Medicare Advantage shoppers in 29 of the 51 places that sell individual plans will face a shorter list for 2027, with Maryland dropping from 63 plans to 47 and Wyoming from 14 to eight. The 51 count takes in 49 states, the District of Columbia and Puerto Rico, and Alaska has no individual plans on sale at all. Open enrollment runs through Dec. 7, and the 2027 plans start Jan. 1.
The national total hides the local picture. The Centers for Medicare & Medicaid Services counts 5,553 Medicare Advantage plans for 2026 and about 5,532 for 2027, a net loss of roughly 21 plans out of more than 5,500. That small number averages together 29 jurisdictions that lost choices, 21 states that gained them and Puerto Rico, where the count did not change.
For a retiree, the practical question is whether the plan on the short list is still sold in the home county, and what remains if it is not. The state totals do not say which counties lost plans, so that answer sits in the county-level list on Medicare’s plan finder, which shows what is actually offered for 2027. The fall window for choosing a 2027 plan closes Dec. 7.
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Maryland and Wyoming take the sharpest cuts
Jakob Emerson of Becker’s Payer Issues, working from CMS’s state-by-state fact sheets, ranked the losses. Maryland went from 63 plans to 47, a drop of about 25 percent. Wyoming went from 14 to eight, about 43 percent and the steepest percentage decline anywhere. Montana fell from 32 to 23, the District of Columbia from 20 to 15 and Minnesota from 68 to 53.
Florida lost the most plans in raw numbers, falling from 611 to 560, while Ohio went from 212 to 180 and Illinois from 157 to 136. Those states still have well over 100 plans each. The damage shows more in small markets, where Wyoming’s eight plans leave a retiree a fraction of the options that remain in Florida.
Wyoming also posted the biggest jump in average monthly premium, from $45.91 to $69.23. Idaho moved from $27.81 to $37.93 and Connecticut from $16.89 to $25.31. Minnesota moved the other way, from $69.11 to $59.40 even as it lost 15 plans, and the District of Columbia fell from $26.28 to $16.91, so fewer plans does not always mean higher premiums.
Tennessee, Missouri, Arizona and Alabama add plans
Not every state lost ground. Tennessee gained the most, rising from 132 plans to 155, while Missouri went from 157 to 174, Arizona from 133 to 148 and Alabama from 98 to 113. Becker’s counts 21 states with more plans in 2027, which is why the headline figure describes a majority of jurisdictions rather than a universal loss.
Federal officials describe the market as stable. CMS said in its Sept. 28 announcement that more than 99 percent of beneficiaries can reach at least one Medicare Advantage plan, 97 percent can reach 10 or more, and about eight in 10 enrollees can stay in their current plan at the same or a lower premium. The weighted average premium is projected to fall from $14.37 to $12.
CMS Administrator Dr. Mehmet Oz urged beneficiaries “to use Open Enrollment as an opportunity to review their coverage.” That advice carries extra weight in the 29 places where the list shrank, because a plan that looked like the obvious pick last year may no longer be sold, and a plan that stays may carry a different premium than it did before.
A plan that leaves is a different problem from a shorter list
Plan counts are not the same as people affected. KFF estimates that 4.3 million Medicare beneficiaries will have a Medicare Advantage or stand-alone drug plan terminated at the end of 2026, including about 3.1 million in Medicare Advantage plans with drug coverage. Humana accounts for about 19 percent of those losing individual plans, UnitedHealth Group for 13 percent and CVS Health for 9 percent.
KFF’s analysts, led by Juliette Cubanski and Jeannie Fuglesten Biniek, say members whose plan is terminated can enroll in another Medicare Advantage plan in their area if one is sold. Otherwise they are switched to Original Medicare automatically. Medicare.gov says the same about a plan that is not renewed, and it opens a second window for those members from Dec. 8 through the last day of February.
That second window belongs only to people whose plan is not being renewed, not to everyone unhappy with a shorter 2027 list. For everyone else, Dec. 7 is the date that counts. A retiree in Wyoming whose plan stays on the list has the same deadline as one in Maryland whose plan is leaving, but less room to recover afterward.
Medigap rights apply only if Original Medicare wins out
Some people will decide a shrinking list is not worth the trouble and return to Original Medicare. Medicare.gov says a person whose Medicare Advantage plan is leaving can buy Medigap Plan A, B, C, D, F, G, K or L from an insurer in the state, starting 60 days before the coverage ends and running no more than 63 days after it ends.
That guaranteed-issue right applies only to people who switch to Original Medicare, not to those who join another Medicare Advantage plan. Medigap coverage cannot start until the Medicare Advantage coverage has ended, and the page tells people to keep the letters or notices showing the coverage ended because an insurer may ask for copies. States can add their own protections, so the state insurance department is the place to ask.
Anyone whose plan simply stays on the list, or is merged into another plan from the same insurer, does not get that guarantee. KFF counts about 1.4 million Medicare Advantage members in merging plans, and those who switch to Original Medicare from one of them lack federal Medigap guaranteed-issue rights.
The decision, then, is local. Maryland’s 47 plans and Wyoming’s eight are statewide totals, and neither says what a given county can still buy. The Dec. 7 deadline and, for people whose plan is leaving, the window through the last day of February are the two dates that decide how long that comparison can take.
Did the plan on the list survive in the home county?
A plan that drops off a county’s list leaves a retiree comparing whatever is still on it, and the state totals for Maryland, Wyoming and the 27 other shrinking jurisdictions cannot say which county lost what.
The 2027 Medicare Open Enrollment Decision Kit is built for that comparison. It includes a cost calculator spreadsheet that compares plans on cost, drugs and doctors, plus the Open Enrollment calendar, and it covers Medigap guaranteed-issue rights when a Medicare Advantage plan leaves, with a call script.
This article was produced with AI assistance and edited for accuracy against the sources linked above.
