Now that the CMS Crosswalk and Landscape files for plan year 2027 have been released, we can highlight where enrollment is being displaced due to plan terminations and service area reductions ("SAR"), and what this means for carriers, distributors, and agents heading into AEP 2027.
(This analysis includes Individual MA/MAPD plans only. Excludes 1876 Cost, MSA, PACE, and employer group plans. Enrollment as of September 2026 based on CMS plan/county data.)
The Big Picture
Roughly 3.16 million enrollees are impacted by terminated plans in 2027 (including both terminated and SAR-terminated plans). That's up from about 2.87 million last year and 2 million the year before.
Disruption is growing faster than the market itself. Impacted enrollment rose 10% year over year, while individual MA enrollment grew just 2.4% (to ~29.9 million).
For context, ATI Advisory research shows that from 2021–2024, the share of members affected by terminations or SARs ranged from 0.4% to 1.5%. That jumped to 7% for AEP 2025 and 10% for AEP 2026, and now stands at 10.6% for AEP 2027.
About three-quarters (75%) of this year's impact comes from plan terminations. Service area reductions account for the remaining 25% (~800,000 enrollees).
👉 Throughout this analysis, "Terminated" refers to both terminated and SAR-terminated plans combined.
With this background in mind, let’s drill down into more details…
By Plan Type
Local PPOs lead in total disruption for the third straight year, and the gap is widening.
Plan Type | Current Enrollment | Total Terminated | % Terminated (2027) | % Terminated (2026) |
|---|---|---|---|---|
HMO/HMOPOS | 19,871,275 | 1,292,000 | 7% | 7% |
Local PPO | 9,842,649 | 1,849,692 | 19% | 15% |
PFFS | 32,014 | 7,764 | 24% | 6% |
Regional PPO | 130,636 | 7,142 | 5% | 16% |
Grand Total | 29,876,574 | 3,156,598 | 11% | 10% |
Nearly 1 in 5 Local PPO enrollees (19%) is losing their plan, up from 15% last year. Local PPOs account for 59% of all disruption (~1.85 million enrollees), up from ~1.5 million last year and ~1.2 million the year before.
HMO/HMOPOS disruption held steady at ~1.3 million (7%), after doubling last year.
PFFS saw the highest termination rate (24%), though on a very small base of ~32,000 members.
Regional PPO terminations fell sharply, from 16% to 5% (~7,000 enrollees, all UnitedHealthcare).
Medicare-Medicaid Plans (MMPs), which accounted for ~37,000 terminations last year, no longer appear following the end of the MMP demonstration.
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By SNP Plan Type
Plan Type | Current Enrollment | Total Terminated | % Terminated (2027) | % Terminated (2026) |
|---|---|---|---|---|
Non SNP | 21,503,405 | 2,843,256 | 13% | 12% |
D-SNP | 6,427,011 | 254,680 | 4% | 2% |
C-SNP | 1,819,733 | 57,211 | 3% | 4% |
I-SNP | 126,425 | 1,451 | 1% | 2% |
Grand Total | 29,876,574 | 3,156,598 | 11% | 10% |
Non-SNP plans are still driving the vast majority of disruption, at 90% of total terminations (down from 94% last year).
D-SNP disruption nearly doubled, from ~135,000 in 2026 to ~255,000 enrollees (4% of D-SNP members) in 2027. It's still a small slice of the total, but it's the fastest-growing segment of disruption and worth watching.
C-SNP and I-SNP plans remain relatively stable.
By Carrier
There are two "slices" worth highlighting.
The first view highlights the top 15 Parent Companies with the most terminations.
The largest four, Humana, UnitedHealthcare, CVS, and Aware Integrated (Blue Cross and Blue Shield of Minnesota), account for 53% of total terminations.
That's more concentrated than last year (46% from UHC, CVS, Elevance, and HCSC), though still well below the 75% concentration of two years ago.
Humana is back on top with ~601,000 impacted enrollees (9% of its individual book), nearly 40% of them in Florida alone.
Among the national carriers, Centene (19%) and HCSC (16%) are pruning the largest share of their books. Elevance (4%) and UnitedHealthcare (7%) are pruning the least.
Aware Integrated (BCBS of Minnesota) is the biggest single-market story: ~258,000 impacted enrollees, 90% of its individual MA book, all in Minnesota.
UPMC and Corewell Health stand out for the opposite reason: most of their disruption comes from service area reductions rather than full plan terminations.
The top 15 parent companies account for 80% of all impacted enrollment. The remaining 20% is spread across 65 other organizations.
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The second view highlights the top 15 Parent Companies with the highest termination %.
Parent Organization | Total Terminated | % Terminated |
|---|---|---|
Providence St Joseph Health | 53,029 | 100% |
Sharp Healthcare | 17,281 | 100% |
Memorial Hermann Health System | 14,586 | 100% |
CHRISTUS Health | 8,728 | 100% |
Central Mass Health Holding LLC | 7,758 | 100% |
Aspirus Inc. | 5,938 | 100% |
BMC Health System Inc. | 5,107 | 100% |
Aware Integrated Inc. | 258,328 | 90% |
Mass General Brigham Incorporated | 18,105 | 86% |
PacificSource | 42,427 | 78% |
Blue Cross Blue Shield of Kansas | 7,420 | 74% |
Blue Cross Blue Shield of Nebraska | 19,804 | 71% |
Presbyterian Healthcare Services | 28,995 | 67% |
Martin's Point Health Care Inc. | 41,528 | 63% |
Horizon Mutual Holdings Inc | 42,349 | 60% |
Seven organizations are exiting individual MA entirely, up from five last year. Nearly all are provider-sponsored health systems.
BMC Health System finishes the exit it started last year, when 78% of its members were impacted.
Blue plans are a recurring theme: BCBS Minnesota, Kansas, and Nebraska, plus Horizon (BCBS New Jersey), are all shedding the majority of their individual books.
By State & County
State and county-level disruption varies widely, and it's heavily concentrated. The top 10 states account for 61% of all impacted enrollment, even though members in 50 states and 2,500+ counties are affected.
Minnesota leads with ~346,000 impacted enrollees, a remarkable 63% of the state's individual MA market. Florida (~321,000, 11%) is a close second by count.
Beyond Minnesota, the highest disruption rates are concentrated in the Upper Midwest and Mountain West: Wyoming (46%), South Dakota (41%), North Dakota (40%), Idaho (36%), and Nebraska (34%).
At the county level, Hennepin County, MN tops the list with ~67,000 impacted enrollees. That's more than double the next-largest county (San Diego, CA, at ~30,000).
Bottom Line
AEP 2027 marks the third consecutive year of major Medicare Advantage contraction. More than 1 in 10 enrollees (over 3 million people) need to select a new plan. That creates disruption for carriers and opportunity for agents and distributors.
The pullback is still concentrated in Local PPOs and Non-SNP plans. This year, though, it's sharper in specific markets: full exits by provider-sponsored plans, deep cuts by regional Blues, and a near-total reset of the Minnesota market. The reshaping of the MA landscape toward tighter, more profitable footprints shows no sign of slowing.
You can explore localized impacts, including by carrier, plan type, and enrollment volume, using the Medicare Advantage Enrollment Insights web app.
If you're ready to dig deeper, download the full dataset for your own analysis.
