The average person on Medicare can choose from 28 Medicare Advantage plans that include drug coverage for 2027, down from 32 in 2026. Texas takes the biggest cut of any state, with the average Texas beneficiary losing nine of those plans, according to a KFF analysis published Oct. 1.
KFF researchers Jeannie Fuglesten Biniek, Meredith Freed, Nancy Ochieng and Juliette Cubanski built the count from the federal landscape files that list every 2027 plan. The 28 is an average per beneficiary, tied to Medicare enrollment, and it sits well below the peak of 36 plans in 2024. Counting Medicare Advantage plans with or without drug coverage, the average falls from 39 plans to 35.
Anyone enrolled in Medicare Advantage or a stand-alone Part D plan has until Dec. 7 to keep that plan or switch, and a shorter list means fewer alternatives to weigh against the current one. Insurers and brokers started marketing 2027 plans Oct. 1, according to KFF, and open enrollment itself runs Oct. 15 through Dec. 7.
An average of 28 plans says nothing about which handful cover one person’s prescriptions and keep their doctors in network. The 2027 Medicare Open Enrollment Decision Kit includes a cost calculator spreadsheet that compares plans on cost, drugs and doctors.
Compare 2027 plans on drugs, doctors and cost with the Decision Kit calculator →
Where the plan counts fell furthest
Texas lost nine options on average. KFF lists Illinois and Ohio next at eight each, followed by Minnesota, New Mexico and Washington at seven each. The analysis does not publish the 2026 and 2027 totals for Texas in text, only the change.
A big drop does not always mean a thin market. Ohio gave up eight plans and still ranks with Pennsylvania and Michigan among the states where the average beneficiary has at least 40 Medicare Advantage drug plans. KFF counts 26 states and Puerto Rico with at least 20 options in 2027.
At the other end, nine states and Washington, D.C. have fewer than 10. Alaska has none, as in 2026. Four states gain options for 2027, though KFF’s text does not name them.
What the 28 leaves out
The figure covers plans open to the general Medicare population. KFF’s table excludes special needs plans, employer group plans, PACE programs, cost plans and Medicare-Medicaid plans, and it leaves Connecticut out because county reporting differs across the federal files. Medicare Advantage plans with no drug coverage are a small slice: 4 percent of Medicare Advantage enrollees were in those plans in 2026.
Because it is an average, a county can have far fewer plans than its state’s number, or far more. The state figures also say nothing about whether a given plan has a particular pharmacy or a doctor’s group in its network.
The authors add that Medicare enrollees “are often overwhelmed by the number of Medicare Advantage choices” and that most do not compare coverage options every year. With fewer plans on the list, the comparison is shorter, but a plan that has changed its drug list or network can still cost more than it did.
The federal picture beside the KFF count
The Centers for Medicare & Medicaid Services described the 2027 market as stable in its Sept. 28 announcement. CMS says 97 percent of beneficiaries can choose from 10 or more Medicare Advantage plans and that about 8 in 10 enrollees can keep their current plan at the same or a lower premium. It puts the weighted average monthly Medicare Advantage premium at $14.37 in 2026 and projects $12.00 for 2027.
For stand-alone drug plans, CMS lists an average monthly premium of $35.09 in 2026 and a projected $36 in 2027. “CMS is fighting to keep high-quality care options affordable and accessible,” CMS Administrator Dr. Mehmet Oz said in the release. A premium average, like a plan-count average, still has to be set against what one person’s own prescriptions cost under each plan.
Comparing 2027 plans between Oct. 15 and Dec. 7
Medicare’s free comparison tool is Plan Finder. It lists the plans available where a person lives, and CMS’s Sept. 28 announcement gives the same Oct. 15 to Dec. 7 enrollment window.
The useful list to bring is short: every medication with its dose, the pharmacy used, and the names of the doctors and hospitals that matter. Plans that look alike on premium can differ on which drugs they cover and which doctors are in network.
A plan that is still offered can change its benefits and costs for 2027, so the current plan deserves the same comparison as the alternatives. KFF’s point about annual review applies directly: the plan that fit in 2026 is not guaranteed to be the cheapest for the same drugs next year.
Four fewer plans, one Dec. 7 deadline
A shorter list does not shorten the work: the plan a person keeps by default is the one they pay for in 2027 whether or not it still fits their drugs and doctors. The 2027 Medicare Open Enrollment Decision Kit puts a cost calculator spreadsheet and the Open Enrollment calendar in one place, so the keep, switch or wait decision has a written reason behind it by Dec. 7.
Mark the Oct. 15 to Dec. 7 window with the Decision Kit’s Open Enrollment calendar →
This article was produced with AI assistance and edited for accuracy against the sources linked above.
