The $12.00 monthly Medicare Advantage premium CMS announced on September 28 is down 16.5% from $14.37, weighted by projected enrollment across roughly 5,532 surviving plans and 34 million members (CMS, September 2026). Weighted by the plans themselves, the same landscape files show premiums up about 1% (Leerink Partners, via Healthcare Dive, September 2026). Most of the $2.37 decline comes from which plans left and where CMS assumes their members land.
The release sets the other bound in its own access paragraph: "approximately eight in 10 MA beneficiaries will be able to remain in their current plan with the same or a lower premium" (CMS, September 28, 2026). Two in ten, then, lose their plan or pay more for it, and Modern Healthcare's count of the landscape files puts the first group alone at 3.8 million people (Modern Healthcare, October 2026).
Key Takeaways
- $14.37 to $12.00 is the enrollment-weighted MA premium change, while Leerink's plan-weighted figure for the same files rises about 1%; only one of the two is weighted by projected 2027 enrollment in surviving plans, and that weighting carries the entire decline.
- 3.8 million enrollees sit in plans that terminate for 2027, and 181 counties have no MA plan at all, up from 67, on Modern Healthcare's read of the files: about one in ten current members, roughly half of the two in ten CMS says cannot keep their plan at the same price.
- $0.37 separates the $14.00 CMS projected for 2026 a year ago from the $14.37 it now reports for 2026, a 2.6% undershoot by the same projected-enrollment weighting, in a year with fewer terminations than 2027.
- $7.00 is the 2027 MA-PD Part D premium after rebates, down $4.32 or 38%, the residual the rebate-reallocation floor leaves once rebates run out; the extra buydown is worth about $52 per enrollee a year, around 2% of the rebate dollars generated per member.
- $29 a month now separates the $36 standalone PDP average from the $7 MA-PD figure, and KFF finds no $0-premium PDP left for enrollees without the low-income subsidy after 28% of them paid nothing in 2026.
What the September 28 Release Weights
CMS Administrator Mehmet Oz framed the release in one sentence: "By slashing handouts to big insurance companies, CMS is keeping premiums stable" (CMS, September 28, 2026). Under it the figures run: the MA premium from $14.37 to $12.00, the MA-PD Part D premium from $11.32 to $7.00, the standalone PDP premium from $35.09 to $36, plan count from 5,553 to about 5,532, projected enrollment of 34 million or 47.4% of Medicare, and access of more than 99% to at least one plan and 97% to ten or more.
The premium figure is defined in the release as the weighted average across all MA plans, including plans with drug coverage and Special Needs Plans. Special Needs Plans carry premiums near zero and are the segment still growing, so they pull the average down before any general-enrollment plan changes price. Healthcare Dive's Rebecca Pifer Parduhn reported the plan-level view from Leerink's Whit Mayo: the industry-weighted average premium up about 1%, the average maximum out-of-pocket limit up 10%, and Part D deductibles up 30% (Healthcare Dive, September 29, 2026). UnitedHealthcare raised premiums 9% against Humana's 1%.
A year earlier, the same release supplies the restatement. In September 2025 CMS projected the 2026 average at $14.00, the MA-PD Part D premium at $11.50 and the PDP premium at $34.50 (CMS, September 2025). The 2027 release carries 2026 at $14.37, $11.32 and $35.09. Realized enrollment landed in pricier MA plans than the bids projected, by 2.6%, and in cheaper drug coverage.
| Measure | 2026 as projected (Sep 2025) | 2026 as restated (Sep 2026) | 2027 projected (Sep 2026) |
|---|---|---|---|
| MA weighted average premium | $14.00 | $14.37 | $12.00 |
| MA-PD Part D premium after rebates | $11.50 | $11.32 | $7.00 |
| Standalone PDP premium | $34.50 | $35.09 | $36.00 |
| MA plans offered | ~5,600 | 5,553 | ~5,532 |
| Projected MA enrollment (share of Medicare) | 34.0M (48%) | n/a | 34.0M (47.4%) |
Sources: CMS landscape releases of September 26, 2025 and September 28, 2026. Each premium is weighted by the plan-projected enrollment for the year shown.
How Plan Exits Move an Enrollment-Weighted Average
The average is each surviving plan's premium weighted by its projected enrollment. A terminated plan contributes nothing; its 2026 members are carried into whichever 2027 plans the bids project them joining, and the 2027 terminations skew to plans that carried premiums. Humana's 600,000 exiting members, 8% of its 7.2 million, sit in what its CFO called "the lower tail of profitability and return" (Healthcare Dive, July 2026). A contract below 3.5 stars keeps 50% of its benchmark-to-bid spread as rebate, 65% between 3.5 and 4.5 and 70% above, so the plans with the least money to buy a premium down to zero are the ones leaving.
Take the eight-in-ten figure as an enrollment share and Leerink's 1% as the repricing on the plans that continue. Continuing plans then contribute 0.8 times $14.51, or $11.61, toward a $12.00 total, leaving $0.39 for the other fifth: the members CMS projects into replacement plans would need to land at an average premium near $2. Widen the reassigned block to 30% to allow for new entrants and projected SNP growth and the implied premium is about $6. On either assumption the repricing share of the $2.37 decline is close to zero and the mix share is nearly all of it.
