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Medicare Advantage Plans 2027

Reviewed by Russell Noga, Licensed Medicare Insurance Broker (all 50 states) — Last updated October 8, 2026

Medicare Advantage plans, also called Part C, are private health plans approved by Medicare that replace Original Medicare as the way you get your benefits. They cover everything Part A and Part B cover except hospice, usually include drug coverage, and must cap your yearly out-of-pocket costs.

About 34 million people are projected to be in Medicare Advantage in 2027, nearly half of everyone with Medicare. The appeal is easy to see: low or $0 premiums, a yearly cost cap Original Medicare does not have, and extras many plans may include. The tradeoffs are networks, referrals, prior authorization and copays that add up if you use a lot of care.

This guide explains how Medicare Advantage works, the plan types, what you pay, and how to decide whether it fits you. For 2027 changes, see Medicare Advantage plans 2027.

✔ Licensed in all 50 states
✔ Based on CMS 2027 data
✔ Free plan comparison

Key Highlights

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Medicare Advantage covers everything Original Medicare covers except hospice, through a private plan.

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Every plan has a yearly out-of-pocket maximum for covered medical care.

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Most plans include Part D drug coverage; many may include dental, vision and hearing benefits.

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The national average 2027 Medicare Advantage premium is $12 a month, down from $14.37 (CMS).

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You still pay your Part B premium.

Compare plans and enroll online

How Medicare Advantage Works

Medicare Advantage, also called Part C, is a way to get your Medicare benefits through a private insurance company approved by Medicare. The plan covers everything Original Medicare Part A and Part B cover, except hospice care, which Original Medicare still pays. Most plans also include Part D drug coverage, and many may add extras such as routine dental, vision and hearing benefits.

In exchange, Medicare Advantage plans generally use networks of doctors and hospitals, and may require referrals or prior authorization for some services. Every Medicare Advantage plan has a yearly out-of-pocket maximum for covered medical care, which Original Medicare does not have. You keep paying your Part B premium, plus your plan’s premium if it has one.

Feature HMO PPO
Out-of-network care Not covered except emergencies and urgent care Covered at a higher cost
Referrals for specialists Usually required Usually not required
Premiums Usually lower Usually higher
Out-of-pocket maximum In-network limit In-network limit plus a higher combined limit
Best for Lower costs, local care Flexibility, travel, keeping specific doctors

When you join, Medicare pays the plan a set amount each month to cover your care, and the plan handles your claims. You use the plan’s card instead of your red, white and blue Medicare card for most care, though you should keep your Medicare card.

Benefits Medicare Advantage Plans May Offer

Medicare Advantage Plans May Include

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Hospital and medical coverage, the same as Original Medicare Part A and B

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Part D prescription drug coverage on most plans

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Routine dental, vision and hearing benefits

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Fitness programs and over-the-counter allowances

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Telehealth visits and care coordination programs

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A yearly out-of-pocket maximum on every plan

Not all plans offer all benefits. Benefits vary by plan and county and can change for 2027. Check each plan’s Evidence of Coverage before you enroll.

What you need to know about Medicare advantage plans

Medicare Advantage Plan Types

Plan Type Network Rules Referrals Best For
HMO In-network only, except emergencies and urgent care Often required Lower costs and local care
HMO-POS Mostly in-network, with some out-of-network coverage Often required HMO savings with a little flexibility
PPO In-network costs less; out-of-network covered at a higher cost Usually not required Flexibility and travel
PFFS Any provider who accepts the plan’s terms Not required Rare; limited availability
Special Needs Plan Usually a network built for the group Varies Medicare and Medicaid, chronic conditions or nursing home residents

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What Medicare Advantage Costs

Plan Premium

Often low or $0; the 2027 average is $12 a month.

Part B Premium

You keep paying it, unless your plan reduces it.

Copays and Coinsurance

For visits, specialists, hospital stays and more.

Out-of-Pocket Maximum

The most you pay for covered medical care in a year.

