Here is what you’ll find in this week’s newsletter!

It’s only a 5 minute read, but it will make you 10x smarter.

DEEP DIVE 📚

The 2027 Annual Enrollment Period ("AEP") starts October 15.

CMS has released the Crosswalk file, so we can now see where members land. Combined with the 2026 and 2027 Landscape files and September 2026 enrollment, that shows which members renew, which are moved into a different plan, and which have to choose.

In Part 1, we covered the change in the number of plans. Today, we look at where members land and how their plan designs change: premiums, drug deductibles, and MOOPs.

When CMS released the 2027 Landscape, the newsroom headline read: "Medicare Advantage and Medicare Prescription Drug Programs Expected to Remain Stable in 2027."

CMS projects the weighted average MA premium will fall from $14.37 to $12 (-16.5%), and the average PDP premium will rise from $35.09 to $36. Those projections use expected 2027 enrollment, which assumes many members switch plans. The numbers below follow today's members into the plans they're assigned.

—

Of 29.9M individual MA/MAPD members:
→ 24.6M (82%) renew in the same plan
→ 2.1M (7%) are crosswalked into a different plan
→ 3.2M (11%) have no plan to land in and must choose. That includes 2.35M in terminated plans and 0.81M whose plan leaves their county.

Of 18.8M standalone PDP members:
→ 16.3M (87%) renew in the same plan
→ 1.4M (7%) are crosswalked, all HCSC
→ 1.2M (6%) are in terminated plans and must choose

Is that stable? It depends on where you sit.

Most crosswalked MA members (1.2M) are in D-SNPs. That lines up with the new CMS rule limiting carriers to one D-SNP for full-benefit dual eligibles in service areas where they also hold a Medicaid managed care contract.

We show two views below:
→ All MA: individual MA and MAPD, including SNPs
→ Non-SNP: excludes Special Needs Plans, whose listed premiums and cost sharing are largely offset by Medicaid and Extra Help (the Part D low-income subsidy) for dual eligibles

—

Flat overall. Up for non-SNP.

→ The enrollment-weighted average monthly premium (All MA) goes from $13.04 to $12.11 (-7%)
→ Non-SNP goes the other way: $11.99 to $14.80 (+23%)
→ The All MA share in $0-premium plans rises from 67% to 73%, driven by D-SNPs
→ For non-SNP, the $0 share slips from 78% to 75%

All MA:

Non-SNP: 22% increasing (avg +$14.72), 76% the same, 2% decreasing (avg -$15.29).

Among non-SNP members, increases outnumber decreases about 9 to 1.

—

Up again, for the third straight year.

The Inflation Reduction Act's Part D out-of-pocket cap rises from $2,100 in 2026 to $2,400 in 2027, which shifts more cost to plans. The maximum drug deductible rises from $615 to $700.

→ The enrollment-weighted average drug deductible (All MA with Part D) goes from $413 to $509 (+23%)
→ Non-SNP MAPD goes from $361 to $489 (+35%)
→ For context: $176 in 2024 and $308 in 2025, from last year's analysis
→ The share of members in $0-deductible plans falls from 16% to 12% (All MA). In 2024, it was 60%!
→ 42% of members will be at the maximum $700 deductible

Non-SNP: 73% increasing (avg +$197), 19% the same, 8% decreasing.

Members with full Extra Help (LIS) generally pay a $0 deductible, so these increases mainly affect members without LIS.

Crosswalked members get hit harder. For the 0.9M non-SNP members being crosswalked:
→ The average deductible goes from $404 to $562
→ The share at the maximum jumps from 32% to 45%
→ Only 3% land in a $0-deductible plan

—

Last year, MOOP was mixed. This year, it's mostly up.

The maximum in-network MOOP rises from $9,250 to $9,850.

→ The enrollment-weighted average MOOP (All MA) goes from $6,072 to $6,603 (+9%)
→ Non-SNP goes from $5,332 to $5,864 (+10%)
→ 70% of members will see their MOOP increase, compared with 35% last year
→ The share in plans from $7,000 to just below the max more than doubles, from 9% to 19%
→ 29% will be at the new $9,850 maximum

Non-SNP: 66% increasing (avg +$858), 30% the same, 4% decreasing.

For crosswalked non-SNP members, MOOP shows the biggest jump:
→ 78% see an increase, averaging +$970
→ The share at the maximum jumps from 2% to 23%

Crosswalked members are generally landing in leaner plans.

—

CMS ended the Part D Premium Stabilization Demonstration after 2026. That shows up in standalone drug plan premiums.

→ The enrollment-weighted average PDP premium goes from $33.40 to $50.03 (+$16.63, +50%) for members with a 2027 plan
→ 31% of PDP members were in a plan with a $0 listed premium in 2026. In 2027, no PDP has a $0 listed premium. The lowest is $5.30.
→ Members with Extra Help in benchmark plans can still pay $0, though 28% are in plans that will now charge them a small premium.
→ 14% of PDP members will see increases of more than $50 per month

By carrier:
→ Centene (Wellcare), 47% of the PDP market: $6.58 to $7.78 (+$1.20)
→ Humana: $31.63 to $46.77 (+$15.14)
→ UnitedHealth (AARP): $106.89 to $177.76 (+$70.87). Nearly 9 in 10 UHC PDP members see increases of more than $50 per month.
→ CVS Health: SilverScript Choice terminates in 27 states, affecting 948K members. For members in the remaining states, premiums go from $95.16 to $126.98.
→ HCSC: 1.36M HealthSpring members are crosswalked, averaging +$11.62. HealthSpring Extra Rx terminates in 20 states, affecting 192K members.

—

So, what did we learn about individual MA/MAPD and PDP plans going from 2026 to 2027?

→ Disruption: 3.2M MA members and 1.2M PDP members must choose a new plan
→ Premiums: level overall, up for non-SNP
→ Drug deductibles: up significantly, for the third straight year
→ MOOPs: up for 70% of members
→ Crosswalked members: moved into leaner plans, with higher deductibles and MOOPs
→ Standalone PDP premiums: up sharply for many members, with no $0 listed-premium plans left

That's all for now.

Happy AEP!

Enrollment source: CMS MA and Part D enrollment, September 2026. Members mapped through the CMS CY2027 Crosswalk to the destination plan offered in their county (MA) or state (PDP). Excludes Cost, PACE and employer group plans. Premiums, deductibles, and MOOPs are listed plan values, before Extra Help (LIS) and Medicaid cost sharing.

Enrollee Count Source: Medicare Advantage Enrollment Insights web app available to MMI+ subscribers

If you’re ready, here are some ways we can help you: