CMS released its 2027 Medicare Advantage and Part D plan landscape on September 28, projecting that the weighted average monthly MA premium will decline from $14.37 to $12.00 — a 16.5 percent drop.
The national number of MA plans remains nearly unchanged at approximately 5,532, down from 5,553 in 2026. MA plans project roughly 34 million enrollees for 2027, representing approximately 47.4 percent of all people enrolled in Medicare.
More than 99 percent of Medicare beneficiaries are expected to have access to at least one MA plan. About 97 percent will have access to 10 or more options.
2027 at a glance (projections)
This is how we are projecting the next year:
| Metric | 2026 | 2027 projected | Change |
| Weighted average MA monthly premium | $14.37 | $12.00 | -16.5% |
| National MA plan count | 5,553 | ~5,532 | -21 plans |
| Projected MA enrollment | ~34M (plan projection) | ~34M | Broadly flat |
| MA-PD Part D premium component (after rebates) | $11.32 | $7.00 | -38% |
| Stand-alone Part D average premium | $35.09 | $36.00 | +$0.91 |
Source: CMS September 28, 2026
CMS says hearing, dental, and vision supplemental benefits are expected to remain broadly stable nationally. About 8 in 10 MA beneficiaries will be able to remain in their current plan at the same or lower premium.
Premiums versus payments
Billing teams should not confuse the two financial flows.
- $12/month is the beneficiary premium, not provider reimbursement
- CMS separately finalized a +2.48% increase in federal MA payments in April (>$13B additional)
- Below-benchmark plan bids generate rebates that subsidize benefits and lower premiums
CMS can pay insurers more while plans charge beneficiaries less. Those are different sides of the same system. The premium decline does not mean provider reimbursement is falling.
TWO DIFFERENT CMS ANNOUNCEMENTS
Federal payments to plans ≠ premiums charged to beneficiaries
APRIL 6 — RATE ANNOUNCEMENT
+2.48%
Average increase in federal payments to MA plans (>13Badditional)
Source: CMS 2027 MA Rate Announcement (April 6); CMS 2027 plan landscape (September 28)
Local market exits
The national plan count drops by only 21. That number masks significant geographic reshuffling.
Becker’s analysis of CMS’s state-level data found that individual MA plan choice is declining in 29 of the 51 jurisdictions where individual Medicare Advantage plans are available.
| State | 2026 plans | 2027 plans | Change |
| Florida | 611 | 560 | -51 |
| Ohio | 212 | 180 | -32 |
| Illinois | 157 | 136 | -21 |
| Maryland | 63 | 47 | -16 |
| Wyoming | 14 | 8 | -6 |
States gaining plans include Tennessee, Missouri, Arizona and Alabama. Source: CMS state-level data via Becker’s
The national market is not shrinking — it is being redistributed.
KFF found that roughly 2.6 million MA-PD beneficiaries were enrolled in plans being terminated for 2026 (double the prior year). Humana said in July that its planned 2027 exits will affect approximately 600,000 members.
For practices in affected markets, 2026 participation agreements may not cover patients’ new 2027 products — particularly under HMO and PPO network arrangements.
Common misreadings
The national average obscures important variation.
| Claim | Reality |
| Every beneficiary’s premium falls 16.5% | Wyoming’s average rises from $45.91 to $69.23; Mississippi’s drops from $11.18 to $4.08 |
| Provider reimbursement falls 16.5% | $12 is a beneficiary premium, not physician/hospital allowed amounts |
| MA enrollment will be exactly 34 million | Plan projection — CMS says these historically understate actual enrollment |
| Supplemental benefits are unchanged | “Stable nationally” ≠ identical per enrollee; plans may modify limits, vendors and copays |
The 16.5 percent figure is a weighted national average, not a guarantee for any individual enrollee or market.
The RCM impact
The premium decline does not directly change provider reimbursement.
The operational relevance comes from Open Enrollment (October 15 through December 7) and plan transitions taking effect January 1.
A patient who had the same insurer in December may not have the same plan in January. That creates specific pre-claim verification needs.
- Re-verify eligibility for all January 2027 dates of service
- Recheck network status in markets where insurers exited or consolidated
- Confirm prior-auth rules per plan — lower premiums ≠ less utilization management
- Validate coverage, referrals and patient responsibility before the first 2027 claim
The failure chain during a plan transition is predictable.
| Step | Failure point |
| 1 | Inactive or changed plan carried forward from 2026 |
| 2 | Wrong payer ID on the claim |
| 3 | Service rendered out-of-network under new product |
| 4 | Missing referral or prior authorization |
| 5 | Incorrect patient responsibility |
| 6 | Claim denied — problem started at the front desk |
Each step is preventable with January eligibility verification.
