverage face the biggest risk of higher costs or gaps if they miss the deadline.

Start by reading the Annual Notice of Change or plan termination letter that arrived this fall. Then list every prescription, dose, and pharmacy, along with preferred doctors and hospitals. Use the Medicare Plan Finder or call 1-800-MEDICARE to compare plans on total yearly cost, not just the monthly premium.

CMS Administrator Dr. Mehmet Oz urged beneficiaries to use open enrollment “as an opportunity to review their coverage.” Free, unbiased help is available through each state’s State Health Insurance Assistance Program, known as SHIP. People with limited income can ask whether they qualify for Extra Help, which lowers Part D costs.

Changes also hit provider networks, not just plan counts. MedicalDaily recently reported on a hospital network split affecting Hampton Roads Medicare Advantage members, a reminder that a plan can stay available while a familiar hospital drops out.

CMS says that starting in October, Medicare.gov users can review more details on preventive services and will see messages about changes to their current plans. KFF’s analysis does not examine costs or benefits, so enrollees will need to check those themselves during the roughly seven-week enrollment window.

How many people will have no general Medicare Advantage drug plan in 2027?

About 638,000 beneficiaries in 193 counties, up from 399,000 in 123 counties in 2026, according to KFF.

Alaska, California, Colorado, Idaho, Kansas, Minnesota, Montana, Nebraska, Nevada, New Hampshire, North Dakota, Oklahoma, Oregon, South Dakota, Utah and Vermont, plus U.S. territories other than Puerto Rico.

Will I lose Medicare if no plan is offered in my county?

No. You can use Traditional Medicare and add a stand-alone Part D drug plan, and many people also buy a Medigap policy.

When is Medicare open enrollment for 2027?

Open enrollment runs Oct. 15 through Dec. 7, 2026, with new coverage starting Jan. 1.

What happens if my plan is leaving my area?

You generally get a special enrollment period to pick new coverage. If you switch to Traditional Medicare, you may also have a time-limited right to buy certain Medigap policies without medical underwriting.

Are stand-alone drug plan premiums going up?

CMS estimates the average rises from about $35 to $36 a month, but some popular plans will increase $50 or more, and zero-premium plans will not be available to people without low-income help.

Where can I get free help choosing a plan?

Contact your state’s SHIP program, call 1-800-MEDICARE or use the Medicare Plan Finder on Medicare.gov.