Medicare’s 2027 Annual Enrollment Period runs from October 15 through December 7, 2026. During this period, beneficiaries can review and change coverage for January 1, 2027. A recent analysis reports that Medicare Advantage PPO options have fallen by almost 21 percent since 2025. The change makes plan-specific review important, especially for people who depend on particular doctors, hospitals, pharmacies, or prescriptions.
MARKET UPDATE: PPO OPTIONS AND NETWORKS
In an October 13 analysis, The Washington Post’s WP Intelligence reported that the number of Medicare Advantage Preferred Provider Organization (PPO) options has declined by almost 21 percent since 2025. The analysis describes insurers shifting toward Health Maintenance Organization (HMO) models with tighter networks. It also reports growth in Special Needs Plans (SNPs), which now cover roughly one in four Medicare Advantage enrollees. Higher SNP payments have raised fiscal concerns. (Read the WP Intelligence analysis.)
The reported decrease concerns the number of PPO options, not the share of beneficiaries enrolled in PPOs. It also does not mean that every PPO is ending or that every HMO has fewer useful providers. Medicare Advantage availability and provider networks vary by county and plan. PPOs may cover some out-of-network care, usually under different cost-sharing rules. A PPO label alone does not confirm that a specific provider is covered at an acceptable cost.
2027 AVAILABILITY: NATIONAL TOTALS AND LOCAL CHANGES
The Centers for Medicare & Medicaid Services (CMS) has described Medicare Advantage and Part D as expected to remain stable overall in 2027. Its September 28 release projects about 5,532 Medicare Advantage plans nationally, compared with 5,553 in 2026. CMS also estimates that more than 99 percent of beneficiaries will have access to at least one Medicare Advantage plan. (Read the CMS 2027 outlook.)
That national outlook sits alongside changes beneath the overall totals. KFF’s county-level analysis finds that 638,000 beneficiaries in 193 counties will have no Medicare Advantage drug plan available for general enrollment in 2027, up from 399,000 people in 123 counties in 2026. In 187 of those counties, no Medicare Advantage plan of any kind will be offered for general enrollment. KFF also reports that UnitedHealth Group is exiting hundreds of counties. (Review KFF’s county availability analysis.)
These findings describe different measures: national plan totals and access estimates do not establish which plans, networks, or benefits are available at a particular address. The KFF county analysis concerns general-enrollment plans; other plan types, including some SNPs, have separate eligibility rules.
Standalone Part D options also vary by state. KFF’s 2027 state table shows two fewer standalone prescription drug plans in Texas and California, while Florida is the only state gaining a plan. The corresponding state agent directory pages list local records for Texas, California, and Florida. These directory records do not establish which Medicare plans or drug plans are available in a county.
BEFORE DECEMBER 7: SIX-STEP COVERAGE CHECKLIST
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Read the Annual Notice of Change (ANOC) line by line. Note changes to premiums, benefits, deductibles, cost sharing, and plan terms for 2027.
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Confirm doctors, hospitals, and pharmacies for 2027. Check the plan’s current provider directory and confirm directly with each provider. PPO-to-HMO moves are a point at which network access may narrow. Confirm participation for the specific plan, not just the insurer.
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Check every prescription against the 2027 formulary. Review coverage, drug tiers, prior authorization, quantity limits, and the pharmacy’s cost for the exact medication list. A plan with a low premium may have different costs at the pharmacy.
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Compare estimated annual costs, not only monthly premiums. Include premiums, deductibles, copayments, coinsurance, expected prescriptions, and the plan’s maximum out-of-pocket limit. For PPOs, include potential out-of-network costs if that care may be used.
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Verify the plan’s 2027 star rating. Compare the rating for the specific plan and year. A prior-year rating may not reflect the current plan’s status.
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Complete any plan change by December 7, 2026. Changes made during this Annual Enrollment Period generally take effect January 1, 2027. Use Medicare.gov Plan Compare to review plans available for the beneficiary’s location, including costs and coverage details.
For beneficiaries with Original Medicare and a standalone drug plan, prescription costs deserve separate review. KFF’s October 2 Part D analysis reports that people who remain in AARP Medicare Rx Preferred face premium increases of $50 or more in every state and the District of Columbia; increases exceed $75 in 37 states and $100 in four. These figures apply to the specified plan and do not describe all Part D plans.
DECISION FRAMEWORK: KEEP, SWITCH, OR REVIEW ORIGINAL MEDICARE
Keep the current plan if the ANOC shows only minor changes and the 2027 provider network, drug formulary, and estimated costs continue to meet the beneficiary’s needs.
Compare other Medicare Advantage plans if a current doctor, hospital, or prescription is being removed or materially changed. Confirm the alternatives against the beneficiary’s address, provider list, and medication list before enrolling.
Consider Original Medicare with a standalone Part D plan, and possibly Medigap, if provider flexibility is the main consideration. Original Medicare generally does not use Medicare Advantage plan networks, but cost exposure and supplemental coverage choices differ. Medigap availability may depend on eligibility, timing, and state rules.
If the current plan is being discontinued, review the notice and applicable enrollment rights promptly. A Special Enrollment Period for affected beneficiaries runs through February 28, 2027. Delays may create a coverage gap, so the end date and effective date of replacement coverage should be confirmed.
MEDIGAP GUARANTEED-ISSUE TIMING
Beneficiaries whose Medicare Advantage plan is ending have a guaranteed-issue right to buy Medigap Plan A, B, D, G, K, or L without health questions, from November 1, 2026 through March 4, 2027, 63 days after coverage ends. Eligibility and available policies should be independently confirmed. Keep the plan’s non-renewal letter as documentation of the coverage change.
QUESTIONS TO ASK AN AGENT OR BROKER
Before switching, request clear answers to these questions:
- Is the current plan actually changing, or is its premium only being repriced?
- Which of the beneficiary’s doctors leave the network on January 1?
- What will the plan charge at the pharmacy for the beneficiary’s exact drug list?
- What happens if the beneficiary does not review or change coverage?
- Is the agent licensed in the beneficiary’s state, and how can the license be verified?
AGENT RECORDS AND LICENSE VERIFICATION
Insurance licenses are issued by states; there is no national insurance-agent license. Every licensed agent has a National Producer Number (NPN). An NPN is an identifying number, not confirmation that a license is current or that the agent is authorized for every product in every state.
VerifiedAgent is an insurance agent directory with searchable state pages and agent profiles. Available profile records may include NPN, recorded license information, customer reviews, and listed insurance categories. The directory lets users find and compare licensed health insurance agents by state. Use the state selection page to locate local agent records.
Before sharing Medicare or personal information, compare the agent’s profile details and independently confirm current state license status. Ask the agent to confirm the scope of assistance and any relevant plan appointments. Directory information may be incomplete or outdated; current licensing, plan availability, provider networks, benefits, and costs should be confirmed with the relevant state regulator, plan, provider, and Medicare resources.
SUMMARY
The 2027 Medicare Advantage market is described as stable in national totals while PPO availability, county offerings, drug-plan options, and provider networks shift. The reported decline in PPO options makes review of the ANOC, doctors, hospitals, prescriptions, and total costs relevant before December 7, 2026. VerifiedAgent provides state-based agent records and NPN information where available; licensing and coverage details should be independently confirmed.
