Medicare Advantage plan benefits, options shift in 2027

Payers’ yearslong pullback from Medicare Advantage (MA) will continue in 2027.

The Centers for Medicare and Medicaid Services (CMS) has described MA 2027 plan options as “stable,” with lower average premiums. But experts told Healthcare Brew that payers are increasing cost-sharing for enrollees, shifting them into narrower networks, and cutting supplemental benefits in response to a spike in utilization and medical costs over the last couple years.

“A senior may be able to keep their plan, but that doesn’t mean they’re going to have the same level of benefit that they had from the previous year, and in many cases, they may not,” Alexis Levy, senior partner at consulting firm HealthScape Advisors, told Healthcare Brew.

CMS did not respond to a request for comment by deadline.

Benefits shrink, costs rise. An Oct. 1 analysis of the Medicare Plan Finder from healthcare investment bank Leerink Partners found that many major carriers cut dental benefits and raised enrollees’ cost-sharing requirements in MA for 2027, though they typically kept primary care costs the same.

Clover Health, UnitedHealthcare (UHC), Humana, and Centene are seeing the biggest “prioritization of margin over growth,” the report said. Of those four, Humana was the only payer that didn’t decrease dental allowances. Clover’s maximum out-of-pocket cost increased by $1,144 for all sampled members, the most of any represented payer.

Healthcare Brew reached out to Centene and Humana but did not hear back by deadline.

Jamie Reynoso, CEO of Medicare Advantage at Clover, told Healthcare Brew over email that “looking only at how much the benefits have changed from one year to the next doesn’t tell the full story. What’s equally important is how those benefits compare with other available plans and the overall value they continue to provide,” adding that many of Clover’s preferred provider organization (PPO) prescription drug deductibles are lower than many other leading plans.

There are also no longer $0 premiums offered to 4 million standalone Part D drug plan enrollees who got them last year, though enrollees who qualify for low-income subsidies may still get $0 premiums, per a KFF analysis. These plans are separate from MA but generally managed by the same major companies.

MA plans with $0 premiums dropped this year, too, Brooks Conway, a principal at Oliver Wyman actuarial consulting, told Healthcare Brew.

“In most regions, for a long period of time, if you wanted to be a competitive Medicare Advantage insurer, you needed a $0 product,” Conway said. “In 2026 and continuing into 2027…you’re either seeing no options for a $0 product or the benefits that are associated with that $0 product becoming leaner.”

Plans are cut. In addition to rolling back benefits, some payers are exiting MA and others are canceling certain plans.

The two largest MA providers by enrollment, Humana and UHC, are ending plans impacting a cumulative nearly 1 million people.

Parent company UnitedHealth Group (UHG) spokesperson Eric Hausman confirmed to Healthcare Brew via email that about 390,000 members will be impacted by plan closures. High MA utilization and costs caught the company by surprise and tanked its stock in 2025. It has since shrunk MA membership and reported having 7.6 million members at the end of Q3.

About 600,000 people are in a Humana MA plan that is ending in 2027, Humana CFO Celeste Mellet said during a July earnings call, amounting to about 8% of the payer’s nearly 7.2 million MA members.

Why end a plan? When payers end a plan, they either want to lose those customers altogether or get those customers to switch to a different, typically pared down and more profitable plan, Conway said.

Take Humana. Mellet said during the July call that the payer hopes to “recapture a significant portion” of the 600,000 people impacted by plan exits. The company took a “targeted” approach, primarily ending plans with low returns and keeping plans with high returns rather than cutting “uniformly across the board,” she said.

UHC focused its cuts in 2027 on PPO plans, continuing a yearslong strategy that prioritizes health maintenance organization (HMO) and special needs plans (SNPs), UHC President Bobby Hunter said during the payer’s Oct. 13 Q3 2026 earnings call.

SNPs, HMOs grow. For plan years 2025 and 2026, payers generally decreased PPO plan offerings and maintained or added HMOs and SNPs, according to a 2026 HealthScape report. Levy and research and advisory company Forrester’s Principal Analyst Arielle Trzcinski told Healthcare Brew the trend continued this year.

Plans are turning to HMOs because they typically have more limited networks and higher cost sharing compared to PPOs, allowing plans to better control utilization, Trzcinski said. SNPs also have higher margins and provide personalized benefits to patients with more intensive needs, arguably allowing for more active care management, she said.

Levy said the increase in chronic special needs plans (C-SNPs) is continuing to “ramp up” this year. Experts previously told us that C-SNPs are likely growing in part due to new requirements related to D-SNPs intended for people dually eligible for Medicare and Medicaid.

“We’re still seeing the chronic condition plans as the growth engine for the MA market,” Levy said.