For 2027, 680 Medicare Advantage plans are pulling out of at least one county where they are sold this year, according to a BenefitsUSA count of Medicare's 2027 plan list, which the Centers for Medicare & Medicaid Services (CMS) released in September. Each of these plans keeps running in other places, but in the counties it leaves, its coverage ends on December 31, 2026. The count is of plans, not people. It leaves out Medicare Cost plans, a separate kind of private Medicare plan.
What the count shows
BenefitsUSA compared CMS's 2026 and 2027 plan lists, county by county. A plan made the count if it covered a county in 2026, does not cover that county under the same plan number in 2027, and still runs somewhere else. Plans that vanish from the list entirely are not counted. Our report on Humana and UnitedHealthcare ending Medicare plans covers plans that are closing.
The 680 plans drop 4,973 plan-and-county combinations in 45 states and Washington, D.C. In 1,604 counties, at least one Medicare Advantage plan sold in 2026 is leaving.
Of the 680 plans, 109 are special needs plans for people who have both Medicare and Medicaid. Federal rules let those Medicaid plans move members into another of the company's plans in some cases, instead of ending their coverage. Leaving the Medicaid plans out, 571 plans are pulling out of at least one county.
Three companies account for about two of every three plan-and-county exits. UnitedHealth Group, which owns UnitedHealthcare, accounts for 1,394 of the 4,973. CVS Health, which owns Aetna, accounts for 1,288, and Humana for 669. Medicare's plan list has no membership numbers, so these figures count plans and counties, not people.
72 counties lose every regular Medicare Advantage drug plan
In 72 counties in 11 states, Medicare's 2027 list shows no regular Medicare Advantage plan with drug coverage, though each county had at least one in 2026. "Regular" here means a plan that is not a special needs plan. Special needs plans take only people who have Medicaid, certain chronic conditions, or a need for nursing home level care.
| State | Counties left with no regular plan | Of those, no Medicare Advantage plan at all |
|---|
| North Dakota | 21 | 0 |
| Minnesota | 15 | 0 |
| South Dakota | 10 | 0 |
| Oklahoma | 7 | 0 |
| Colorado | 5 | 0 |
| Idaho | 4 | 0 |
| Montana | 3 | 3 |
| Nebraska | 3 | 0 |
| New Hampshire | 2 | 1 |
| California | 1 | 1 |
| Utah | 1 | 0 |
| Total | 72 | 5 |
In five counties, Medicare's 2027 list shows no Medicare Advantage plan of any kind: Lake County, California; Custer, Hill and McCone counties, Montana; and Coos County, New Hampshire. Where a county has no other Medicare Advantage plan, federal rules let the company offer its members the choice to stay in the plan.
In 67 of the 72 counties, the 2027 list still shows some other private Medicare plan, such as a Cost plan, a plan without drug coverage, or a special needs plan. Original Medicare works in every county, and each of the 11 states has between 8 and 10 stand-alone drug plans on the 2027 list.
What happens if your plan is leaving your county
Federal rules require a company to mail each affected member a letter at least 90 days before the exit takes effect on January 1, 2027, so the mailing deadline falls in early October. The letter has to describe the member's other coverage options and the special enrollment period.
Anyone with Medicare can change plans during Open Enrollment, October 15 to December 7, 2026, with changes starting January 1, 2027. People whose plan is leaving their county also get a special enrollment period from December 8, 2026, to February 28, 2027. Under CMS rules, a plan picked in December starts January 1, one picked in January starts February 1, and one picked in February starts March 1.
A member who picks no new plan by December 31 is moved to Original Medicare on January 1. Original Medicare has no drug coverage, so that member needs a stand-alone drug plan to keep drug coverage. Medicare assigns a stand-alone drug plan to people who get Extra Help, the program that lowers drug costs, when their Medicare Advantage plan leaves their county, unless they already have drug coverage for 2027.
A member who goes back to Original Medicare also gets a federal right to buy certain Medigap policies, the extra insurance that helps pay what Original Medicare leaves unpaid. Medicare.gov says to apply between 60 days before the Medicare Advantage coverage ends and 63 days after. The right applies only to people who choose Original Medicare over another Medicare Advantage plan. Outside windows like this one, federal law does not guarantee that a Medigap company will sell you a policy, and the price can be higher because of your health. Our guide to moving from Medicare Advantage to Original Medicare has the steps.
What to do before December 31
- Open your mail. A letter saying your plan will not cover your county in 2027 is your official notice. Keep the letter for any Medigap application.
- Check whether your plan is leaving your county.
- Compare plans for your ZIP code at Medicare.gov/plan-compare, or call 1-800-MEDICARE (1-800-633-4227).
- Choose by December 31 to have new coverage start January 1, 2027. Our Open Enrollment dates guide explains what you can change.
- Get one-on-one counseling from your State Health Insurance Assistance Program (SHIP), an unbiased source of Medicare help. Find yours at shiphelp.org.
Sources
- CMS, CY2026 and CY2027 Medicare Advantage and Part D Landscape files, September 2026 releases (BenefitsUSA's county-by-county comparison of both files)
- eCFR, 42 CFR 422.530, Plan crosswalks, and 42 CFR 422.506, Nonrenewal of contract
- CMS, Medicare Advantage and Part D Enrollment and Disenrollment Guidance, sections 30.6.10, 40.1.9 and 60.2.7
- Medicare.gov, Special Enrollment Periods
- Medicare.gov, When can I buy a Medigap policy?
- Medicare.gov, Other Medicare health plans
- SHIP National Technical Assistance Center, shiphelp.org
