The average person on Medicare will be able to choose from 35 Medicare Advantage plans for 2027, down from 39 for 2026, according to a new count from KFF, the health policy research group. The drop is small, and the 2027 total is still close to double the 18 options available in 2017. It lands just before Open Enrollment opens on October 15, when millions of people pick drug and health coverage for the new year. The federal government is telling a calmer story about prices than the shrinking menu might suggest.
Medicare Advantage is the private-plan alternative to Original Medicare, and many of its plans bundle in prescription drug coverage. KFF’s figure of 35 covers every general-enrollment Medicare Advantage plan, with or without drug coverage. The count leaves out special needs plans, employer group plans, PACE programs, cost plans and a few other types. It is an average across the country, so a person in one county can see far more or far fewer choices than the national number.
What KFF counted for 2027
KFF researchers Jeannie Fuglesten Biniek, Meredith Freed, Nancy Ochieng and Juliette Cubanski published the 2027 plan availability analysis on October 1. Its headline number is narrower than the 35: the average person will have 28 Medicare Advantage plans that include drug coverage, down from 32 for 2026. That figure peaked at 36 in 2024. The 2027 level is still higher than in 2021, when the average was 27, and in every year before that.
The biggest difference between states shows up at the edges. KFF found 26 states plus Puerto Rico where the average person has 20 or more drug-covered plans to pick from, and Pennsylvania, Michigan and Ohio have 40 or more. Nine states and the District of Columbia have fewer than 10. Alaska has none. A national average of 35 therefore tells a person very little about a local market or the choices in a given county.
The price side of the story comes from the Centers for Medicare & Medicaid Services, which said on September 28 that 88 percent of beneficiaries who do not get Extra Help can reach a basic Part D plan for $10.30 a month or less in 2027. Part D is the stand-alone drug benefit. The statement covers the cheapest basic plan reachable by that group, not what a typical person pays. The premium is only one part of what a plan costs, because deductibles and the price of each drug also count.
The 2027 Medicare Open Enrollment Decision Kit is built for that exact question of which Part D plan is cheapest for one person’s own drug list. It includes a cost calculator spreadsheet that compares plans on cost, drugs and doctors, plus a prescription-by-plan comparison.
Get the 2027 Part D prescription-by-plan comparison →
Premiums CMS expects for 2027
CMS Administrator Dr. Mehmet Oz said in the release that the agency is “fighting to keep high-quality care options affordable and accessible for the millions of beneficiaries who rely on Medicare Advantage and Part D prescription drug plans.” The agency projects the average monthly Medicare Advantage premium will fall from $14.37 in 2026 to $12.00 in 2027, a decline of 16.5 percent. About 34 million people, or 47.4 percent of everyone on Medicare, are expected to be enrolled in Medicare Advantage.
The Part D numbers move in two directions. For stand-alone drug plans, the average monthly premium is projected to rise by less than $1, from $35.09 to $36. Inside Medicare Advantage plans that include drug coverage, the drug portion of the premium is projected to fall from $11.32 to $7. CMS also says 93 percent of non-low-income beneficiaries can reach an enhanced Part D plan for under $6 a month. The 88 percent figure is the one tied to the lower-cost basic plans.
CMS puts the total number of Medicare Advantage plans at about 5,532 and says more than 99 percent of beneficiaries will have at least one available. It adds that 97 percent will have 10 or more to compare. KFF’s average of 35 is smaller because it counts only the general-enrollment plans open to the average beneficiary and leaves out special needs plans and several other plan types.
The people the 88 percent leaves out
The 88 percent figure applies only to people who do not get Extra Help, the federal program that pays Part D premiums, deductibles and copays. Medicare says people qualify automatically if they have full-benefit Medicaid, get help from a state Medicare Savings Program with Part B premiums, or receive Supplemental Security Income. Everyone else can apply through the Social Security Administration. For 2026 the limits are $23,940 in income for an individual and $32,460 for a married couple.
For 2027, Medicare lists Extra Help copays capped at $5.80 for generic drugs and $14.40 for brand-name drugs at participating pharmacies. People on Extra Help are also allowed to change drug plans monthly instead of waiting for the fall window. For this group the $10.30 figure is not the measure that applies, and the choice of plan turns more on which drugs and pharmacies it includes.
Medicare Rights Center, a nonprofit, pointed out in its October 1 summary of the new data that roughly 80 percent of Medicare Advantage members are expected to keep their current plan with the same or a lower premium in 2027. The rest face a plan that is ending or changing. Those members, not the national average, are where the count of 35 matters most, since each one has to find a replacement before December 7.
Comparing 2027 Part D plans before December 7
Open Enrollment runs from October 15 to December 7, and the official tool is Medicare’s Plan Finder at Medicare.gov. It takes a list of prescriptions with doses, a pharmacy choice and a ZIP code, then shows each plan’s premium, deductible and estimated yearly cost. The estimated total for a person’s own drugs is the number to rank on. The monthly premium alone is only one piece of it.
The gather-first list is short: every prescription with its strength and monthly quantity, the pharmacy used now, and any plan letter about 2027 changes. A plan’s deductible can apply to a drug that the plan lists as covered, so the estimate for each drug matters more than the premium alone.
KFF’s count shows the average choice shrinking by four plans for 2027, but the number that decides a person’s costs is the one for their own county and their own drug list. The CMS figure of $10.30 or less is a ceiling on the cheapest basic plan reachable by most people not on Extra Help, not a promise about any one prescription. Whether a plan that cheap also covers a particular drug at a workable price is something only the Plan Finder estimate will show.
The 2027 Medicare Open Enrollment Decision Kit puts that comparison in one place, with a cost calculator spreadsheet that compares plans on cost, drugs and doctors and the Open Enrollment calendar for the October 15 to December 7 window. It is an optional paid add-on to the free Plan Finder.
Compare 2027 drug plans with The 2027 Medicare Open Enrollment Decision Kit →
This article was produced with AI assistance and reviewed by The Money Overview’s editorial team.
