Medicare Advantage by State in 2027: Plans, Premiums and Out-of-Pocket Limits

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In Georgia, 92.5% of Medicare Advantage plans charge no monthly premium for 2027. In California, only 82.0% do. That sounds like Georgia is the better place to be on Medicare — until you look at what happens when you get sick. The median Georgia plan caps your annual out-of-pocket costs at $9,850, the highest figure federal law allows. The median California plan caps them at $3,400.

Free and protective are not the same thing, and one tells you nothing about the other. We downloaded CMS’s plan-level data for the 2027 plan year — 5,841 state-by-state plan listings across the United States — and worked out, state by state, what you’re actually being offered in the enrollment window that opened on October 15. The full table is below, with each state’s 2026 limit alongside so you can see what moved.

What We Found

Five things stood out, and none of them appear in the national averages that most coverage relies on.

Four states have a median out-of-pocket limit at the legal maximum. In Georgia, New Jersey, New York and — new this year — South Carolina, half of all Medicare Advantage plans cap your in-network spending at $9,850, the highest figure federal rules allow for 2027. Not close to the ceiling: at it. The midpoint of the 51 state medians is $7,150, so these four aren’t marginally above average. They’re at the wall. (That $7,150 is a different statistic from the $7,100 midpoint across all individual plans we quote elsewhere on this site: ranking states gives Vermont the same weight as Florida.)

Almost every state got less protective than it was in 2026. The median limit rose in 49 of the 51 rows. It held still in Puerto Rico and fell in exactly one state, Arkansas, by $100. The biggest jump was South Carolina’s, up $1,650 in a single year, followed by Kansas at $1,400. Part of that is the legal ceiling itself moving from $9,250 to $9,850, but most states are nowhere near the ceiling and rose anyway. Over the same year the share of plans with a $0 medical premium fell in 41 states.

The national version of that shift, with the average premium going down while the limit goes up, is in our count of the 2027 plans against the 2026 ones.

The share of free plans tells you nothing about protection. Puerto Rico, Florida, Arizona and Nevada have the highest shares of $0 premiums in the country, all above 96%, and four of the five lowest out-of-pocket limits. Georgia is not far behind them on free plans, at 92.5%, and sits at the legal maximum. Massachusetts has the lowest share of $0 plans anywhere, 49.5%, and a median limit of $6,750 — a little below the middle of the table, neither good nor bad. Put all 51 rows together and there is no dependable link between the two columns. If you shop on premium alone, you are choosing blind on the number that matters more.

Choice is wildly uneven. Florida has 560 plans from 22 insurers. Vermont has five plans from a single insurer, and Wyoming eight from two. National statistics describing dozens of options per beneficiary do not describe Vermont in any useful sense.

Quality varies by geography as much as by carrier — and it moves. On the 2027 star ratings, which CMS published on October 8, 2026, average overall stars run from 3.31 in Oregon to 4.79 in Puerto Rico, a spread of 1.48 stars. A year ago the large carriers sat much closer together than the states did. For 2027 they have pulled apart — from 3.24 at HealthSpring to 4.47 at Kaiser Permanente, a spread of 1.23, with Humana jumping from 3.76 to 4.16. And the state averages themselves moved: Florida fell from 4.41 to 4.09, Pennsylvania from 4.19 to 3.99, while Washington, West Virginia and New Hampshire rose by a quarter of a star or more. Neither where you live nor whose name is on the card settles it. The 2027 rating of the specific plan does.

The Extremes

	Highest	Lowest
Plans available	Florida, 560	Vermont, 5
Insurers competing	California, 35	Vermont, 1
Share of $0 premium plans	Puerto Rico, 100%	Massachusetts, 49.5%
Median out-of-pocket limit	Georgia, New Jersey, New York, South Carolina — $9,850	California and Puerto Rico, $3,400
Average star rating (2027)	Puerto Rico, 4.79	Oregon, 3.31

Puerto Rico appears three times, and every time on the good side: all of its plans free, the joint-lowest limit and the highest ratings. Vermont appears twice at the thin end, with five plans from one company. Neither looks anything like the national average, which is the clearest illustration of why a single national figure misleads.

Why Geography Decides This

None of this variation is random, and understanding where it comes from makes your own row easier to read.

Medicare sets a spending benchmark for every county, based on what care has historically cost there. Insurers bid against that benchmark, and a plan bidding below it gets part of the difference back as a rebate — money the law requires them to spend on extra benefits, lower cost sharing, or a lower premium. Our guide to how Medicare Advantage works goes through the mechanism in more detail.

Two consequences follow, and between them they explain most of the table.

The first is that a generous benchmark produces generous rebates, and insurers choose where to spend them. A plan can put that money into waiving the premium, or into a lower out-of-pocket ceiling, or into dental and grocery allowances — but not into all of them at once. States where nearly every plan is free are states where insurers have collectively decided the premium is where the money is best spent. That choice comes out of the same pot that would otherwise have bought you a lower cap.

The second is competition. Where 35 insurers compete, as in California, plans have to distinguish themselves on something a shopper will notice — and a lower out-of-pocket limit is one of the few levers left once everyone is already charging $0. Where three or four companies share the market, that pressure is weaker. It is a tendency rather than a rule, though: New York has 22 insurers and its median plan still sits at the legal maximum.

What does not follow is a simple trade-off between the two columns. Where the benchmark is generous enough, the rebate pays for both at once, which is why Florida, Nevada and Puerto Rico manage nearly all-free plans and some of the lowest limits in the country. Where it isn’t, something gives — and in Georgia what gave was the limit. You cannot tell which kind of market you live in from the premium column, which is the whole reason the limit column is there.

Medicare Advantage by State, 2027

Every state and territory with Medicare Advantage plans available for 2027. Alaska is absent because the file lists none there for individual enrollment, which is why the rows below total 51 rather than 52. “Plans available” counts distinct plans offered somewhere in that state, not in every county. The out-of-pocket figure is the median in-network annual limit across those plans, and the star figure is the mean overall rating of the rated plans; both are shown for 2027 with the 2026 figure beside them.

State	Plans available	% with $0 premium	Median out-of-pocket limit, 2027	Same limit in 2026	Insurers	Average star rating, 2027	Same rating in 2026
Alabama	113	87.6%	$7,150	$6,600	8	3.85	3.98
Arizona	148	97.3%	$5,500	$4,900	16	3.78	3.64
Arkansas	84	91.7%	$7,150	$7,250	10	3.73	3.69
California	394	82.0%	$3,400	$3,072	35	3.68	3.68
Colorado	104	95.2%	$6,700	$5,900	11	3.94	4.06
Connecticut	48	83.3%	$7,400	$6,800	6	3.73	3.68
Delaware	38	81.6%	$7,500	$6,750	8	3.50	3.81
District of Columbia	15	60.0%	$7,151	$6,750	5	3.90	3.88
Florida	560	97.7%	$3,975	$3,900	22	4.09	4.41
Georgia	161	92.5%	$9,850	$9,250	12	3.75	3.93
Hawaii	46	71.7%	$7,150	$6,700	6	3.60	3.73
Idaho	44	63.6%	$7,000	$6,700	7	3.76	3.72
Illinois	136	87.5%	$5,700	$5,000	11	3.85	3.63
Indiana	140	92.1%	$7,150	$6,350	12	3.71	3.62
Iowa	64	75.0%	$7,150	$5,900	12	3.84	3.93
Kansas	80	93.8%	$6,600	$5,200	8	3.71	3.80
Kentucky	123	91.9%	$7,150	$6,700	11	3.79	3.68
Louisiana	124	94.4%	$6,875	$6,300	10	3.88	4.07
Maine	50	72.0%	$7,650	$7,000	6	3.83	3.80
Maryland	47	68.1%	$8,050	$7,900	8	3.69	3.91
Massachusetts	97	49.5%	$6,750	$5,500	11	3.84	4.04
Michigan	181	65.7%	$6,700	$5,600	16	3.99	3.98
Minnesota	53	60.4%	$7,150	$5,900	10	4.03	4.07
Mississippi	102	93.1%	$8,200	$7,350	9	3.79	3.68
Missouri	174	93.7%	$5,900	$5,000	12	3.80	3.79
Montana	23	69.6%	$6,750	$6,700	3	4.00	3.56
Nebraska	48	83.3%	$7,150	$6,250	10	3.74	3.53
Nevada	98	96.9%	$4,450	$3,700	12	3.85	4.08
New Hampshire	20	85.0%	$7,225	$6,700	3	4.14	3.67
New Jersey	71	85.9%	$9,850	$9,250	12	3.91	3.92
New Mexico	61	90.2%	$6,150	$5,900	6	3.87	3.58
New York	224	73.2%	$9,850	$9,250	22	3.67	3.76
North Carolina	179	89.4%	$7,150	$6,700	16	3.98	4.15
North Dakota	17	58.8%	$7,150	$6,700	4	4.07	3.94
Ohio	180	79.4%	$6,375	$5,800	20	3.88	3.88
Oklahoma	81	87.7%	$6,700	$6,000	9	3.90	3.75
Oregon	95	71.6%	$7,150	$6,700	14	3.31	3.35
Pennsylvania	338	70.1%	$7,150	$6,750	17	3.99	4.19
Puerto Rico	63	100.0%	$3,400	$3,400	3	4.79	4.81
Rhode Island	22	90.9%	$7,025	$5,900	4	3.70	4.03
South Carolina	97	89.7%	$9,850	$8,200	12	3.83	4.01
South Dakota	22	50.0%	$7,150	$6,750	4	4.08	3.94
Tennessee	155	87.1%	$6,750	$5,900	11	3.78	3.80
Texas	421	91.7%	$7,150	$6,700	21	3.88	4.01
Utah	51	92.2%	$6,750	$6,500	8	4.15	4.03
Vermont	5	80.0%	$7,150	$6,500	1	4.10	3.83
Virginia	148	84.5%	$7,500	$6,750	10	3.86	3.83
Washington	115	79.1%	$7,150	$6,700	14	3.95	3.68
West Virginia	70	77.1%	$7,550	$7,000	8	3.88	3.63
Wisconsin	103	76.7%	$6,050	$5,400	13	3.86	3.90
Wyoming	8	75.0%	$7,075	$6,750	2	4.00	3.55

