193 Counties Have No Medicare Advantage Drug Plan for 2027, Including Colorado and Utah

What did KFF find about 2027 Medicare Advantage availability?

KFF published a county-level analysis of CMS 2027 landscape data on October 9, 2026. It found that 193 counties will have no Medicare Advantage prescription drug plan available for general enrollment, up from 123 counties in 2026, and that about 638,000 Medicare beneficiaries live in those counties, an increase of 239,000 from the prior year.

The national averages look calmer than the county maps. The average beneficiary has 28 Medicare Advantage prescription drug plans available in 2027. CMS projects more than 99 percent of beneficiaries will have access to at least one Medicare Advantage plan, with about 5,532 plans nationally, down from 5,553. If you live in one of the 193 counties, those averages do not help you.

Which states and counties are on the list?

KFF lists the affected counties in 16 states: Alaska, California, Colorado, Idaho, Kansas, Minnesota, Montana, Nebraska, Nevada, New Hampshire, North Dakota, Oklahoma, Oregon, South Dakota, Utah and Vermont, plus U.S. territories other than Puerto Rico. As in 2026, no MA-PD plans are offered for general enrollment in any Alaska county, covering about 110,000 beneficiaries.

In six counties, in Nebraska and South Dakota, a Medicare Advantage plan without prescription drug coverage is still offered. In the other 187 counties, no Medicare Advantage plan of either kind is open to general enrollment. Colorado and Utah each have rural counties in the group, and at least one Utah carrier published a 2027 service area reduction covering several rural counties, with notices mailed to affected members the first week of October.

County names change as CMS refreshes the landscape file, so check your own ZIP code on the Medicare Plan Finder rather than relying on a map. Your 2027 Annual Notice of Change or non-renewal letter tells you directly whether your plan survives into January.

Why are carriers leaving rural counties?

Rural counties have fewer enrollees, thinner provider networks and less room to manage medical costs. When a carrier decides the math no longer works, it files to exit the county rather than reprice the plan.

KFF’s analysis shows the pullback is concentrated among large insurers. UnitedHealth Group is exiting 228 counties while entering 9, and Humana is departing 62 counties while entering 4. Health Care Service Corporation is leaving 498 counties, Centene 359 and CVS Health 186, while Devoted Health is entering 342 counties. Entries cluster in metro markets, so a national net change of a few dozen plans still empties some rural maps. We covered the mechanics in our post on carriers dropping Medicare Advantage plans for 2027.

What are your options when no MA-PD plan is offered?

Original Medicare plus a stand-alone Part D plan

This is the path most people in these counties will take. Part A and Part B work everywhere, and stand-alone Part D plans are sold statewide, so drug coverage stays available even where Medicare Advantage disappears. For 2027, the standard Part D deductible is $700 and the annual out-of-pocket threshold is $2,400, after which covered drugs cost nothing for the rest of the year.

Pick the drug plan by matching your exact prescriptions and pharmacy, not the premium alone. Our guide to the four factors that decide your Part D plan for 2027 walks through formulary tiers, and our Part D hub covers deductibles and the payment plan option.

A Medicare Advantage plan without drug coverage

Only a handful of counties have one. Joining a stand-alone Part D plan ends your enrollment in most Medicare Advantage plans, so confirm the plan type with the carrier before you submit two applications in the same week.

A Special Needs Plan, if you qualify

In some counties where general-enrollment Medicare Advantage plans are not available, other private options remain, including cost plans and special needs plans, which restrict enrollment to beneficiaries who meet specific criteria. Those criteria usually mean Medicaid eligibility, a qualifying chronic condition, or institutional level of care. Eligibility is verified, not self-reported.

What happens to your Medigap rights if your plan is not renewed?

Losing a plan because the carrier left your county is involuntary, and federal rules can create a guaranteed-issue right to buy certain Medigap policies when you return to Original Medicare. The federal window generally opens 60 days before coverage ends and closes 63 days after. Keep the non-renewal letter, because insurers often ask for it.

State rules add to the federal floor and differ sharply. Colorado’s insurance regulation provides that when a termination is involuntary, the guaranteed-issue period begins on the date of involuntary termination and ends six months after that date. Utah applies the federal rules unless its insurance department has adopted something broader, so confirm before you assume. Outside a guaranteed-issue window, Medigap carriers in most states may use medical underwriting, and we explain the timing in our post on switching from Medicare Advantage to Medigap.

What should you do before December 7, 2026?

The Annual Election Period runs October 15 to December 7, 2026 for coverage that starts January 1, 2027. Members of a non-renewing plan generally get an additional special enrollment period from December 8 to the last day of February; your notice controls the dates. Choosing by December 31 keeps coverage continuous.

If you are weighing the two routes rather than just replacing a plan, read our side-by-side look at Medicare Advantage and Medigap for 2027, and start at our Medicare hub for enrollment windows and penalties. Doing nothing is the one choice with no upside: a plan that ends December 31 leaves you in Original Medicare with no drug coverage, and the Part D late enrollment penalty is 1 percent of the national base beneficiary premium for each uncovered month.