A survey of the people who actually design Medicare Advantage benefit packages says next year’s plans are headed toward being thinner, not richer. HealthScape Advisors polled leaders at 35 health plans and found that nearly 70% of them expect their own 2027 offerings to be less generous than this year’s, with grocery allowances, dental coverage, and rebate cards among the benefits most likely to shrink. For beneficiaries who picked a plan specifically for those extras, the open question is which ones survive the fall’s redesign.
What Plan Leaders Themselves Expect to Cut
Insurance-broker analysis reviewed by Axios found that not one of the 35 surveyed plan leaders expected a richer 2027 benefit package, and the most commonly named targets were consistent across companies. Plans are looking at removing or shrinking “giveback” benefits, the rebate that reduces or eliminates a member’s Part B premium, along with cutting major dental coverage, raising specialist copays, and tightening out-of-pocket drug costs. Some insurers are reportedly even capping new enrollment partway through the annual sign-up period rather than accepting every applicant who wants in.
A Leerink analyst note cited in the same reporting singled out two of the largest national carriers, saying 2027 “sets up as another year of broad-based industry benefit reductions” with UnitedHealthcare and Humana likely cutting the most. UnitedHealthcare has reportedly dropped roughly 13% of the plans it previously offered across 18 states, narrowing the number of options available to members shopping in those markets this fall. Humana’s own broker feedback described “much less rich plans,” and the company has separately said plan exits could affect around 600,000 of its members. HealthScape’s own survey report puts a number on the sentiment behind those broker notes: 93% of the plan leaders it surveyed said their Medicare Advantage business is not currently profitable, and most do not expect a return to profitability for at least two more years.
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Why Insurers Say the Money Stopped Working
Medicare Advantage used to be reliably profitable for insurers, largely because the federal government paid plans more than traditional Medicare spends per beneficiary, leaving room for the extra dental, vision, grocery, and OTC benefits that traditional Medicare does not cover. That math changed as underlying medical costs rose faster than insurers had priced in after the pandemic, provider contract negotiations grew more contentious, and federal oversight of coding and billing practices tightened. Insurers now describe the extra benefits as a margin problem rather than a competitive advantage.
The squeeze is not coming from a federal pay cut. CMS’s final 2027 rate announcement delivered plans a 2.48% increase, worth more than $13 billion in additional payments, reversing an earlier proposal that would have held rates far flatter and that the industry had fought hard against. Even with that increase in hand, plan leaders surveyed by HealthScape still expect to trim benefits, which insurers frame as a deliberate move toward sustainable long-term margins rather than a response to being underpaid this particular year.
Industry trade groups dispute that benefit erosion reflects poor stewardship of that federal money. A spokesperson for the Better Medicare Alliance, which advocates for the private Medicare option, has argued that plans still deliver more comprehensive and affordable coverage than traditional fee-for-service Medicare and that funding pressure and policy changes, not insurer choices, are squeezing what plans can offer. Beneficiary advocates counter that a member who chose a plan for its dental or grocery card has no guarantee that benefit survives to the next plan year regardless of who is assigned the blame.
What a Beneficiary Can Still Check Before Enrollment Closes
The annual window to compare and switch Medicare Advantage plans runs from October 15 through December 7, before the specific 2027 benefit designs behind this survey become final and public. Because insurers set exact benefit packages plan by plan, the HealthScape finding does not mean every plan cuts the same benefit by the same amount; some plans in some counties may hold their extras steady even as national averages point downward, and the only way to know is to compare the actual 2027 summary of benefits once it is published for a specific plan.
One detail with practical weight for anyone relying on a supplemental card: unspent grocery, OTC, or dental allowance balances on a Medicare Advantage benefit card generally do not carry over between plan years even when the benefit itself continues, so a member with an unused balance in December has an incentive to spend it before the calendar turns rather than assume it rolls forward.
Axios’s reporting closes on a warning from the Medicare innovation center’s own director, who told an industry audience that federal policymakers are not finished reshaping Medicare Advantage rules and that further changes intended to push the program in “a free market direction” should be expected, meaning this fall’s benefit redesigns may not be the last word for the program’s trajectory.
The Programs That Never Get Filed
The “giveback” benefit some Medicare Advantage plans are trimming works by covering part of a member’s Part B premium, but a separate, permanent federal program can cover that same premium in full no matter which plan, or which insurer’s 2027 benefit design, a beneficiary ends up enrolled in. Medicare Savings Programs pay the Part B premium outright for beneficiaries under a state’s income and asset limits, a protection that does not disappear when an insurer redesigns its extras.
The Benefits Checklist covers Medicare Savings Programs and ten other programs across 69 pages, with the 2026 income limits for each one and a 50-state phone directory for finding the office that actually processes each application.
Compare eligibility for this and other programs against The Benefits Checklist.
This article was researched and drafted with AI assistance and reviewed against primary sources before publication.