How to Read Your Own Row

The median out-of-pocket limit is the column to start with. It tells you what a typical plan in your state does when you have a bad year, and it’s the number that varies most. If your state’s median sits near $9,850, that isn’t a reason to avoid Medicare Advantage — it’s a reason to sort by out-of-pocket limit rather than by premium, because in your market the good plans and the average ones are further apart than elsewhere. Then compare it with the 2026 column beside it: if your state’s figure jumped, the plan you are already in has probably moved too, and the Annual Notice of Change your insurer sent you says by how much.

The insurer count tells you how much competition there is. Where a handful of companies hold the market, shopping matters more, not less — there’s less pressure on any of them to improve terms.

The $0 premium share is the column to weight least. In most states the great majority of plans are free, so it rarely narrows anything. Our guide to what a $0 premium actually means covers why that money hasn’t disappeared, only moved.

One important limit on all of it: these are state figures, and Medicare Advantage is sold county by county. Your state’s median is a description of your market, not a quote. The plans you can actually buy are the ones the Medicare Plan Finder shows for your ZIP code.

How We Built This

The source is the CY2027 Landscape file published by the Centers for Medicare & Medicaid Services, released on September 22, 2026, and revised on September 30. It lists every approved Medicare Advantage and Part D plan by county, with premiums and out-of-pocket limits. The 2027 star ratings come from the 2027 Star Ratings data tables CMS published on October 8, 2026, matched to each plan through its contract. The 2026 comparison columns come from the CY2026 file, in its September 2026 version, processed by the same code.

We included plans in the MA, MA-PD and SNP categories and excluded stand-alone Part D plans, Cost plans and employer-sponsored plans, which are not available to an individual shopping for coverage. The file lists each plan once per county it serves, so we reduced it to one entry per plan per state — 5,841 state-plan combinations for 2027, against 5,968 for 2026.

From those we calculated, for each state: the number of distinct plans, the share whose Part C premium is $0, the median in-network maximum out-of-pocket amount, and the number of distinct parent organizations offering plans. The star columns are the mean of the published overall star ratings across the plans that carry one, for each year.