Payment data fit that reading. The CY2027 rate announcement raised plan payments 2.48%, more than $13 billion, or 4.98% with risk score trend (CMS, April 2026), after an advance notice at 0.09% that Georgetown's Center on Health Insurance Reforms described as a move from flat to favorable (CHIR, April 2026). In the files, the increase shows up as higher cost sharing and a larger Part D buydown, and the plan-level premium still rose about 1%. For a 2028 bid, reading $12.00 as a market-wide price cut would set the competitive premium assumption about $2 a month too low.
The $7 Residual and the States Where the Average Rose
The site read CMS's late-July guidance in August as driving MA-PD Part D premiums to zero during rebate reallocation, and the landscape average landed at $7.00. CMS's Office of the Actuary sets the floor in its reallocation rules: rebates allocated to the Part D basic premium cannot exceed that premium, the total Part D premium net of rebates must be at least $0, and a bid with no MA rebate dollars is excluded from reallocation (CMS Office of the Actuary). The $7 sits in plans whose rebate ran out: bids above benchmark, sub-3.5-star contracts at a 50% share, and enhanced drug coverage priced above the basic premium.
The extra $4.32 of buydown is $51.84 per MA-PD enrollee a year, about 2% of the roughly $2,400 of rebate per member the site's August analysis traced, taken from the pool that funds dental and vision. Standalone drug plans have no such pool. With the Premium Stabilization Demonstration ended and the national average bid at $296.05 (CMS, July 2026), the PDP average rises to $36, a $29 monthly gap. KFF finds no $0-premium PDP for enrollees without the low-income subsidy, after 28% of them paid nothing in 2026, and PDP choices per beneficiary down from 11 to 9 (KFF, October 2026).
State fact sheets show where the national average was assembled. Where plan counts fell, the average rose: Massachusetts from $36.19 to $37.80 as plans went from 103 to 97, Michigan from $14.88 to $16.21 on 192 to 181, New Mexico from $3.41 to $4.58 on 73 to 61 (CMS state fact sheets, September 2026). Where plans were added, it fell: North Carolina from $12.49 to $6.19, Alabama from $11.25 to $7.76, New York from $36.19 to $30.79.
KFF counts 35 plans for the average beneficiary, down from 39, with Alaska again at zero (KFF, October 2026). The $12.00 is the second group of states outweighing the first, and 181 counties, up from 67, now have no plan at either price.
Last year's restatement is the test the 2027 projection has to pass. CMS projected $14.00 a year ago and reported $14.37 this year because members sorted into pricier plans than the bids assumed, in a year when fewer than 3 million lost a plan. The $12.00 asks a fifth of the market to land at about $2 a month while 3.8 million people choose under duress, and the same annual enrollment period that decides where they go decides how much of the $12 survives to next September's restatement.
Further Reading
- CMS's 2027 Rebate Reallocation Rule Drives MA-PD Part D Premiums to Zero
- CMS 2027 Part D Preliminary Bid: The Stabilization Demo Ends and Standalone PDPs Return to the Market
- Humana Sheds 600,000 Medicare Advantage Members for 2027, Recaptures Fewer Than Half
- UnitedHealth, Presbyterian and Humana's 2027 Medicare Advantage Exits Trace to County Benchmark Math
- Medicare Advantage Premiums Fall While Benefits Shrink: KFF Spotlight Exposes the Actuarial Trade-Off
- Medicare Advantage Plan Exits Force 3 Million to Switch in 2026
Sources
- Medicare Advantage and Medicare Prescription Drug Programs Expected to Remain Stable in 2027 (CMS, September 28, 2026)
- 2027 Medicare Advantage and Part D Landscape: State-by-State Fact Sheets (CMS, September 28, 2026)
- Medicare Advantage and Medicare Prescription Drug Programs Expected to Remain Stable in 2026 (CMS, September 26, 2025)
- 2027 Medicare Advantage and Part D Rate Announcement (CMS, April 6, 2026)
- Medicare Part D 2027 National Average Monthly Bid Amount Information (CMS, July 28, 2026)
- Rebate Reallocation Training Handout (CMS Office of the Actuary)
- Here's How Much Insurers Are Cutting Medicare Advantage Plans for 2027 (Healthcare Dive, September 29, 2026)
- Humana to Exit More Medicare Advantage Plans in 2027 (Healthcare Dive, July 29, 2026)
- Medicare Advantage Insurer Exits Pile Up for 2027 (Modern Healthcare, October 1, 2026)
- The Average Medicare Beneficiary Has 28 Medicare Advantage Prescription Drug Plan Options for 2027 (KFF, October 1, 2026)
- Many Medicare Part D Stand-Alone Drug Plan Enrollees Will See Modest Premium Increases for 2027 (KFF, October 2, 2026)
- From Flat to Favorable: How Medicare Advantage Payments Increased in the CY 2027 Rate Announcement (Georgetown CHIR, April 17, 2026)