No Drug Plan in Your County? What Medicare Advantage Members Should Know for 2027

For most people, 2027 still brings plenty of Medicare Advantage choices. For a small but growing group, it brings none. Here’s how to tell whether you’re affected and what to do before open enrollment ends on December 7.

What KFF found

• 193 counties have no Medicare Advantage drug plan open to general enrollment in 2027.
• In 187 of them, no Medicare Advantage plan of any kind is open to the general public.
• In six counties, the only Medicare Advantage option has no drug coverage: Boyd County, Nebraska, and Aurora, Beadle, Bon Homme, Brown and Charles Mix counties in South Dakota.
• Alaska has no Medicare Advantage drug plans in 2026 or 2027.

The big picture is still that most people have many options: the average beneficiary can choose from 28 Medicare Advantage drug plans in 2027, down from 32. KFF counted plans open to general enrollment, so employer plans and special needs plans, which have their own eligibility rules, are separate.

Which situation are you in?

Why you usually can’t just add a drug plan

If you’re in a Medicare Advantage HMO or PPO, you generally can’t also have a stand-alone Part D plan. A few plan types are exceptions, such as some Private Fee-for-Service plans. That’s why a missing drug option matters: in a county with no Medicare Advantage drug plan, the realistic route to drug coverage is Original Medicare plus a stand-alone Part D plan.

Stand-alone Part D in 2027: shop carefully

KFF reports the average beneficiary will have 9 stand-alone Part D plans in 2027, down from 11. There will be no $0-premium stand-alone plans for people without Extra Help, and some popular plans are raising premiums sharply while others are cutting them. Don’t assume last year’s plan is still the best fit. Our guide to Part D premiums in 2027 explains how to compare, and Extra Help can lower costs if your income is limited.

If your current plan is the one leaving

Your plan must mail a non-renewal notice. Keep it. Then:

• If you do nothing, you return to Original Medicare, which doesn’t include drug coverage.
• You have a Special Enrollment Period to pick a new plan through the last day of February, in addition to open enrollment.
• You may have a Medigap guaranteed issue right if you return to Original Medicare. Federal law gives you up to 63 days after your old coverage ends to buy certain Medigap policies without health questions. Some states give more protection.
• Add a Part D plan so you aren’t left without drug coverage and don’t face a late enrollment penalty.

Our 7-day action plan walks through each step.

A 7-minute county check

1. Go to the Medicare Plan Finder at Medicare.gov and enter your ZIP code.
2. Look for Medicare Advantage plans with drug coverage.
3. Enter your prescriptions and preferred pharmacy.
4. If no plans appear, switch to Original Medicare and look at stand-alone Part D plans.
5. Call 1-800-MEDICARE (1-800-633-4227) or your State Health Insurance Assistance Program (SHIP) if the results look wrong.

The cost of going without

If you go 63 days or more in a row without Part D or other creditable drug coverage after you’re first eligible, a late enrollment penalty is added to your premium for as long as you have Part D. Even if you take few medicines, consider a low-cost plan.

Common questions

How do I know if my county is one of the 193?

Search your ZIP code in the Medicare Plan Finder. If no Medicare Advantage plan with drug coverage appears for general enrollment, call 1-800-MEDICARE or your SHIP.

Can I keep my Medicare Advantage HMO and add a drug plan?

Generally no. Most HMO and PPO members can’t also have a stand-alone Part D plan.

Is this the same as my plan ending?

Not always. A plan can end while others remain in your county. This guide covers counties where no drug option remains for general enrollment.

Where can I get free help?

Your SHIP offers free, unbiased counseling, and 1-800-MEDICARE can answer general questions.