Nearly 200 Counties, Zero Medicare Advantage Drug Plans: What to Do Before Dec. 7

Smart Senior Daily's Medicare Awareness Week continues

In 193 U.S. counties (about 638,000 people), there won't be a single Medicare Advantage plan with drug coverage open to general enrollment in 2027. That's up from 123 counties this year, according to a new KFF analysis of federal plan data.

Not all of these people are in Medicare Advantage, but anyone in one of those counties with an Advantage plan will have to find drug coverage somewhere else.

The bigger story is the pullback behind it. UnitedHealthcare, Humana, Blue Cross Blue Shield plans, Centene and others are dropping plans in hundreds of counties, so even people in well-served areas may be losing the plan they have now.

Why? Pick one: People using more medical care... rising drug costs... changes in how Medicare pays... new rules... rural counties with small Medicare populations, where it's harder for an insurer to spread costs.

What KFF Found

The counties with no Advantage drug plan are spread across 16 states plus U.S. territories other than Puerto Rico:

Alaska, California, Colorado, Idaho, Kansas, Minnesota, Montana, Nebraska, Nevada, New Hampshire, North Dakota, Oklahoma, Oregon, South Dakota, Utah, and Vermont.

For most people, choices are shrinking rather than vanishing. That, too, could be a problem. The average beneficiary will have 28 Advantage drug plans to pick from in 2027, down from 32 this year, KFF reports. Federal officials point out that more than 99% of beneficiaries still have access to at least one Advantage plan, ConsumerAffairs reported.

Who's Pulling Back

Here's how many counties each big insurer is leaving (and entering) with its Advantage drug plans for 2027, per KFF:

Health Care Service Corp. (Blue Cross plans in IL, MT, NM, OK, TX): leaving 498
Centene (Wellcare): leaving 359, entering 15
UnitedHealthcare: leaving 228, entering 9
Aetna (CVS Health): leaving 186, entering 63
Blue Cross Blue Shield of Michigan: leaving 177, entering 1
Anthem (Elevance Health): leaving 66, entering 10
Humana: leaving 62, entering 4
Devoted Health: the exception, entering 342

What to do before Dec. 7

Find your plan's letter. If your plan is leaving, your insurer is required to mail you a non-renewal notice, usually in early October. It may look like junk mail. Also read your Annual Notice of Change if your plan is staying, since benefits and drug lists can shift.
Look up what's left in your ZIP code. Use the Medicare Plan Finder or call 1-800-MEDICARE (1-800-633-4227). Options vary a lot from one county to the next, so a friend's plan two counties over may not be available to you.
Check your doctors, drugs and pharmacy first. Before you pick a new plan, confirm your doctors are in its network and your prescriptions are on its drug list at a price you can live with.
If no Advantage plan is left, plan for Original Medicare. You'll need a separate Part D drug plan, and you may want a Medigap supplement. Stand-alone drug plans are available in every state; the average beneficiary will have nine to choose from in 2027, per KFF.
Budget for a drug plan premium. There are no $0-premium stand-alone drug plans in 2027 for people who don't get Extra Help, according to KFF. Shopping around matters: KFF projects the average stand-alone premium could hit $51 a month if people stay put, up from $34.
Enroll by Dec. 7. That's the cleanest path. Coverage starts Jan. 1 with no gap.

What to Do Before Dec. 7

Read your mail. If your plan is leaving, your insurer must send a non-renewal notice, usually in early October. It's easy to mistake for junk mail.
See what's left in your ZIP code. Use the Medicare Plan Finder or call 1-800-MEDICARE (1-800-633-4227).
Check your doctors, drugs and pharmacy against any plan before you pick it.
No Advantage plan left? Go with Original Medicare plus a Part D drug plan, and consider a Medigap supplement. Every state has stand-alone drug plans, but none are $0-premium in 2027 unless you get Extra Help, per KFF.
Enroll by Dec. 7 so coverage starts Jan. 1 with no gap.

Missed Dec. 7?

If your plan is ending, you get a second window from Dec. 8 through Feb. 28, the Washington State Insurance Commissioner explains. But a plan picked in January doesn't start until Feb. 1, and doing nothing leaves you in Original Medicare with no drug plan.

The upside: when your Advantage plan leaves, you can buy certain Medigap policies without answering health questions for up to 63 days after your coverage ends, according to the Indiana State Health Insurance Assistance Program.

Where to Get Free Help

Your State Health Insurance Assistance Program offers free, unbiased counseling. Find yours at shiphelp.org. And remember, Medicare never cold-calls to sell you a plan. If someone does, hang up.