Major insurers are scaling back Medicare Advantage offerings for 2027, leaving fewer choices

The pullback is uneven, with some companies exiting only selected counties

• Large insurers, including UnitedHealthcare and Humana, are shrinking their Medicare Advantage coverage areas for 2027, while two smaller insurers are exiting the general-enrollment Medicare Advantage prescription drug plan market altogether.

• In 2027, residents of 193 U.S. counties will have no Medicare Advantage plans with prescription drug coverage available for general enrollment, up from 123 counties in 2026.

• Rising medical costs and concerns about profitability are pushing the retreat, forcing some retirees to look for new coverage during Medicare Open Enrollment.

Millions of Americans have chosen Medicare Advantage instead of traditional Medicare because of lower premiums and extras such as dental, vision and hearing benefits. For 2027, however, some of the country's biggest health insurers are cutting back their participation, reducing options for seniors in certain communities.

A new analysis from the health policy research group KFF, also known as the Kaiser Family Foundation, finds that insurers are withdrawing from hundreds of counties, and some are eliminating their general-enrollment Medicare Advantage prescription drug plans entirely.

The reduction is especially notable in rural areas, where Medicare Advantage choices were already limited.

According to KFF, 193 counties will have no Medicare Advantage prescription drug plans available for general enrollment next year, compared with 123 counties in 2026. Roughly 638,000 Medicare beneficiaries live in those counties, although not all are currently enrolled in Medicare Advantage.

The changes do not mean Medicare Advantage is going away. Most beneficiaries will still have several plans to choose from. Even so, the departures highlight increasing financial strain on a program that has become a bigger part of the U.S. health insurance system.

Which insurers are reducing their footprint?

KFF's review of federal Medicare plan data shows several major insurers making notable changes for 2027.

UnitedHealth Group, the nation's largest Medicare Advantage insurer, is withdrawing its Medicare Advantage prescription drug plans from 228 counties while adding nine new ones.

Humana, another major provider, is leaving 62 counties and entering four.

Other insurers are making even sharper geographic cuts:

• Health Care Service Corporation, which operates several Blue Cross Blue Shield plans, is exiting 498 counties.

• Centene, the parent company of Wellcare, is exiting 359 counties and entering 15.

• Blue Cross Blue Shield of Michigan is exiting 177 counties and entering one.

• Elevance Health is pulling back from 66 counties while expanding into 10.

Two companies, Clear Spring Health's parent Group 1001 and Molina Healthcare, are leaving the general-enrollment Medicare Advantage prescription drug plan market entirely. Molina will still offer certain Special Needs Plans.

That does not necessarily mean these companies are abandoning Medicare Advantage as a whole. Many are focusing on markets where they believe they can remain profitable.

At the same time, some insurers are expanding. Devoted Health is entering 342 additional counties, underscoring that companies have different views of the program's financial prospects.

Why are insurers stepping back?

The main reason appears to be financial pressure.

Medicare Advantage plans receive federal payments to deliver Medicare-covered services through private insurance networks. Insurers must manage medical costs while meeting federal rules.

Several developments have made that model harder to sustain.

Medical spending has risen as older Americans use more healthcare services. Prescription drug costs have also increased pressure on insurers, while Medicare payment changes and quality ratings can affect how much money companies receive from the government.

Insurers are also adapting to changes in the Medicare prescription drug program that shift some of the financial burden.

In Minnesota, where several insurers are pulling back from numerous counties, industry representatives have pointed to rising pharmacy costs, increased medical use and reimbursement that they say does not match expenses.

As a result, insurers are rethinking the markets where they believe they can no longer earn acceptable returns.

Instead of withdrawing from Medicare Advantage nationwide, companies are increasingly choosing the counties and populations they think they can serve sustainably.

Federal officials say the program remains broadly available

Despite the cutbacks, the Centers for Medicare & Medicaid Services says Medicare Advantage remains widely accessible.

The agency projects that more than 99% of Medicare beneficiaries will have access to at least one Medicare Advantage plan in 2027, while 97% will have access to at least 10 choices.

CMS also projects that the average monthly Medicare Advantage premium will fall from $14.37 in 2026 to $12 in 2027.

The total number of Medicare Advantage plans nationwide is expected to stay relatively steady, slipping from 5,553 to about 5,532.

Still, those national numbers can hide major local differences.

Plan availability varies widely by county

KFF found that the average beneficiary will have 28 Medicare Advantage prescription drug plans available in 2027. In some counties, residents will have dozens of options, while in others they will have none.

That makes a beneficiary's ZIP code increasingly important when comparing Medicare coverage.

What happens if a Medicare Advantage plan is discontinued?

For beneficiaries whose plans are being dropped, the immediate priority is keeping healthcare coverage in place without interruption.

Medicare Advantage insurers generally notify members when their coverage will not be renewed for the next year.

Affected beneficiaries can choose another Medicare Advantage plan, if one is available, or return to Original Medicare.