Your real yearly cost depends on how much care you use. Compare two scenarios for each plan: a light year with a few doctor visits, and a heavy year where you reach the out-of-pocket maximum. A plan with a small premium and a lower maximum is often safer than a $0 premium plan with a high maximum, especially if you have ongoing health needs.

Pros and Cons

Advantages

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Often a low or $0 premium

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A yearly out-of-pocket maximum

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Drug coverage usually included

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Many plans may include dental, vision and hearing benefits

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One card and one plan

Tradeoffs

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Networks; HMOs require in-network care except emergencies

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Prior authorization and referrals are common

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Copays add up if you use a lot of care

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Plans and networks can change every year

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Switching to Medigap later may require health questions

How Medicare Advantage Covers Prescription Drugs

Who Can Join

You can join a Medicare Advantage plan if you have Medicare Part A and Part B and live in the plan’s service area. People with end-stage renal disease can also join. You can only be in one Medicare Advantage plan at a time, and a Medigap policy will not pay anything while you are in Medicare Advantage.

Networks, referrals and prior authorization

HMO plans generally cover care only from in-network providers, except emergencies, urgent care and out-of-area dialysis. PPOs cover out-of-network care at a higher cost. Most plans also require prior authorization for some services, such as certain surgeries, imaging or skilled nursing stays. Ask how a plan handles the care you expect to need.

Special Needs Plans

Special Needs Plans (SNPs) are Medicare Advantage plans built for specific groups. Benefits, networks and drug lists are designed around the members they serve, and many include care coordinators. For 2027, Special Needs Plans are one of the few areas where large insurers are adding plans, even as they cut PPOs.

Type Who Qualifies What Is Different
Dual Special Needs Plan (D-SNP) People with both Medicare and Medicaid Coordinates both programs; often very low costs and added benefits
Chronic Condition SNP (C-SNP) People with qualifying conditions such as diabetes, heart failure or chronic lung disease Doctors, drugs and programs built around the condition
Institutional SNP (I-SNP) People living in a nursing home or who need that level of care at home Care delivered where the member lives

Medicare Advantage vs Medigap

Medicare Advantage Original Medicare + Medigap
Monthly premium Often low or $0 (2027 average $12, CMS) Higher; varies by plan letter, age and ZIP
Doctors Usually a network Any provider in the U.S. that accepts Medicare
Costs when you get care Copays and coinsurance up to a yearly maximum Low and predictable; little or nothing on Plan G after the Part B deductible
Drug coverage Usually included Add a separate Part D plan
Dental, vision, hearing Many plans may include some coverage Not included
Changing later Every year during Annual Enrollment Health questions in most states after your Medigap Open Enrollment Period

Guaranteed issue: if your Medicare Advantage plan leaves your area, you generally can buy certain Medicare Supplement plans without health questions, until 63 days after your coverage ends.

Drug Coverage in Medicare Advantage

$700

Maximum 2027 Part D deductible, up from $615.

$2,400

2027 Part D out-of-pocket cap, up from $2,100.

About $36

Average 2027 standalone Part D premium, up less than $1 (CMS).

$7

Projected average drug portion of a Medicare Advantage premium for 2027, down from $11.32.

If your Medicare Advantage plan includes drug coverage, you cannot also have a separate Part D plan. If you choose a plan without drug coverage, you generally cannot add a standalone Part D plan, except with certain plan types such as PFFS.

The 2027 Medicare Advantage Market

The 2027 numbers from CMS show a stable national picture:

$12 a Month

Average 2027 Medicare Advantage premium, down from $14.37 in 2026 (CMS).

About 34 Million

People CMS projects will be in Medicare Advantage in 2027, about 47% of Medicare.

About 5,532

Medicare Advantage plans nationwide for 2027, nearly flat from 5,553.

8 in 10

Members who can keep their current plan at the same or a lower premium (CMS).

