Medicare Advantage Drug Plans Unavailable in 193 Counties for 2027, KFF Finds

Those counties hold 1% of all Medicare beneficiaries. In 2026, 399,000 people lacked such an option, so the group has grown by 239,000. KFF built the analysis from Centers for Medicare & Medicaid Services (CMS) plan landscape data. It looks only at plan availability, not at costs or benefits.

The gaps are not spread evenly. The affected counties sit in 16 states and in U.S. territories other than Puerto Rico. New Hampshire, North Dakota and Oklahoma are new to the list. Alaska again has no such plans in any county, which covers about 110,000 beneficiaries.

In six counties, one in Nebraska and five in South Dakota, a Medicare Advantage plan without drug coverage is still offered. In the other 187 counties, no generalenrollment Medicare Advantage plan of any kind is available. Some of these counties still have other private options, such as cost plans and special needs plans. Special needs plans limit enrollment to people who meet certain criteria.

The pullback is led by several large insurers. According to KFF, Health Care Service Corporation is exiting 498 counties and entering none. Centene is leaving 359 and entering 15. UnitedHealth Group is leaving 228 and entering 9. CVS Health is leaving 186 and entering 63. Blue Cross Blue Shield of Michigan is leaving 177 and entering one, and will offer these plans only in Michigan and Wyoming. Humana is leaving 62 and entering 4. Elevance Health is leaving 66 and entering 10.

UnitedHealth and Humana are the two largest Medicare Advantage insurers. Humana still offers drug plans in about 80% of U.S. counties, as in 2026. UnitedHealth now covers about 70%, down from nearly 80%.

Two insurers are leaving the general Medicare Advantage drug plan market entirely: Group 1001, marketed as Clear Spring Health, and Molina Healthcare. Molina will still sell special needs plans in many counties.

Devoted Health is moving the other way. It is entering 342 counties and exiting none. Kaiser Foundation Health Plans is holding steady, leaving three counties and entering three.

The exits hit different kinds of places. In four Minnesota counties, three insurers each have stopped offering these plans. Some exits are in urban markets with high Medicare Advantage use. KFF cites Health Care Service Corporation leaving Miami-Dade County, Florida.

Choice is also narrowing at the top. The share of beneficiaries with more than 40 drug plan options fell from 27% in 2026 to 20% in 2027. Those people live in 4% of counties, down from 6%. Lancaster, Pennsylvania has the most options, at 66.

This report adds to The Arising's October 15 coverage of the average beneficiary losing four options. That piece drew on a separate KFF analysis published October 1. It found 28 plans for the average beneficiary in 2027, against 32 in 2026. This new analysis looks at the county level, where the losses are uneven.

The strategic picture is one of retreat by large insurers in specific counties, with one fast-growing exception. The KFF data show where plans are offered, but not why insurers are leaving. They do not show whether the exits will continue, or what happens to costs and benefits, which the analysis does not examine.

What to watch next

Whether the open enrollment period, which follows these plan announcements, shows people in exited counties moving to traditional Medicare or to other private plans, and whether insurers expand or cut further in 2028.

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