Update Note: This article reports new KFF plan-availability data released on October 1, 2026, following MedicalDaily's earlier coverage of 2027 Medicare premiums. Figures reflect KFF's analysis of CMS landscape files for plan year 2027. Medicare open enrollment runs October 15 through December 7, 2026.
The average person with Medicare will be able to choose from 28 Medicare Advantage plans that include drug coverage in 2027, down from 32 this year, according to a new KFF analysis published October 1. That is well below the peak of 36 in 2024. Texas saw the steepest drop of any state, losing nine plans for the average enrollee.
The shrinking menu matters most for people whose current plan is leaving their county or changing its doctors and drug list. Fewer options can mean fewer networks to choose from, which raises the stakes for anyone managing a chronic condition or taking several prescriptions. For adult children helping a parent sort through mail from insurers, the next two weeks are the time to gather plan documents before enrollment opens.
The cut is uneven across the country. KFF found that Illinois and Ohio each lost eight plans for the typical enrollee, while Minnesota, New Mexico, and Washington each lost seven. Only four states gained options, and nine saw no change.
Where Plan Choices Fell the Most
KFF's count reflects how many plans the average beneficiary can actually pick from where they live, rather than a raw national total. That distinction helps explain a gap in the numbers. The Centers for Medicare & Medicaid Services reported on September 28 that 5,532 Advantage plans will be offered nationally in 2027, only slightly fewer than 5,553 this year, yet KFF found the typical person's local choices of Advantage plans with drug coverage fell by four.
Some places still offer far more choice than others. Pennsylvania, Michigan, and Ohio each average 40 or more plans with drug coverage even after the cuts, while nine states and Washington, D.C., average fewer than 10. Alaska has no such plans in 2027, as in 2026. KFF's count excludes special needs plans, employer-sponsored plans and certain other plan types, so some people may see different numbers when they search.
MedicalDaily previously reported on CMS's 2027 premium projections, which showed the average Advantage premium falling to about $12 a month. The new KFF figures add a different piece of the picture: lower average premiums are arriving alongside fewer choices for the person shopping in a given county.
Shopping Habits Lag Behind a Changing Market
The concern is that many people do not look at their options at all. An earlier KFF analysis, based on 2022 Medicare Current Beneficiary Survey data and published in 2024, found that 69% of beneficiaries did not compare their coverage with other Medicare options during open enrollment. Among Advantage enrollees with drug coverage, 82% did not compare drug coverage specifically. Because that survey covers an earlier year and relies on self-reported answers, it does not measure how many people will shop this fall.
Prescription costs are also shifting. According to Medicare.gov, the maximum Part D deductible rises to $700 in 2027 from $615, and the annual out-of-pocket cap on covered drugs rises to $2,400 from $2,100. People who take expensive brand-name or specialty drugs could reach that cap sooner, so the drug list and pharmacy network of each plan carry real financial weight.
The Medicare Rights Center, a nonprofit consumer group, said in its October 1 analysis that "Plans can differ on everything from costs to coverage, making detailed analysis both critical and difficult." The group urged people to assess how their current coverage is working and compare it with what else is available.
CMS has offered a reassurance of its own. The agency said, "approximately eight in 10 MA beneficiaries will be able to remain in their current plan with the same or a lower premium in 2027." Still, a steady premium does not guarantee that a plan's doctors, hospitals, or covered drugs will stay the same.
Checking Networks, Drug Lists, and Free Counseling
KFF recommends comparing the extra benefits each plan offers, cost sharing for medical care, out-of-pocket limits, prior authorization and referral rules, drug formularies, and provider networks. A good first step is the Annual Notice of Change letter that plans were required to mail by September 30. It lists what is changing in a member's current plan for next year.
Medicare's online Plan Finder lets users enter their medications and preferred pharmacies to estimate yearly costs across available plans. Enrollees should confirm directly with doctors' offices and hospitals that they will be in network for 2027, since directories can lag behind contract changes. People in active treatment, such as cancer care or dialysis, have the most to lose from a network change.
Free, unbiased help is available through each state's State Health Insurance Assistance Program, which offers one-on-one counseling by phone or in person. The 1-800-MEDICARE line also runs around the clock. Counselors can be especially useful for people with limited internet access or those comparing plans for a relative.
Cost and access barriers are real for many older adults. Those with lower incomes may qualify for Extra Help with drug costs or Medicare Savings Programs, and SHIP counselors can screen for eligibility. Enrollees should be cautious with unsolicited calls or ads promising extra benefits, and no one should stop or switch a prescribed medication because of a plan change without speaking with a health care professional.
Open enrollment begins October 15 and ends December 7, with new coverage starting January 1. People whose plans are leaving their area may have additional time to choose through a special enrollment period. The shrinking number of choices is a real change for millions of households, but checking coverage now, before the window opens, is the most direct way to avoid surprises when 2027 bills and pharmacy visits begin.
Key Questions Answered
How many Medicare Advantage drug plans will the average enrollee have in 2027?
KFF found the average beneficiary will be able to choose from 28 Medicare Advantage plans with drug coverage in 2027. That is down from 32 in 2026 and 36 in 2024.
Which states lost the most plan options?
Texas had the largest drop, with nine fewer plans for the typical enrollee. Illinois and Ohio each lost eight, while Minnesota, New Mexico, and Washington each lost seven.
Do most people compare Medicare plans each year?
No. A KFF analysis of 2022 survey data found that 69% of beneficiaries did not compare their coverage with other options during open enrollment.
What is the Part D out-of-pocket cap for 2027?
Medicare.gov lists the 2027 cap on out-of-pocket spending for covered Part D drugs at $2,400, up from $2,100 in 2026. The maximum deductible rises to $700.
When is Medicare open enrollment?
Open enrollment runs from October 15 through December 7, 2026. Changes take effect January 1, 2027.
Where can I get free help comparing plans?
Each state's State Health Insurance Assistance Program provides free, unbiased counseling. People can also use Medicare's online Plan Finder or call 1-800-MEDICARE at any hour.
Published by Medicaldaily.com
