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Open enrollment for 2027 ends December 7, and millions of people will find that their current plan has ended or been replaced on January 1. A new analysis from the consulting firm Wakely, Medicare Advantage 2027: Beyond the Plan Count, and its full white paper, compares the 2026 and 2027 Medicare Advantage markets using the federal government's own plan files. It was written for insurers and analysts, but its numbers matter to families, because a plan change that no one notices can end a relationship with a doctor, a home health agency, or a drug the person depends on. This article translates what Wakely found and adds what a family can do about it. Two cautions first: Wakely's figures are approximate and describe the national market, and the white paper does not break out Ohio or Missouri.
A Market That Is Narrowing, Not Collapsing
Wakely counts 5,844 plan offerings for 2027, down from 5,922 in 2026. The decline comes mainly from general enrollment plans, the ordinary plans open to everyone with Medicare. Special needs plans, which are limited to people with particular circumstances, continued to grow. The paper reads the overall picture as selective pruning: insurers are closing weaker products and expanding targeted ones, not leaving the market across the board:
- Plans That End: Of 1,226 plans that are exiting, more than 6.3 million members, about 18.5 percent of all Medicare Advantage enrollment, are affected, either because their plan terminates or because they are moved ("crosswalked") into another plan.
- No Automatic Landing Spot: About 3 million members, or 8.8 percent of enrollment, are in plans that close without an automatic transition. They must pick new coverage themselves. People who do nothing are moved to Original Medicare on January 1, and without a separate drug plan may pay full price for prescriptions.
- Carriers Leaving: Thirty-four carriers are leaving Medicare Advantage entirely, and 10 are entering, with exits concentrated in Florida, Texas, New York, and Minnesota, according to Wakely.
- Fewer PPOs, More HMOs: HMO plans rose by 63 to 2,531 and local PPOs fell by 83. HMOs are now about 46 percent of offerings. A move from a PPO to an HMO usually narrows the set of doctors and facilities a person can use without penalty, so it deserves a look at the network.
Special Needs Plans Are Where the Growth Is
Special needs plans for people with chronic conditions (C-SNPs) grew 34 percent in 2027, after 56 percent growth in 2026, and the number of companies offering them has doubled since 2023, from about 28 to 56. Most new plans target cardiovascular disease, chronic heart failure, and diabetes. Plans for people who are eligible for both Medicare and Medicaid (D-SNPs) numbered 1,052, down slightly from 1,085 but still the largest special needs category. For someone with one of these conditions, a C-SNP can offer coordinated care, but these plans are available only to eligible people. Wakely reports that one company, Devoted Health, accounts for roughly half of the new C-SNP products, with Aetna, United, and Humana also adding plans.
Leaner Benefits Behind Low Premiums
About two-thirds of 2027 plans have no monthly premium, and more than 69 percent of new plans have none. The cost has moved elsewhere. The average Part D deductible in general enrollment plans rose from $363 to $493, and the average maximum out-of-pocket limit for medical care rose from $5,330 to $5,874. That is consistent with the federal ceiling, which rose by $600, from $9,250 to $9,850. Looking only at the premium can hide a bigger bill. Wakely also reports that, for the first time, plans could apply caps to enrollment, but only 64 offerings had an accepted limit.
What a Family Should Do Now
The practical steps are not complicated, but they depend on someone reading the mail. Every Medicare Advantage member should receive a notice from the plan telling them whether it will continue. The annual enrollment period runs from October 15 through December 7. Extra time exists only for people whose plan is ending or who leave its service area, not for everyone who simply misses the annual deadline.
When a Medicare Advantage plan terminates or leaves the service area, federal rules give the member a special enrollment period to choose a new plan, and a separate 63-day guaranteed-issue window to buy a Medigap policy that runs until 63 days after the coverage ends. The Ohio Department of Insurance describes it this way for a plan that was not renewed: choose a new plan by December 31 and coverage starts January 1, and if you miss that date, you get an additional 63 days. A member of a plan that closes without a crosswalk who does nothing moves to Original Medicare and may have no drug plan. A member of a crosswalked plan is moved to the replacement plan instead, which may have different doctors, drugs, and costs.
- Read the Notice for the Person You Help: If a parent has memory loss or no longer opens the mail, ask who does. A plan-ending letter that sits in a pile is the most common way this goes wrong.
- Check the Providers and Medications: Look up each doctor, the home health agency, the pharmacy and the main medications in the 2027 plan before the deadline. Ask the home health agency by name whether it takes the plan next year.
- Know the Medigap Window: A person whose plan is leaving Medicare or the service area has a 63-day guaranteed right to buy a Medigap policy, which insurers cannot deny or price based on health conditions. Outside that window, the rules depend on the state. According to the National Association of Insurance Commissioners' chart, Ohio has no "birthday rule" that lets a person switch Medigap each year without health questions, so the guaranteed window may be the best chance to switch. Missouri is different. It has an anniversary rule: a window of roughly 60 days, 30 days before and after the policy anniversary, when someone with a Medigap policy can switch to the same plan letter with another carrier without underwriting.
- Look at the Whole Bill: Compare the deductible, the medical out-of-pocket limit, and the drug costs, not just the premium. Ask whether prior approval is required for home health or a stay in a skilled nursing facility.
- Use Free Counseling: Ohio's Senior Health Insurance Information Program (OSHIIP) can be reached at 800-686-1578, and Medicare itself at 1-800-633-4227. Missouri residents can use the state's counseling program, CLAIM, to confirm the Missouri rules and the dates of the anniversary window.
Why This Belongs in Your Plan for Aging at Home
Aging at home depends on a set of arrangements that fit together: a doctor who knows the person, a home health agency that accepts the coverage, a pharmacy, equipment suppliers, and a way to pay for a skilled nursing stay if one is needed. A change of plan can break any of them without anyone deciding to. Two points belong in your planning documents. First, make sure the person's durable power of attorney is broad enough for the agent to deal with insurance companies and make coverage decisions, because an insurer may not talk to a family member without authority. Second, put open enrollment on a calendar. The agent or a trusted family member should review the plan every October, ideally with the person present, so the decision reflects what matters to them.
One source of caution on the evidence. Federal investigators have found that some Medicare Advantage insurers denied requests that met Medicare's own coverage rules. In a 2022 report, the Office of Inspector General found that about 13 percent of prior authorization denials in a sample from 15 large insurers in June 2019 met Medicare coverage rules, along with about 18 percent of payment denials that met both Medicare's coverage rules and the insurer's billing rules. The sample is old and does not show how common this is today, but it is a good reason to read the plan's appeal rights before you need them.
A Closing Caution
Wakely's numbers come from CMS landscape and crosswalk files released in September and October 2026 and are described by the authors as approximate. Rules and deadlines can change, and plans differ by county, so confirm the details for your own situation with Medicare or a state counselor.
This article is general information, not legal or insurance advice.
