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Welcome to the 2026 AEP for CY2027 enrollments. While Medicare Advantage continues to evolve, we're confident that agents will navigate this year's challenges successfully, just as in years past.
CY2027 builds on many of the changes we've seen over the past several years. Carriers continue balancing affordability, benefit stability, and rising healthcare costs. Premiums are falling, plan choices are becoming more selective in many markets, and beneficiaries are relying on licensed agents more than ever to help them understand their options.
It's a year that reinforces the value of professional guidance and one where your expertise can make a meaningful difference for clients.
Let's dive into what you need to know to make this AEP successful for you and your clients.
A Year of Significant Change
The Medicare Advantage market continues to evolve in 2027, but overall stability remains strong.
According to CMS, Medicare Advantage enrollment is projected to reach approximately 34 million beneficiaries in 2027, representing about 47.4% of all Medicare beneficiaries. CMS also notes that enrollment projections have historically understated actual enrollment and expects 2027 enrollment to be stronger than current estimates suggest.
While enrollment growth has moderated, Medicare Advantage remains an important coverage option for millions of Americans.
What's Driving the Current Market?
Several factors continue to shape the Medicare Advantage landscape:
- Carriers are balancing rising healthcare utilization with benefit affordability
- Many insurers continue refining their service areas and plan portfolios
- Financial pressures from recent Medicare and Part D changes remain a consideration
- Increased focus on profitability has led carriers to reassess certain markets and products
The total number of Medicare Advantage plans nationwide is expected to remain relatively stable, declining only slightly from approximately 5,553 plans in 2026 to 5,532 plans in 2027.
According to KFF, the average Medicare beneficiary will have access to approximately 35 Medicare Advantage plans, including 28 MA-PD plan options.
Despite some market contraction, beneficiaries continue to enjoy broad access to coverage. More than 99% of Medicare beneficiaries will have access to at least one Medicare Advantage plan, and 97% will have access to 10 or more plan options.
Premiums Are Decreasing
The average Medicare Advantage premium continues to move lower for 2027, overall.
The weighted average monthly Medicare Advantage premium is projected to decline from $14.37 in 2026 to $12.00 in 2027, a decrease of approximately 16.5%.
For Medicare Advantage plans that include prescription drug coverage, the average Part D premium component is projected to decrease from $11.32 to $7.00 per month, a decline of approximately 38%.
Even better, many beneficiaries will continue to have access to low-premium and $0-premium plan options across the country.
Why Are Premiums Decreasing?
Continued competition among carriers, Medicare Advantage rebates, and efforts to maintain enrollment have helped keep premiums attractive for beneficiaries despite ongoing cost pressures throughout the healthcare system.
CMS also expects supplemental benefit offerings, including dental, vision, and hearing coverage, to remain generally stable in 2027.
Supplemental benefits remain one of the key features that differentiates Medicare Advantage plans from Original Medicare.
The Challenge: Out-of-Pocket Costs Still Matter
While premiums continue to decline, beneficiaries should still pay close attention to out-of-pocket costs.
Many carriers continue adjusting deductibles, copays, coinsurance, and maximum out-of-pocket exposure in response to rising healthcare utilization and ongoing financial pressures.
A low premium can be appealing, but beneficiaries who anticipate significant healthcare usage should carefully evaluate their total potential healthcare spending for the year, not just their monthly premium.
Considerations include:
- Hospital copays and coinsurance
- Specialist visit costs
- Maximum out-of-pocket limits
- Prescription drug expenses
- Network limitations
- Cost-sharing for outpatient services
Your clients need to understand that the lowest premium isn't always the best value, particularly for those who expect to use medical services throughout the year.
Special Needs Plans Continue to Grow
While overall Medicare Advantage growth has moderated, Special Needs Plans (SNPs) continue to represent an important and expanding segment of the market.
Carriers continue investing in solutions designed for beneficiaries with chronic health conditions and those eligible for both Medicare and Medicaid.
