Two Sun Belt states are moving against the national tide in Medicare Advantage. Alabama goes from 98 plans in 2026 to 113 in 2027, and Arizona goes from 133 to 148, a gain of 15 each. The counts come from the federal agency that runs Medicare, in state-by-state fact sheets released with the 2027 plan landscape.
What the CMS state fact sheets say for Alabama
The Centers for Medicare & Medicaid Services published its 2027 Medicare Advantage and Part D landscape state-by-state fact sheets on September 28, 2026. The Alabama page lists 98 Medicare Advantage plans for 2026 and 113 for 2027, a net increase of 15. The same page puts the state’s average monthly premium at $11.25 in 2026 and $7.76 in 2027.
The fact sheet reports a state total. It does not name which insurers are adding the 15 plans, which counties they will serve, or whether the new plans are standard Medicare Advantage offerings or special-needs plans. A reader of the document learns that Alabama will have more plans on the shelf next year, and learns nothing about which plans.
Arizona: 133 plans become 148 and the average premium drops
Arizona’s page shows 133 Medicare Advantage plans in 2026 and 148 in 2027, another increase of 15. The average monthly premium listed for the state falls from $4.47 to $2.81. Arizona started from a larger base than Alabama, so the same 15-plan gain is a smaller percentage change there, roughly 11 percent against about 15 percent for Alabama.
The two states land on the same number by coincidence, not by design. Nothing in the fact sheets links them, and the document gives no explanation for either increase. What the sheets do establish is that the 2027 plan year does not shrink every market.
How a national total of 5,532 plans coexists with double-digit state gains
CMS’s September 28, 2026 announcement puts the national count at about 5,532 Medicare Advantage plans for 2027, down slightly from 5,553 in 2026, a net drop of 21 plans. It also says an estimated 34 million people, 47.4 percent of the Medicare population, are expected to be enrolled, that more than 99 percent of beneficiaries have access to at least one Medicare Advantage plan, and that 97 percent have access to 10 or more.
A nationwide net loss of 21 plans leaves room for large movements in both directions underneath. Alabama and Arizona alone add 30 plans between them, so the rest of the country has to lose a net 51 plans for the national count to come out where CMS reports it. Trade press reading the same landscape describes the losses. Becker’s Hospital Review, in a report published October 1, 2026, said 28 states will see fewer plan options, with Florida falling from 611 plans to 560 and Wyoming from 14 to 8. That 28-state count is Becker’s own tally and is not one this piece verified against the CMS sheets.
The geography is the point. A national headline that plans are shrinking is true in aggregate and false for an Alabama or Arizona resident looking at next year’s market, and the reverse holds in Florida.
Indiana, Kentucky and four smaller moves on the same sheets
Alabama and Arizona are not the only states with gains. The fact sheets show Indiana rising from 127 plans to 140 and Kentucky from 114 to 123. Smaller increases appear in Delaware, from 37 plans to 38, Hawaii, from 44 to 46, Connecticut, from 47 to 48, and Iowa, from 63 to 64.
Premiums do not move together with plan counts. Indiana’s average premium goes from $13.22 to $9.27 and Kentucky’s from $10.02 to $4.90. Iowa’s falls from $13.20 to $11.21, Delaware’s from $15.69 to $14.33 and Hawaii’s from $53.44 to $53.04. Connecticut is the exception in this group, with an average premium rising from $16.89 to $25.31 even as its plan count grows by one. More plans in a state did not mean cheaper plans in every state.
What a plan count measures, and what it leaves out
The fact sheets do not define their terms in the pages read. They do not say whether the Medicare Advantage count includes special-needs plans or how different contract types are tallied, so the totals are best read as CMS’s own landscape counts, not as a number of distinct choices open to any one household. A person in Birmingham or Phoenix sees only the plans sold in a particular county, and the state total hides that.
A rise in plan count is also not a statement about quality, network breadth or drug coverage. Those details sit in each plan’s own documents, which the 2027 landscape does not reproduce. Whether a bigger menu helps a given member depends on the doctors and prescriptions that member needs, a comparison the state fact sheets were not built to make.
The timing is fixed. Medicare’s Open Enrollment period for 2027 coverage runs from October 15 through December 7, 2026, according to CMS. The CMS fact sheets put Alabama at 113 plans and Arizona at 148 for the 2027 plan year, and those two counts, 15 above 2026 in each state, stand against the idea that every market is thinning.
A bigger menu of plans still has to be sorted one county at a time
The Alabama and Arizona gains describe a state-level count, and the 2027 Open Enrollment period that runs from October 15 to December 7 is where a larger plan menu turns into an actual choice. Sorting those plans by cost, prescriptions and doctors is the unfinished job the CMS fact sheets do not do.
The 2027 Medicare Open Enrollment Decision Kit is a 42-page decision kit with a cost calculator spreadsheet that compares plans on cost, drugs and doctors, a prescription-by-plan comparison and the Open Enrollment calendar.
Compare 2027 plans with The 2027 Medicare Open Enrollment Decision Kit →
This piece was drafted with AI assistance; the plan counts and premiums were checked against CMS’s 2027 state fact sheets and its September 28 announcement.