The national numbers look calm, but they hide a lot of movement underneath. Several of the largest insurers are trimming PPO plans and pulling standard plans out of counties where they lost money, while a few smaller companies are growing. That means your own plan can change a great deal even in a year when the national average premium goes down.

Insurer Key 2027 Changes
UnitedHealthcare 852 plans (up from 846); standard plans pulled from about 140 counties; leaving Wyoming; 34 PPOs cut
Humana 861 plans (down from 887); leaving 57 counties and Minnesota; 37 PPOs cut; about 600,000 members’ plans ending
Aetna (CVS Health) 654 plans (up from 642); standard plans pulled from 123 counties; leaving Maryland and New Hampshire; 20 PPOs cut; 29 C-SNPs added
HCSC (including HealthSpring) From 948 counties to about 478; leaving CT, KS, MT, NY, OR, UT and D.C.; 48 PPOs cut
Centene (Wellcare) Standard plans pulled from 344 counties; leaving Hawaii, Oklahoma and Tennessee
Elevance (Anthem) Standard plans pulled from 56 counties; leaving South Carolina
Devoted Health Adding 342 counties; entering CT, MI, NH, NJ and NY

Source: CMS 2027 landscape data as reported by Becker’s, October 1, 2026, and company announcements. Wellmark, Blue Cross Blue Shield of North Dakota and Blue Cross Blue Shield of Mississippi are also exiting Medicare Advantage for 2027.

How to Choose a Plan

How to Compare

1

Read your Annual Notice of Change. It lists every change to your current plan for 2027.

2

Check your doctors and hospitals. Confirm each provider is in the 2027 network, not just the 2026 one.

3

Check your prescriptions. Confirm each drug, its tier and any prior authorization or step therapy rules.

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Compare total yearly cost. Add the premium, typical copays and drug costs, and look at the out-of-pocket maximum.

5

Check star ratings. Medicare rates plans from 1 to 5 stars on quality and service.

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Enroll by December 7. Your new coverage starts January 1, 2027.

Use the Medicare Advantage plan finder to compare plans in your ZIP code.

Enrollment Periods

Enrollment Period Dates What You Can Do
Annual Enrollment Period October 15 to December 7, 2026 Join, switch or drop a Medicare Advantage or Part D plan for January 1, 2027
Medicare Advantage Open Enrollment January 1 to March 31, 2027 If you are in Medicare Advantage, switch to another plan or return to Original Medicare once
Initial Enrollment Period 7 months around your 65th birthday month Sign up for Medicare and choose your first plan
Special Enrollment Periods Varies Change plans after events like moving, losing other coverage or your plan leaving your area

Most people make changes during Annual Enrollment. If you are happy with your current plan, you do not have to do anything; it renews automatically. Still, read your Annual Notice of Change, because premiums, copays, networks and drug lists can all change on January 1.

Star Ratings

Medicare rates every Medicare Advantage and Part D plan from 1 to 5 stars each fall, based on things like preventive care, how well the plan manages chronic conditions, member complaints, customer service and drug pricing accuracy. The ratings are shown in Medicare Plan Finder.

Using Star Ratings

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A rating of 4 stars or higher is generally a good sign of quality and service

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Five-star plans have a special enrollment period, so you can switch into one once during the year

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New plans may not have a rating yet, which is not a bad sign by itself

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Ratings measure the plan overall, not how well it covers your specific doctors and drugs

Turning 65

If you turn 65 in 2027, your Initial Enrollment Period lasts seven months: the three months before your birthday month, your birthday month and the three months after. Signing up during the first three months means your coverage starts on the first day of your birthday month.

