Seniors on Medicare Advantage plans face higher out-of-pocket costs next year, according to 2027 plan data released this week by the Centers for Medicare & Medicaid Services and analyzed by STAT News and several investment firms. Leerink Partners analyst Whit Mayo calculates that the industry-weighted average premium is staying largely flat — up about 1% — but the average maximum out-of-pocket limit is up 10%, while Part D prescription deductibles are up 30%. A J.P. Morgan analysis found premiums for MA-PD plans rising by several dollars on average, partly because insurers reduced the number of $0-premium plans.
The sharpest increases came from Clover Health, a five-state MA insurer: its Part D deductible jumped 192% and its maximum out-of-pocket limit rose 13%. Among the giants, UnitedHealthcare raised its maximum out-of-pocket limit 11% and its Part D deductible 33%, while boosting premiums 9%. Humana raised its maximum out-of-pocket limit 8% and its Part D deductible 30%, with premiums up 1%. Broker commentary indicates UnitedHealthcare dropped around 13% of its plans across 18 states, and Humana's new offerings are drawing negative feedback for being much less rich.
Medicare Advantage used to be a very lucrative business, but post-pandemic medical costs rose higher than insurers expected, provider relationships grew fraught, and federal policymaking turned less friendly. A HealthScape Advisors survey of 35 health plans found nearly 70% of plan leaders expect their overall 2027 benefit packages to be less rich — higher specialist co-pays, reduced dental coverage, elimination of "giveback" benefits that rebate part of the Part B premium. CMS says supplemental benefits will "remain stable," but the landscape file tells a different story.
Medicare Advantage covers more than half of the 70 million people on Medicare. For seniors, the impact is concrete: higher out-of-pocket maximums and deductibles mean paying more when they get care and prescriptions; dental and other supplemental benefits shrink; some plans are narrowing their hospital and doctor networks. Anyone who doesn't shop carefully could discover next year that their doctor is no longer in-network. The retreat spans the industry: MA accounts for 80% of Humana's revenue, 33% of Aetna's, and 12% of UnitedHealthcare's, and all three are pulling back.
Medicare's annual enrollment period for 2027 plans begins Oct. 15. Analysts warn that seniors with low health literacy are most at risk of being misled by "stable" premiums: the real costs hide in out-of-pocket maximums, deductibles, and network breadth. The irony: in April, the industry won a 2.48% payment increase for 2027 and delayed reforms from the Trump administration — more money in, benefits cut anyway.