2027 Medicare plan landscape: MA premiums projected down 16.5%, plan counts swing by state, stand-alone Part D subsidy ends

Florida will have 51 fewer Medicare Advantage plans next year than this year. Tennessee will have 23 more [2]. Nationally, the count barely moves: about 5,532 MA plans for 2027, against 5,553 in 2026, according to the Centers for Medicare & Medicaid Services (CMS) [1]. For a practice, the national average is the less useful number.

What changed

CMS released its 2027 Medicare Advantage and Part D projections on September 28, with plan landscape files and a fact sheet for each state [1, 2]. The agency projects the weighted average monthly MA premium will fall from $14.37 in 2026 to $12.00 in 2027, a drop of 16.5% [1]. The average total premium for stand-alone prescription drug plans (PDPs) is projected to rise from $35.09 to $36, after CMS’s temporary Part D Premium Stabilization Demonstration ends [1]. Open enrollment runs October 15 through December 7, and 2027 coverage begins January 1 [1, 2].

None of this changes the Medicare fee schedule. It changes which plan, network and formulary each Medicare patient brings through the door in January.

Who it affects

Medicare Advantage is now close to half of Medicare. Based on plan projections, CMS estimates 34 million MA enrollees in 2027, about 47.4% of everyone in Medicare, and says plan projections have historically understated actual enrollment [1]. More than 99% of beneficiaries will have at least one MA plan available, and 97% will have 10 or more [1].

The state fact sheets show where plan menus are moving most. Net MA plan counts, 2026 to 2027 [2]:

• Florida: 611 to 560
• Ohio: 212 to 180
• Illinois: 157 to 136
• Maryland: 63 to 47
• Minnesota: 68 to 53
• Tennessee: 132 to 155
• Missouri: 157 to 174
• Arizona: 133 to 148
• Alabama: 98 to 113

Smaller markets swing too. Wyoming goes from 14 MA plans to 8, and Montana from 32 to 23 [2]. These are net figures. A state that adds plans can still lose specific products, and the fact sheets do not say which insurers or networks are behind any change [2].

Patients with stand-alone drug coverage are the second group. PDP enrollment grew from 22.8 million in 2024 to 24.9 million in 2026, KFF reported [3]. Most states will have 8 to 12 stand-alone plans in 2027 [2]. The share of PDP enrollees who can find a plan with a lower premium than they paid in 2026 varies widely: 100% in states such as California, New York and Pennsylvania, but 34.05% in Wisconsin, 37.97% in Virginia and 38.67% in Arizona [2].

What it means for your practice

Your January patient mix. CMS says roughly eight in 10 MA enrollees will be able to stay in their current plan at the same or a lower premium [1]. That leaves about one in five whose current plan will cost more in 2027 or will not be available to them. In a state like Ohio, where the net MA count falls by 32, some of those moves will come from products that no longer exist [2]. For your front desk, that means new member IDs, new plan names and, for some patients, a plan your practice does not contract with. CMS’s calendar has plans notifying enrollees of 2027 changes starting in September, so some patients already hold those letters [2].

Your name in Plan Finder. CMS says Medicare Plan Finder now lets users find and save providers while comparing plans, and that starting in October it will show clear, prominent messages about changes to a user’s current plan for 2027 [1]. Patients who check whether you are in a plan’s network will see what that tool shows. CMS said Plan Finder would carry 2027 plan information by October 1 [2].

Drug coverage and prescribing. Part D changes reach the exam room as formulary and cost questions. CMS projects the average Part D premium inside MA drug plans, after rebates, will drop from $11.32 to $7, a 38% decrease [1]. Stand-alone plans are moving the other way, if only slightly on average. KFF warned in July that without the demonstration’s subsidies, some PDP enrollees could face larger premium increases than in recent years, and that rising drug prices and growing use of GLP-1s and other specialty drugs are likely to keep pressure on plan sponsors [3]. AJMC noted that CMS’s averages may mask substantial plan-level increases for some enrollees [4]. A patient who switches plans to escape a premium jump may land on a new formulary in January, with new coverage rules for drugs you prescribe. Medicare.gov is adding direct links to plan formularies and Summaries of Benefits [1].

Quality signals. The 2027 Star Ratings for health and drug plans are due on Medicare.gov on or around October 8, a week before open enrollment opens [2].

What to do now

1. Read your state’s fact sheet. CMS’s single PDF covers every state and territory, with the 2026 and 2027 MA plan counts, the average MA premium change, the number of stand-alone plans and the lowest available PDP premium [2]. In most states the cheapest stand-alone plan is $5.30 a month; in New York it is $37.30 [2].
2. Search for your own clinicians in Plan Finder. Because patients can save providers while comparing plans, check how your practice appears before October 15 [1].
3. Plan to re-verify coverage in January. New plan coverage starts January 1, 2027 [2]. Treat the first visit of the year as a fresh eligibility check for every Medicare patient, including those who did not mention a change.
4. Know where to send coverage questions. 1-800-MEDICARE is available 24 hours a day, seven days a week, and Medicare.gov has the Plan Finder [1]. Patients who want to keep their coverage generally do not need to re-enroll [1].
5. Flag patients who may qualify for help with costs. Medicare Savings Programs may pay Medicare premiums and some deductibles and cost sharing, and anyone enrolled in one automatically qualifies for Extra Help with Part D costs [1]. CMS’s fact sheets also point patients to the Medicare Prescription Payment Plan, which spreads drug costs across the year [2]. In Alabama, 28.45% of stand-alone PDP enrollees already get Extra Help [2].

Why is the Part D stabilization demonstration ending?

CMS set up the voluntary demonstration in 2024 to steady stand-alone plan premiums while the Inflation Reduction Act redesigned Part D, capping enrollees’ out-of-pocket costs and shifting more liability to plan sponsors [3]. In 2025 it reduced the base beneficiary premium by $15 and limited year-over-year premium increases to $35; for 2026 it scaled back to a $10 reduction and a $50 cap [3]. KFF put the cost at $9.8 billion over the two years and cited MedPAC estimates that the subsidies cut the average monthly PDP premium by $26 in 2025 and $16 in 2026 [3]. When CMS announced the end of the demonstration in July, it said PDP sponsors had gained “sufficient experience” to support bid development, KFF reported [3]. CMS originally said the program could last at least three years [3, 4].

The policy fight

CMS frames the 2027 numbers as proof the market can stand without the extra money. Its release says there is “broad pricing stability across the Part D market” despite “speculation and misleading reports” about the demonstration’s end [1]. “By slashing handouts to big insurance companies, CMS is keeping premiums stable,” CMS Administrator Dr. Mehmet Oz said, pointing to the 93% of non-low-income beneficiaries who can get an enhanced Part D plan for less than $6 a month [1].

KFF’s reading, published before the plan data came out, was more cautious. It said the subsidies “worked as intended” to keep PDP premiums and enrollment steady, while noting that some policymakers had questioned their rationale and cost [3]. It also pointed to a gap that predates 2027: even with the subsidies, the average 2026 stand-alone premium was more than four times the average for drug coverage in MA plans, $36 against $8, because MA drug plans can use rebates to buy premiums down [3]. AJMC, reporting on the release, put the projected 2027 gap at roughly five times, $36 against $7, and cautioned that the averages do not show what any individual plan will charge [4].

Plan-level premiums are in the landscape files CMS posted, but how many stand-alone enrollees see increases well above the $1 average depends on which plans they hold and whether they switch [1, 4]. That answer arrives with enrollment data after December 7.