The 2027 plan year is shaping up to be another one of disruption for Medicare Advantage (MA) beneficiaries. Approximately one in eight general-enrollment members is currently covered by a plan that will no longer be available. Those whose plans remain still face changes to benefits or will see higher out-of-pocket costs.
In response, millions of people will choose new coverage for the year ahead, potentially reshaping enrollment across carriers and products. The 2027 annual enrollment period runs from October 15 to December 7.
While 2026 was marked by broad-based market pullbacks, the changes for 2027 reflect a more selective approach, with carriers discontinuing some products and exiting certain markets while also investing in new offerings and growth opportunities in new geographies. This points to a market that is undergoing a reset rather than simply shrinking the number of options available.
Health plans are adapting to a shifting MA landscape
The shift in the MA landscape has been caused by ongoing financial pressures from medical trends outpacing rate increases, rising prescription drug costs, and reimbursement changes. While medical trend stabilization offered relief for some in 2026, carriers remain focused on restoring profitability by making increasingly selective decisions about their products and the markets where they compete.
Our analysis of products being offered for the 2027 plan year found fewer general-enrollment MA plans being offered. In this analysis, general-enrollment MA plans include individual, non-special needs plan (SNP) MA plans with or without Part D prescription drug coverage (MA-PD and MA-only). At the same time, some carriers continue to invest in selective growth, adding new products and counties, particularly for chronic condition special needs plans (C-SNPs).
2.8 million people are enrolled in MA plans not offered for 2027
Many beneficiaries are seeing fewer options locally for the 2027 plan year. The average number of general-enrollment MA plans available per county fell from 26.1 to 23.1. The reduction is occurring across geographies: Average availability fell from 44 to 38.3 plans in large metropolitan counties, and from 20.1 to 17.3 in rural counties.
Some individual markets are seeing considerably larger changes. For example, the number of general-enrollment MA plans available in Harris County, Texas, fell from 69 to 49, and in Jackson County, Oregon, the number fell from 20 to just five.
The impact on members will be notable. About 2.8 million general-enrollment MA members — 13% of 2026 enrollment — are currently enrolled in plans that are not available for 2027. Three of the largest MA operators — Humana, UnitedHealthcare, and Aetna (CVS Health) — are scaling back and exiting some markets for 2027 to protect profit margins amid higher medical utilization and tighter federal reimbursement. Those companies account for roughly 42% of general-enrollment MA enrollment that will be affected by plan exits, representing approximately 540,000, 390,000, and 260,000 members, respectively.
Medicare Advantage plan reductions extend to Texas and Florida
Even historically strong MA markets are experiencing changes. In Florida, approximately 308,000 general-enrollment MA members, or 17% of current enrollment, are in plans that aren’t being offered for 2027, while average plan availability in the state declined from 33.1 to 28.7 plans per county.
Texas is facing similar pullback, with approximately 193,000 members affected and average availability falling from 24.1 to 18.0 plans per county. The changes suggest that even in established MA markets with significant enrollment, carriers are reassessing where they can operate profitably rather than prioritizing geographic expansion or membership growth alone.
However, markets are not contracting everywhere. There are 506 general-enrollment MA bid IDs associated with new contract-plan entries for 2027, with the newest products being offered in New York (43) and California (40). These additions likely reflect a mix of new product launches and carriers that are replacing existing offerings rather than new carriers entering the market. At the same time, 285 continuing bid IDs have expanded into at least one additional county in 2027.
Medicare Advantage PPO plans face deeper cuts than HMOs in 2027
Preferred provider organizations (PPOs) continue to account for a disproportionate share of the general-enrollment MA pullback. For the 2027 plan year, the number of general-enrollment MA health maintenance organization (HMO) and HMO point-of-service (POS) bid IDs declined only slightly, from 2,140 to 2,115, or approximately 1%. PPO bid IDs declined from 1,591 to 1,426, a 10.4% reduction. This is the second consecutive year in which the number of PPOs fell disproportionately. Last year's MA market analysis found PPO plans had declined 12%, compared with an 8% decline for HMOs.
The member impact is particularly pronounced among PPOs. About 1.79 million general-enrollment MA PPO members (20.8% of current PPO enrollment) are in plans that will not be available in 2027, compared with 1.03 million HMO/HMO-POS members (8.0% of enrollment). The continued decline in PPO offerings suggests that carriers are still struggling to manage the performance of these products. Broader provider access and fewer network restrictions can make it more difficult to manage utilization, steer members toward cost-effective, high-quality care, and establish effective value-based arrangements with providers.
Medicare Advantage SNP growth shifts toward chronic condition plans
The proliferation of SNP plan offerings reflects the distinct nature of these markets. While dual eligible SNP (D-SNP) availability has contracted modestly, C-SNPs have experienced significant growth, with institutional SNPs (I-SNP) also expanding from a smaller base.
