The federal tally of Medicare Advantage plans is thinner for 2027, and the loss is not spread evenly. The Centers for Medicare & Medicaid Services counts about 5,532 plans for next year, compared with 5,553 in 2026, while its state sheets show 28 states and Washington, D.C., losing plans and 21 states adding them.
A net drop of 21 plans that looks larger state by state
The national figure comes from the CMS announcement of Sept. 28, which lists total Medicare Advantage plans at 5,553 in 2026 and approximately 5,532 in 2027. That is a net decline of 21 plans, about 0.4%.
The state-by-state fact sheets paint a busier picture. Each sheet reports how many plans are “available” in that state, so a plan sold in several states is counted in every one of them. Because of that, the state rows cannot simply be added up to reach the national total, and a state’s decline says nothing about how many members are affected. It measures shelf space, not people.
Counting the rows that carry Medicare Advantage data, 28 states plus the District of Columbia show fewer plans in 2027 than in 2026, and 21 states show more. The 28-and-D.C. and 21 tallies are a count of those rows rather than a figure CMS prints.
Florida’s 51 missing plans set the pace for the retreat
Florida posts the sharpest cut. Its fact sheet shows 560 plans available in 2027 against 611 in 2026, a loss of 51. Ohio follows with 32 fewer, and the next five states are Illinois (21 fewer), Maryland (16), Minnesota (15), New Jersey (13) and New Mexico (12).
Jakob Emerson, reporting for Becker’s Payer Issues, put some of the endpoints in a Sept. 28 roundup of the states losing the most plans: Ohio dropping from 212 to 180, Illinois from 157 to 136, Maryland by about 25% (63 to 47) and Minnesota by 22% (68 to 53). Percentages tell a different story than raw counts. Florida’s 51 fewer plans are under 9% of its 611, while Maryland’s 16 are a quarter of its lineup.
Tennessee and Missouri run the other way
Not every state is shedding options. Tennessee adds the most, rising from 132 plans to 155, a gain of 23. Missouri climbs from 157 to 174, or 17 more. Alabama (98 to 113) and Arizona (133 to 148) also show larger 2027 counts on their sheets, which helps explain why the national total slips so little even with 28 states and D.C. trimming.
The pattern matters because Medicare Advantage is sold county by county. A state gaining plans overall can still contain counties where a familiar carrier has withdrawn, and a state losing plans overall can still leave a county with a wide choice. The state sheet is a weather map, not a forecast for one address.
Cheaper on average, narrower in the aisle
The same CMS release reports a national weighted average Medicare Advantage premium falling from $14.37 a month to $12.00 in 2027. CMS Administrator Dr. Mehmet Oz said in the release that the agency “is fighting to keep high-quality care options affordable and accessible for the millions of beneficiaries who rely on Medicare Advantage and Part D prescription drug plans.”
The premium is only one line of a plan’s cost. Drug tiers, deductibles, copays and which doctors and hospitals sit in the network decide what a member actually pays over a year, and none of those appear in a plan count. Maryland shows how the two measures can diverge: the sheet lists 47 plans in 2027 against 63 in 2026, yet an average monthly premium that edges up from $23.39 to $23.82.
What a shrinking shelf means when a plan letter arrives
For most members the practical event is not the count but the notice. The choice that follows a plan change runs inside Open Enrollment, which Medicare.gov lists as Oct. 15 through Dec. 7, with changes taking effect Jan. 1. The plan must receive an enrollment request by Dec. 7.
A member whose plan stays put loses nothing by looking, and a member whose plan is among the ones leaving the county has a firmer reason to. In both cases the comparison turns on the household’s own drug list, pharmacy and doctors, not on the size of a state’s list.
Medicare Advantage carries a further wrinkle for households that shop by state headline. A large drop can coexist with a low premium, as Ohio’s sheet shows with an average that falls from $12.12 to $9.00, and a small drop can coexist with a rising one. Reading a state’s count alongside its average premium, and then alongside the specific plans sold in a member’s own county, keeps the headline from standing in for the decision.
The state figures come straight from the CMS fact sheets: 47 Maryland plans in 2027 against 63 in 2026, 180 in Ohio against 212, and 560 in Florida against 611, all inside a national total that CMS puts at about 5,532.
Plan counts fall in 28 states, but one member’s plan is what decides
CMS’s 2027 tally puts the national count at about 5,532 Medicare Advantage plans, down from 5,553, with 28 states and Washington, D.C., losing plans. A state that loses plans, such as Florida with 51 fewer, does not show which plan a member’s own county keeps or how its drug and doctor costs compare with the alternatives that remain.
The 2027 Medicare Open Enrollment Decision Kit combines a cost calculator spreadsheet that compares plans on cost, drugs and doctors with a provider call script and the Open Enrollment calendar for working through the Oct. 15 to Dec. 7 window.
Click here to get The 2027 Medicare Open Enrollment Decision Kit →
AI tools helped draft this article, which was checked against the CMS fact sheets and announcement cited above.