Turning 65 Checklist

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Sign up for Part A and Part B, unless you have qualifying employer coverage and choose to delay Part B

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Decide between Medicare Advantage and Original Medicare with Medigap

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Join a drug plan, or a Medicare Advantage plan with drugs, to avoid a Part D late penalty

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If you choose Medigap, buy during your six-month Medigap Open Enrollment Period

Help Paying Medicare Costs

If your income and savings are limited, two programs can cut your Medicare costs sharply:

Medicare Savings Programs

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Run by your state Medicaid office

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Can pay your Part B premium, and sometimes deductibles and coinsurance

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Income and asset limits vary by state

Extra Help (Part D)

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Run by Social Security

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Lowers Part D premiums, deductibles and copays

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People in a Medicare Savings Program qualify automatically

If you qualify for both Medicare and full Medicaid, you may also be able to join a Dual Special Needs Plan. See help for low-income Part D beneficiaries.

Getting Help

You do not have to compare plans alone, and you should not have to pay for help. These are the free options:

Free Help Comparing Plans

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Medicare Plan Finder on Medicare.gov, available any time

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1-800-MEDICARE (1-800-633-4227), available 24 hours a day, seven days a week

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Your State Health Insurance Assistance Program (SHIP), which offers free, unbiased counseling

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A licensed insurance agent or broker, who can compare plans from several insurers at no cost to you

Before any call, have your Medicare card, your list of drugs and doses, your doctors and your preferred pharmacies ready. It turns a long conversation into a short one.

Bottom Line

The Bottom Line

Medicare Advantage trades networks and copays for low premiums, a yearly cost cap and extras many plans may include. Confirm your doctors and drugs, compare total costs, and choose during Annual Enrollment, October 15 to December 7, 2026.

Compare plans and enroll online

Frequently Asked Questions

➤ What is a Medicare Advantage plan?

A private health plan approved by Medicare that replaces Original Medicare as the way you get your Part A and Part B benefits. Most plans include drug coverage, and every plan has a yearly out-of-pocket maximum.

➤ Is Medicare Advantage the same as Medicare Part C?

Yes. Medicare Advantage is the common name for Medicare Part C. These plans are offered by private insurers approved by Medicare and cover your Part A and Part B benefits, and most also include Part D drug coverage. About 34 million people are projected to be enrolled in 2027.

➤ Do I still pay my Part B premium with Medicare Advantage?

Yes. You keep paying your Part B premium, plus your plan’s premium if it has one. The standard Part B premium is $202.90 a month in 2026, and the 2027 amount, projected at $209.50, is announced in November. The average Medicare Advantage plan premium for 2027 is $12 a month.

➤ What is the difference between an HMO and a PPO?

An HMO generally covers only in-network care except emergencies and often requires referrals. A PPO covers out-of-network care at a higher cost and usually does not require referrals.

➤ Can I have Medicare Advantage and Medigap?

No. A Medigap policy will not pay anything while you are in Medicare Advantage, so people generally drop one when they choose the other. If you switch from Medicare Advantage back to Original Medicare, insurers in most states can use health questions for Medigap unless you have a guaranteed issue right.

➤ Do Medicare Advantage plans include dental and vision?

Many plans may include routine dental, vision and hearing benefits, but not all plans offer all benefits, and amounts vary by plan and county. Original Medicare does not cover routine dental, eyeglasses or hearing aids, so check each plan’s Summary of Benefits for annual limits and networks.

➤ When can I enroll in a Medicare Advantage plan for 2027?

Annual Enrollment runs October 15 to December 7, 2026, with coverage starting January 1, 2027. If you are already in Medicare Advantage, you can also make one change from January 1 to March 31, 2027.

➤ What happens if my Medicare Advantage plan is ending?

You will get a non-renewal notice, and your coverage continues through December 31, 2026. You can choose a new plan during Annual Enrollment or a Special Enrollment Period, and you generally have a guaranteed issue right to buy certain Medigap plans.

Have Questions?

Speak with a licensed insurance agent

1-855-398-0716

TTY users 711

Mon-Fri: 8am-9pm ET

Find & Compare Plans Online

Speak with a licensed insurance agent

1-855-398-0716TTY 711

Mon-Fri: 8am-9pm ET

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