Florida is losing more Medicare Advantage plans in 2027 than any other state

Medicare Advantage plans are shrinking their footprint across the Sunshine State in 2027, forcing returning enrollees to re-examine their coverage before the Dec. 7 deadline.

Florida leads the nation in total Medicare Advantage plan discontinuations for 2027, dropping 8.7% from 611 plan offerings to 560 as insurers pull out of underperforming counties.

“We are getting a lot of people calling because their plan has been canceled,” said Beatrice Scafidi, SHINE liaison with the Area Agency on Aging of Palm Beach/Treasure Coast.

Rising care costs and shrinking profits are leading major carriers like Humana and UnitedHealthcare to eliminate some plans or shift others from PPOs to HMOs. Fifteen regional insurers, including some Blue Cross and Blue Shield plans, have received federal approval to cap enrollment in 2027.

“In Palm Beach County, a big change is that anyone who has Aetna PPO plans needs to know that those plans are being terminated,” said Evan Tunis, president of E&M Global Insurance, a South Florida health insurance firm. “That’s just the general trend of PPO plans.”

About 81,000 Medicare Advantage members in Miami-Dade, Broward and Palm Beach counties are in plans that end or will merge into other plans in 2027. Of those, 42,289 are in plans that will no longer be offered in their county. Another 38,738 are in plans being combined with a different plan from the same company,  according to analysis of CMS Medicare 2026 and 2027 files by Mike Boshardy, an insurance broker and founder of The Pocket Protector.

Boshardy said HealthSpring is ending both of its individual Medicare Advantage plans in South Florida and will not offer any in the three counties in 2027. In addition, UnitedHealthcare has the most members in merging plans in South Florida (15,551).

Florida enrollees should read their plan’s 2027 Annual Notice of Change carefully and be aware they may receive a non-renewal notice. If a plan ends or is limited, ignoring an insurer’s communication can have significant consequences. If an enrollee takes no action by Dec. 31, the individual could automatically become enrolled in January on Original Medicare without Part D prescription drug coverage or a Medigap supplemental plan.

“If you get a non-renewal notice, you have until December 31st to pick your replacement, and it can either be a different Medicare Advantage plan that’s available in your area, or you can go to Original Medicare and have guaranteed access to a Medigap plan, which is not normally the case,” said Louise Norris, health policy analyst for medicareresources.org. “But if you do nothing, your Advantage plan will end on December 31st and, as of January 1, you will be in Original Medicare with no supplement.”

Seniors will pay more for Medicare in 2027; big changes coming across all plans

Broward County will have 106 Medicare Advantage plans in 2027 from 15 parent organizations (down from 119 plans in 2026), while Palm Beach has 111 plans from 15 parent organizations (down from 121 in 2026).

Statewide, no insurer comes close to Humana in terms of the sheer number of plan offerings in 2027. This holds true in Broward and Palm Beach, where Humana has 32 offerings in each county, more than any other insurer. Elevance Health has the second-largest number of offerings, with 13 plans in each county.

Even with the elimination of some plans, “Broward and Palm Beach are actually looking pretty good compared to the rest of the country,” Tunis said. “There are a decent amount of plans here and the carriers still want to be here.”

In 2027, the Florida market is heavily tilted toward Special Needs Plans. Sixty-two plans in Broward and Palm Beach are SNPs, serving populations such as beneficiaries who also qualify for Medicaid, residents of institutions, and people with certain chronic diseases.

Across Florida, Medicare Advantage insurers are moving toward shifting the state’s seniors from wider-network PPOs to tightly managed HMOs. In Broward, only 17 plans are PPOs, plus five special-needs PPO plans. In Palm Beach, only 21 are PPOs, along with six  special-needs PPO plans, according to the Centers for Medicare & Medicaid Services Landscape for 2027.

“There is a gradual shift away from PPO, and you’re going to see a more aggressive stance by these insurance companies to just offer HMO plans because they’re trying to make a profit,” said Ricky Rash, a health insurance broker with Health Options USA in Hollywood. “With a PPO, the client can go out of network, but that doesn’t benefit the insurance company. So, last year some insurers pulled their PPOs, and that will continue this year.”

Floridians also will have fewer choices of Medicare Advantage plans with prescription drug coverage.

Nationally, the number of individual Medicare Advantage plans with prescription drug coverage will decline 8% to 425 in 2027, according to CMS data. In Broward and Palm Beach, only about a third of those counties’ total Medicare Advantage plans will offer drug coverage in 2027.

Seniors face higher Medicare prescription costs in 2027

Fewer supplemental benefits

While $0-premium plans still exist, many insurers are quietly trimming the extra non-medical perks that originally drove Florida’s Medicare Advantage boom just a few years ago. Some of those cuts will affect perks such as dental, vision and hearing coverage, gym memberships, and Part B “givebacks.”

“Even if they still offer dental and vision, they might be cutting down the maximum amount that they pay on those sort of benefits,” Norris said.

“Those supplemental benefits, those extras shouldn’t be the deciding factor of how you pick a plan because when you look at the big picture, your medical needs are potentially going to be much more expensive than your routine vision care needs,” Norris said. “You should pick your plan based on your major medical needs being covered and an out-of-pocket cost that you can manage, and then use the supplemental benefits to narrow it down.”

Scafidi notes that seniors seeking a specific benefit can search on the Medicare.gov site for plans that offer it, a new feature.

“If you go on the Medicare.Gov site, they’re adding more categories with the plan finder. So if you’re looking for telemonitoring, you can look to see which plan carries that if that’s important to you,” she said.

Rash said smaller, regional insurers are more likely to offer perks. “They’re trying to grow their membership, and the only way they can do that is by offering their clients all of these sexy items,” he said. “With larger companies like UnitedHealthcare and Aetna, if you look at their trend, it is ‘We’re going to hold the line. We’re not going to be as aggressive.'”

Higher costs for doctors, specialists and medications

Medicare experts say some Medicare Advantage plans will raise specialist copays, add premiums to plans that previously had none, or move away from flat copays such as $40 for a specialist toward percentage-based coinsurance such as 20% of the cost.

With significant changes expected, they advise checking that your doctors, hospitals and pharmacies are still in-network, and reviewing your medication formularies, tiers, and prior authorization requirements.

“Go ahead and put your provider’s names in there, your doctor’s name, and just make sure that they’re still in-network with your plan,” Norris said.

More Special Needs Plans

As part of a national trend, insurance companies are investing in higher-margin Special Needs Plans, or SNPs. The number of SNPs will rise 9.2% to 1,855 next year. In Florida, about two-thirds of plans offered in 2027 are SNPs.

Special Needs Plans cover members with specific long-term health issues, who also qualify for Medicaid, or who need institutional care.

SNPs are increasingly popular with insurers as the population grows older and has more complex medical conditions — and because they generate higher per-enrollee margins than other Medicare Advantage plans.

“Floridians are aging,” Scafidi said. “We are seeing more people who need these plans and more insurers who are offering them.”

South Florida Sun Sentinel health reporter Cindy Goodman can be reached at cgoodman@sunsentinel.com.

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