Medicare Advantage Premiums Seen Down 16% in 2027 as Enrollment Holds at 34 Million
Medicare Advantage premiums are projected to fall more than 16% from 2026 to 2027, with enrollment and supplemental benefits holding steady. The Centers for Medicare & Medicaid Services published that outlook on Sept. 28, 2026. CMS
Enrollment is projected at about 34 million beneficiaries in 2027. Supplemental benefits, meaning extras beyond standard hospital and doctor coverage, are projected to remain stable. Both points were reported in coverage of the CMS outlook. Becker's
The payment side was settled months earlier. CMS released the final 2027 pay rules, the Rate Announcement for Medicare Advantage and drug coverage, on April 6, 2026. CMS CMS projects those rules will lift average payments to plans by 2.48% net, or more than $13 billion in 2027. CMS
The starting trend underneath is higher. The effective growth rate, basically the growth in traditional Medicare costs used to set rates, is put at 4.40% for 2027 for non-ESRD care, which excludes kidney-failure care paid under separate rules. CMS The step down from 4.40% to 2.48% net is mechanical. Star ratings, which are quality scores, plus a yearly normalization of risk scores and other legal adjustments, sit between cost growth and what plans actually get. The final 2.48% is also well above the January draft, when the government proposed a 0.09% average rise for 2027. Reuters January was a proposal. April is final and is the number to use.
Drug coverage has separate, binding figures. The national average bid for 2027 will be $296.05. The base member premium will be $41.33. CMS published both on July 28. CMS Think of the bid as the anchor for the government payment and the base premium as the starting average. Actual plan premiums then vary with each plan bid, basic versus enhanced design, and low-income subsidy effects.
Two dates frame what is still to come. CMS said the 2027 landscape with finalized plan offerings would follow in mid-to-late September. Detail on benefits, networks, and county premiums lives in that release, not in this topline outlook. CMS is also expected to announce Part B monthly premiums and Part A and Part B deductibles in late October or early November. Kiplinger Those figures feed into total member cost and cash planning for dual-eligible and Medigap households.
The broader context here is the tension to reconcile. Underlying costs are running at 4.40%, yet CMS projects much lower average premiums with stable benefits and flat enrollment at 34 million. Lower premiums do not mean lower revenue. They often point to tight bids against county benchmarks and use of rebates to buy down Part B, Part D, or cost sharing. Whether that math works plan by plan rests on star results, county benchmarks, coding intensity, and control of medical costs. None of that shows in a national average.
In my view, the sequence matters more than any single figure. The January proposal set a low anchor. The April final raised the pay path to 2.48%. The July bid and base premium fixed the drug math. The September outlook added stable enrollment and lower premiums. The missing pieces are distribution, not direction. The landscape will show where premium drops cluster and whether benefit richness was trimmed to get there. The Part B release will complete the household cost picture. Until then, treat the 16% decline as a national projection, not a promise for any market.