D-SNPs, which remain the largest SNP segment, contracted modestly for 2027. Bid IDs declined 3.0%, from 1,085 to 1,052, while average availability fell from 11.2 to 10.6 plans per county. Despite this, there are 152 bid IDs associated with new contract-plan entries, while 118 continuing D-SNP bid IDs expanded into additional counties. As in general-enrollment MA, carriers pulled back in some markets while continuing to invest in others. Some of this activity is likely driven by carriers responding to upcoming D-SNP integration requirements across markets.
C-SNPs are the clearest area of growth and focus for 2027. Bid IDs increased 34.2% (from 562 to 754) while average availability rose from 3.1 to 3.9 plans per county. There are also 254 C-SNP bid IDs associated with new contract-plan entries for 2027. That growth is not evenly distributed across carriers. Devoted Health accounts for roughly 69% of the net increase in C-SNP bid IDs, more than doubling its portfolio from 122 to 255 bid IDs. Its C-SNP footprint expanded from 978 to 1,322 counties for the 2027 plan year. Aetna is the next-largest contributor, increasing from 46 to 73 C-SNP bid IDs and expanding its footprint by 177 counties. Together, Devoted and Aetna account for roughly 83% of the net increase in C-SNP bid IDs. I-SNPs remain a much smaller segment but continue to expand. Bid IDs increased from 156 to 163, while average availability rose from 1.8 to 2.3 plans per county.
Medicare Advantage carriers pursue different growth and exit strategies
The market-level changes reflect very different strategies among individual carriers. Some carriers are expanding. For example, Devoted Health’s general-enrollment MA (non-SNP) portfolio increased from 241 to 407 bid IDs, while its county footprint expanded from 999 to 1,341 counties. Its SNP portfolio grew from 186 to 333 bid IDs and expanded from 989 to 1,339 counties. Its C-SNP expansion is particularly significant, making Devoted one of the largest contributors to overall SNP growth for 2027.
Other health plans have pulled back. For example, Centene's general-enrollment MA portfolio declined from 187 to 110 bid IDs, while its footprint fell from 1,731 to 1,387 counties. Approximately 158,000 people are currently covered by Centene general-enrollment MA plans that are not being offered for the 2027 plan year. Health Care Service Corporation (HCSC) has also reduced its general-enrollment MA footprint substantially, from 948 to 450 counties, impacting about 58,000 members. Some smaller and regional carriers have made much deeper reductions relative to the size of their own portfolios.
Other carriers have restructured their portfolios while maintaining broad geographic participation. Humana’s general-enrollment MA county footprint has remained virtually the same — 2,656 counties in 2026 compared with 2,599 for 2027 — even as its bid IDs declined from 653 to 621.
Approximately 543,000 Humana general-enrollment MA members are enrolled in plans that won’t be offered for 2027, the largest absolute number among carriers. UnitedHealthcare and Aetna are also discontinuing general-enrollment MA products, affecting approximately 390,000 and 262,000 members, respectively. Both carriers are emphasizing HMO products and specialized plans for 2027, particularly C-SNPs and D-SNPs. Aetna is expanding its Prime HMO offerings in selected markets and extending C-SNP availability into six additional states. These changes among national carriers reflect a more selective approach to product design and geographic participation rather than a uniform pullback from the MA market.
How Medicare Advantage carriers can prepare for the 2028 bid cycle
The 2027 filings build on the portfolio recalibration we have observed over the last several years and provide a clearer view of where carriers are landing. General-enrollment MA choice continues to narrow, PPO pressure persists, and growth within SNPs is becoming increasingly concentrated in C-SNPs. But this is not a uniform pullback. Carriers are making more deliberate choices about the products, populations, and geographies where they believe they can compete sustainably.
For carriers, understanding their member population will be critical. Plans will need to closely monitor who they retain, who they gain, and who they lose during the annual enrollment period. They will also need to understand how the risk, utilization, and clinical characteristics of their membership are changing and what that means for care management and member engagement in 2027.
Those insights must also feed quickly into the next bid cycle. Getting the 2028 bid strategy right will be critical to ensure a sustainable path forward. As carriers plan for the 2028 plan year, they will need to determine where further action is needed across benefit design, product portfolio design, network strategy, geographic participation, and care management. They will also need to determine where improving performance may create opportunities to invest in growth. Most important, this all must be done in the context of a multi-year Medicare strategy.
Analysis uses bid ID as the primary plan unit. Local availability reflects distinct bid IDs available within each county. Enrollment figures are based on reported May 2026 enrollment and are rounded where appropriate. General-enrollment MA refers to non-SNP Medicare Advantage plans (MA-PD and MA-only), including HMO, HMO-POS, PPO, PFFS, and MSA products in the analysis. D-SNP, C-SNP, and I-SNP plans are excluded and analyzed separately.