Chronic Condition SNPs (C-SNPs)
C-SNPs serve beneficiaries with qualifying chronic health conditions such as diabetes, cardiovascular disease, chronic heart failure, and other serious illnesses.
Dual Eligible SNPs (D-SNPs)
D-SNPs serve beneficiaries who qualify for both Medicare and Medicaid and often provide enhanced care coordination and additional support services.
If you're not already familiar with SNP opportunities, now is an excellent time to learn. These plans can provide significant value to eligible beneficiaries while helping address some of the healthcare system's most vulnerable populations.
New Provider Directory Requirements
CMS continues implementing changes designed to improve provider directory management and transparency.
Medicare Advantage carriers are required to:
- Share provider directory information with CMS for public access
- Notify CMS of material directory updates
- Regularly attest to directory accuracy
- Maintain responsibility for provider directory information, even when delegated to other entities
These changes are intended to improve the beneficiary experience and reduce confusion surrounding provider network participation.
Non-Commissionable Plans: A Growing Challenge
One of the most disruptive trends affecting agents remains the growth of non-commissionable plans.
While the impact is not as severe as what many agents have experienced in portions of the Part D market, non-commissionable Medicare Advantage plans continue presenting challenges.
Carriers facing pressure to keep premiums competitive while managing increased costs and regulatory changes continue looking for ways to reduce expenses, and agent compensation remains an area of focus.
Understanding these developments is critical as you evaluate product availability and service strategies heading into AEP.
Star Ratings Remain Important
Star Ratings continue to play a significant role in carrier performance, plan funding, marketing opportunities, and beneficiary perception.
Agents should review 2027 Star Ratings carefully during AEP preparations, as ratings influence plan competitiveness, bonus payments, and future benefit offerings.
Changes in Star Ratings can affect:
- Supplemental benefits
- Premium structures
- Marketing opportunities
- Enrollment growth
- Carrier profitability
As always, keeping up with annual rating changes can help agents better understand how plans may evolve in future years.
IntegrityCONNECT: Your Essential Tool for 2027
With increased complexity, shifting compensation structures, and clients who need more guidance than ever, efficiency isn't optional.
Luckily, IntegrityCONNECT is Integrity's all-in-one growth engine, helping agents connect with clients and carriers while streamlining key parts of the sales process.
The platform combines quoting, enrollment, CRM functionality, compliance support, lead management, and client engagement tools into a single ecosystem.
Key features include:
- Comprehensive quoting and enrollment capabilities
- Client relationship management tools
- Ask Integrity® AI functionality
- Client Sync integration
- Lead management and pipeline tracking
Best of all, IntegrityCONNECT remains available at no cost to Integrity agents, including New Horizons agents.
Ready to learn more about IntegrityCONNECT? Reach out to us to register or for personalized training.
Navigating Medicare Plan Finder Updates
Beyond IntegrityCONNECT, make sure you're familiar with Medicare Plan Finder enhancements available for the 2027 plan year.
The provider network comparison tools help beneficiaries verify doctor and hospital participation before enrolling. Enhanced plan comparison functionality and prescription cost tools can also help beneficiaries make more informed decisions during AEP.
Encouraging clients to review their options annually remains one of the most valuable services you can provide.
Conclusion
Medicare Advantage continues to evolve as carriers adapt to changing market conditions, healthcare utilization trends, and regulatory requirements.
Premiums are declining. Supplemental benefits remain stable. Plan offerings continue to provide robust choice for most beneficiaries. At the same time, provider networks, out-of-pocket costs, non-commissionable plans, and changing market dynamics reinforce the importance of professional guidance.
But here's what we know about independent insurance agents: you're resilient.
You've successfully adapted through regulatory changes, market disruptions, carrier exits, compensation changes, and economic uncertainty. And throughout it all, you've continued serving Medicare beneficiaries who depend on your expertise.
The core mission hasn't changed: helping Medicare beneficiaries navigate their healthcare options and find coverage that meets their needs and budgets.
So let's make this AEP our best one yet!
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