Who has to choose a new Medicare Advantage plan for 2027
4,062,886 people in a 2026 Medicare Advantage plan have to choose a new one for 2027 — 13.7% of the 29,693,500 members CMS counts in 2026 county-plans. Another 1,192,180 are in a plan being consolidated into a successor: their coverage continues automatically on January 1 and they need do nothing, though the benefits may differ. Reported from the CMS crosswalk, not estimated.
Not everyone whose plan “leaves” has to do something
| What happened to the plan | Members | What the member has to do |
|---|---|---|
| Plan terminated, no successor | 2,384,806 | must actively choose a new plan |
| Plan renewed, but not in this county | 1,678,080 | must actively choose a new plan |
| Plan consolidated into a successor | 1,192,180 | moved automatically on January 1 |
Where it lands hardest
Counties with at least 5,000 members, ranked by the share who must choose. 2,738 of the 3,069 counties with enrollment have at least one.
| State | County | Must choose | Share of members |
|---|---|---|---|
| Minnesota | Crow Wing | 10,823 | 95% |
| Oregon | Lincoln | 4,567 | 91% |
| Minnesota | Olmsted | 7,981 | 90% |
| Minnesota | Morrison | 4,378 | 83% |
| Minnesota | Cass | 4,084 | 80% |
| Minnesota | Sherburne | 7,720 | 80% |
| Minnesota | Otter Tail | 7,549 | 80% |
| Oregon | Deschutes | 14,442 | 79% |
| Minnesota | Douglas | 5,199 | 78% |
| South Dakota | Pennington | 6,569 | 78% |
How this is counted
- One row per 2026 county-plan. A plan filed in 40 counties is 40 rows, because a service-area reduction can remove it from some counties and not others.
- Members come from the CMS monthly enrollment file. CMS suppresses any county-plan cell of 10 or fewer; those are counted as suppressed, never as zero, so the true totals are slightly higher than shown.
- “Must actively choose” means the plan is not available to that member in 2027. Doing nothing does not leave them uninsured — they return to Original Medicare, which may carry a Part D late-enrollment penalty.
- Consolidated members are moved by CMS on January 1. Their new plan’s benefits can differ materially; see what changed for 2027.