Fifteen insurers have set enrollment caps on 65 of their Medicare Advantage plans for 2027, and the smallest cap is 410 members. Once a capped plan reaches its limit, it cannot accept another applicant until space opens up. Medicare’s annual enrollment period runs through December 7, 2026, so a plan picked late in the season could already be closed.
How many plans have caps, and where?
A Becker’s Payer Issues review of federal data, published September 29, counts 65 capped plans in 11 states. Cap sizes run from 410 members at the small end to 56,345 at the large end.
The smallest cap belongs to Martin’s Point Health Care in Maine, which capped nine plans at between 410 and 22,350 members. The largest belongs to Network Health in Wisconsin, which capped 10 plans at between 1,522 and 56,345 members.
What happens when a capped plan fills up?
Federal rules leave the insurer no discretion once the cap is hit. The Centers for Medicare & Medicaid Services says in its 2027 enrollment guidance, updated August 25, 2026, that “a plan that has reached its capacity limit must remain closed to all applicants until space becomes available.”
Anyone already in a capped plan is not pushed out. HealthPartners states that current members of a plan with a capacity limit who live in its 2027 service area “are not affected by this change.” The cap only decides who can join.
What changed this year: Social Security and Medicare change every year, and nobody sends you a memo. The Retirement Money Brief breaks down what changed and what to do.
Get the Retirement Money Brief →
We may earn a commission from links on this page.
For anyone eyeing one of these plans, the practical question is whether that specific plan is still taking applicants. HealthPartners, for example, lists six capped 2027 plans by contract number and county, and all six were marked open when the page was last updated October 14. A person in the Twin Cities, central Minnesota or northeastern Wisconsin should confirm the plan is still open on the day they apply, and keep a second choice ready in case it is not.
Which insurers set a cap?
The capped plans sit in these states, according to Becker’s:
- Hawaii: Hawaii Medical Service Association, with five plans capped at 5,000 to 12,800 members.
- Maine: Martin’s Point Health Care.
- Maryland: Johns Hopkins Healthcare, CareFirst BlueCross BlueShield and LifeBridge Health.
- Massachusetts: Blue Cross Blue Shield of Massachusetts, with seven plans capped at 1,560 to 26,390 members.
- Michigan: Henry Ford Health System, with two plans capped at 34,000 and 35,000 members.
- Minnesota: HealthPartners and Sanford Health.
- Nebraska: Sanford Health and Blue Cross Blue Shield of Nebraska.
- New Jersey: Horizon Blue Cross Blue Shield of New Jersey.
- New York: Independent Health Association.
- North Carolina: Blue Cross Blue Shield of North Carolina.
- Wisconsin: HealthPartners, Group Health Cooperative of Eau Claire and Network Health.
HealthPartners and Sanford Health each cap plans in two states, which is how 17 insurer-state listings add up to 15 insurers.
Why are caps landing on top of plan exits?
For some members, the cap is only one of two changes. HealthPartners says its Journey Steady and Journey Stride plans end in every Minnesota county, and Journey Pace and Journey Smart end in seven counties: Kandiyohi, McLeod, Meeker, Pope, Redwood, Renville and Swift. Those members must pick a new plan, and the plans they would move to may carry caps.
Counselors in Maine describe the pressure. Ann Shea, the Medicare supervisor at the Eastern Area Agency on Aging, told the Maine Monitor the caps and terminated plans “are really putting a lot of pressure on consumers.” AgeMaine received more than 1,300 requests for coverage reviews in October, compared with about 850 in the same period last year.
Where can someone check whether a plan is open?
Medicare’s Plan Finder lists every plan offered in a ZIP code, and the insurer’s own enrollment line can say whether a capped plan is still accepting applications. HealthPartners staffs its sales line at 844-363-8979 from 8 a.m. to 8 p.m. every day. Open enrollment ends December 7, and coverage chosen now starts January 1, 2027.
The caps are new, the closing rule is federal, and insurers decide when to stop accepting applicants. Whether the plan a person has circled is still open the week they apply is the one fact the posted lists cannot promise.
Need a 2027 plan that is still open before December 7?
A capped plan that fills before an application goes through leaves a person starting over in late November, with fewer days to compare drugs, doctors and monthly costs on a second choice. That is how a plan change gets rushed and a pharmacy or specialist ends up out of network.
The 2027 Medicare Open Enrollment Decision Kit includes a cost calculator spreadsheet that compares plans on cost, drugs and doctors, and the Open Enrollment calendar that keeps December 7 in view. It also has a prescription-by-plan comparison, so a backup plan can be checked against the same medicine list as the first choice.
Get the plan-comparison calculator for a backup if a capped 2027 plan closes →
More Financial Reading
- 21 Ways to Stretch a $2,087 Social Security Check
- 15 Places to Find Your Share of the $4.25 Billion States Give Back
- 17 Medicare Money Moves Now That Part D Caps at $2,400
This article was produced with AI assistance and edited for accuracy against the sources linked above.
