Medicare’s annual open enrollment opens Thursday, October 15, and this year it arrives with a consequential change for the roughly 69 million Americans on Medicare: fewer plans to choose from—and in a growing number of counties, no Medicare Advantage plans at all.
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The numbers, per KFF:
- 181 counties will have zero Medicare Advantage plans in 2027—up from 67 counties in 2026.
- The typical beneficiary can choose from 28 Medicare Advantage prescription-drug plans for 2027, down from 32 in 2026 (and down from a peak of 36 in 2024).
- Counting all Advantage plans, the average beneficiary sees 35 options, down from 39 last year.
- UnitedHealthcare is exiting 228 counties (entering just 9); Humana is leaving 62 counties (entering 4).
- More than half of eligible Medicare beneficiaries were enrolled in Medicare Advantage in 2026.
Insurers are pulling back from less profitable markets to protect margins rather than chase enrollment growth. For most beneficiaries the menu is simply a little shorter. But for people in the hardest-hit counties—or anyone whose specific plan is being discontinued—this enrollment season requires real attention.
What to do if your plan is being discontinued
If your insurer is leaving your county or discontinuing your plan, you should receive a non-renewal notice in the mail. Don’t ignore it—and don’t assume you’ll be automatically moved into equivalent coverage. Here’s the practical sequence:
- Read the non-renewal notice carefully. It explains when your coverage ends (typically December 31, 2026) and what happens if you do nothing.
- Compare 2027 options early. Use the Medicare Plan Finder at Medicare.gov or call 1-800-MEDICARE (1-800-633-4227). With fewer plans available, popular options can feel picked-over late in the window.
- Check your doctors and drugs first. A shrinking menu matters most when plans change their provider networks and drug formularies. Confirm your physicians are in-network and your prescriptions are covered before you enroll—especially if you manage a chronic condition or take several medications.
- Know your fallback. If no Advantage plan is available in your county, Original Medicare plus a Part D drug plan—and, if you qualify, a Medigap supplemental policy—remains available everywhere.
- Don’t miss the deadline. Open enrollment runs October 15 through December 7, 2026. Changes take effect January 1, 2027.
Comparing 2027 Medicare plans?
See what’s available in your county and compare costs side by side.
Why this is happening
The retreat is a deliberate business decision, not a sign the program is collapsing. Insurers are trading scale for margin: exiting counties where medical costs run hot and keeping the markets where their plans earn strong quality ratings (which bring bonus payments from the federal government). The long-term structural case for Medicare Advantage—an aging population enrolling every year—hasn’t changed. But the 2027 map has noticeably fewer choices on it, and the average number of plans per beneficiary has now fallen three years in a row.
Frequently Asked Questions
How do I know if my county is one of the 181 with no Medicare Advantage plans?
Enter your ZIP code in the Medicare Plan Finder at Medicare.gov. If no Advantage plans appear for 2027, your county is affected. Your insurer is also required to send a non-renewal notice if your specific plan is being discontinued.
What happens if I do nothing and my plan is discontinued?
Read your non-renewal notice—it spells out the default. In most cases you’ll be returned to Original Medicare, but you may need to actively choose a Part D drug plan to avoid a late-enrollment penalty. Don’t assume the default is your best option.
Can I switch to a Medigap policy instead?
Possibly. If your Advantage plan is leaving your area, you may have guaranteed-issue rights to buy certain Medigap policies without medical underwriting—but the rules and time windows are specific. Check Medicare.gov or call 1-800-MEDICARE to confirm what applies to your situation.
When is the deadline to pick a 2027 plan?
Medicare open enrollment runs October 15 through December 7, 2026. Any change you make takes effect January 1, 2027.
Are my drugs and doctors guaranteed to stay covered if I keep my plan?
No. Even plans that aren’t discontinued can change their formularies and provider networks for 2027. Re-verify your prescriptions and physicians every enrollment season.
References
Sources: KFF analysis of 2027 Medicare Advantage plan availability, via The Cheap Investor (Oct. 12, 2026); CMS star ratings data; Medicare.gov. Plan availability and insurer participation are reported figures—always confirm your county’s 2027 options in the official Medicare Plan Finder before making enrollment decisions.
