The quiet cut: 2027 Medicare Advantage plan changes, by the numbers

Most of what changed for 2027 is not on the mailer. Members will find it at the pharmacy counter.

2027 at a glance: Every Medicare Advantage plan, 2027 against 2026 · star ratings not yet released · provider networks not included

• 66% of plans raise the out-of-pocket max
• 872 plans move brand drugs to coinsurance
• 600 plans add new prior authorization
• 405 plans drop OTC entirely
• 353 plans add a medical deductible
• 267 plans terminated by Aetna, UnitedHealthcare and Wellcare

The cost moved

Part B givebacks held. The number on the mailer looks the same.

Everything else moved to the moment a member uses the plan. The deductible at the first visit. The coinsurance at the pharmacy. The prior auth before therapy. The smaller OTC order.

Carriers are answering rising utilization. Providers are pushing back on terms. The member is in the middle.

And members do not read the Annual Notice of Change. They find out in January.

The ceiling went up

The out-of-pocket max rises on 66% of plans. The average goes from $6,214 to $6,729.

The federal cap moved from $9,250 to $9,850. But the average plan still sits more than $3,000 below it. Most of this increase is a choice.

Nobody thinks about MOOP until the diagnosis. Then it is the only number that matters.

Plans that end. Plans that leave the county.

• Aetna: 98 plans terminated, 172 losing counties
• Wellcare: 88 plans terminated
• UnitedHealthcare: 81 plans terminated, 175 losing counties

Several carriers have no 2027 plans in the data at all: BCBS of Texas (all 21 plans), Central Health, Braven, Providence and ConnectiCare. Some may be rebrands, not exits.

A county cut is the easy one to miss. The plan still exists. Just not where the member lives.

Less on the OTC card

405 plans drop OTC entirely. Humana drops it on 103, UnitedHealthcare on 74, HealthSpring on 39.

45% of plans cut it. The average allowance falls from $255 to $215 a year. Triple-S Enlace Plus goes from $2,400 to $1,200. Highmark Together Blue goes from $780 to $180.

OTC is often why a member picked the plan. They will notice at their first order.

The pharmacy counter

872 of 1,359 plans move brand drugs from a flat copay to a percentage. Humana does it on 569 plans, mostly $47 to 17%. HealthSpring does it on 142, $47 to 20%.

A copay is a number a member knows. Coinsurance depends on the drug. On an expensive brand, 17% can be several times the old $47.

Drug deductibles climb too. 30% of drug plans raise theirs by more than the $85 federal increase.

Same plan name. Different plan.

353 plans add a medical deductible where there was none. UnitedHealthcare adds $1,000 to 122 of them.

A 5-day hospital stay costs more on 49% of plans. The average goes from $1,538 to $1,701.

For a member who chose $0, this is not the plan they bought.

A new step before care

600 plans add prior authorization for at least one service. Anthem adds it for diabetes supplies. Highmark adds it for mental health therapy.

The doctor is still in network. The care now needs a sign-off. That is the plan and provider standoff, landing on the member.

They will find out the day they need it.

What held

• Part B givebacks. Not shrinking overall.
• Medical copays vs. coinsurance. A wash, except lab work, which moves to coinsurance at Devoted (302 plans) and HealthSpring (171).
• Still to come. 2027 star ratings land in mid-October. Network changes are not in this data.

Members will not call about this

Every change above is a reason to shop. Most members do not know it yet.

The ones who call are the easy ones. The ones who do not call are the ones another agent reaches first.

2027 is a retention year before it is a sales year.

What agencies tell themselves

"The carrier sent the letter." Members set it aside. They connect it to their care in January.

"Our agents will catch it in AEP." One pass through a 5,000-member book is about 2,500 agent hours. That is nearly half a 20-agent team's season, before a single new sale.

"We will wait for star ratings." None of these changes depend on stars. Every week of waiting is a week another agent gets there first.

Before October 15

1. Know who changed. Tag every member by what changed for them.
2. Start with the biggest changes. Terminations and county cuts first.
3. Call about their plan. "Your deductible goes from $0 to $1,000" starts a conversation. "Let's review your coverage" does not.
4. Book it on the first call. Capture the SOA. Get them to a licensed agent while they are on the line.
5. Answer every inbound call. No member should hit voicemail the week they decide to shop.

Plan Crosswalk in careCycle runs the first four. It checks every member against 2027 plan data and tags what changed. AI employees call each member about their change, capture the SOA and warm-transfer to a licensed agent. careCycle answers every inbound call for the fifth.

See who on your book changed. Book a walkthrough.

Know who changed. Call them first. Keep the book.

That's careCycle.

This is careCycle's own analysis. We compared 2026 and 2027 Medicare Advantage plan benefit data from a licensed industry data source. Where that source had gaps at the county level, we filled them with the CMS plan crosswalk file, which shows whether each 2026 plan renews, consolidates or terminates in 2027.

We work hard to get every number right. But this is a large dataset built from more than one source, and errors are possible. Figures may also change as carriers and CMS update their files. Star ratings and provider networks are not included.

This is not plan-specific advice. Before advising a member, confirm their plan's details in the carrier's Annual Notice of Change and Evidence of Coverage, or on Medicare Plan Finder.

Spot something off? Let us know and we will correct it.