Three caveats we’d rather state than bury. The star ratings are not in the 2027 plan file itself — CMS publishes them separately in October — so we matched them in from the ratings tables; a plan too new to be rated is left out of the star average rather than counted as zero. A median is a midpoint, not a promise: half the plans in your state are better than the figure shown and half are worse, which is exactly why the figure is a starting point for comparison rather than a substitute for it. And “% with $0 premium” is the medical (Part C) premium only, counted per plan rather than per member, so it will not match the enrollment-weighted figures published elsewhere. Which plan year each figure on this site describes is set out on our editorial methodology page.

Frequently Asked Questions

Why does my state have so few plans? Medicare Advantage is only worth offering where there are enough beneficiaries and a workable provider network. Rural and low-population states attract fewer insurers — Vermont has one, Wyoming two — while Florida has 22.

Is a high $0 premium share good news? It is neither good news nor bad, because it doesn’t predict anything. Georgia is at 92.5% and its median out-of-pocket limit is at the legal maximum; Florida is at 97.7% and its median limit is $3,975. The premium tells you what the plan costs monthly; the out-of-pocket limit tells you what it costs when you need it.

What does the median out-of-pocket limit actually mean for me? It’s the midpoint of what plans in your state cap your in-network spending at for the year. Federal rules for 2027 allow up to $9,850 in network, up from $9,250 in 2026. A state median close to that means most plans there offer relatively weak protection, so the exact figure on the plan you pick matters more.

Why is Puerto Rico’s star rating so much higher than everywhere else? Its average is 4.79 on the 2027 ratings, across 63 plans from three insurers, and it was 4.81 the year before. A small, concentrated market with a few strong performers can produce averages that larger, more fragmented states can’t match.

Does this tell me which plan to pick? No — it tells you what kind of market you’re shopping in. Use it to decide what to prioritize, then compare actual plans for your ZIP code, checking that your doctors and medications are covered.

Bottom Line

National averages describe a country nobody lives in. The average beneficiary has dozens of plans to choose from; the average Vermonter has five. The average plan caps out-of-pocket costs somewhere in the middle; the median Georgian plan caps them at the legal maximum. And the national median limit rose $600 for 2027, while South Carolina’s rose $1,650.

Find your row. If the median limit is high, sort by that column first. If there are few insurers, look harder rather than assuming the market has done the work for you. And treat the $0 premium share as background — in most states it no longer separates anything.

Then compare the plans actually sold at your address using the official Medicare Plan Finder, or call your local State Health Insurance Assistance Program (SHIP) for free, unbiased guidance.

Sources

• CY2027 Medicare Advantage and Part D Landscape file — Centers for Medicare & Medicaid Services, released September 22, 2026, and revised September 30, 2026. The source for every 2027 figure in the table above: plan counts, $0 premium shares, median out-of-pocket limits and insurer counts. All state-level calculations are our own, using the method described in “How We Built This”.
• CY2026 Medicare Advantage and Part D Landscape file — Centers for Medicare & Medicaid Services, September 2026 version. The source for the 2026 limit and star columns, counted by the same method. The full state table for both years, with a few extra columns, is available as a downloadable spreadsheet (CSV).
• CY2027 Rate Announcement — Centers for Medicare & Medicaid Services. The document that sets the maximum out-of-pocket limits Medicare Advantage plans may use in 2027, including the $9,850 in-network ceiling.
• Medicare Advantage in 2026: Premiums, Out-of-Pocket Limits, Supplemental Benefits and Prior Authorization — KFF. Source for the $9,250 federal in-network out-of-pocket ceiling for 2026.
• 2027 Star Ratings Data Tables — Centers for Medicare & Medicaid Services, published October 8, 2026. Source for the 2027 star column, matched to each plan through its contract, and for the insurer-level star averages quoted above.

The 2027 plan figures on this page were counted from the CMS Landscape file on October 4, 2026, the 2026 figures by the same method on the same day, and the 2027 star ratings on October 12, 2026. Every state-level calculation is our own, by the method set out in “How We Built This”. Plan availability changes; confirm current details on Medicare.gov before making a decision.

Disclaimer: Figures reflect 2027 plan data and star ratings, with 2026 comparisons, from the Centers for Medicare & Medicaid Services (CMS) and vary by county and plan. Always confirm current details directly with Medicare.gov, 1-800-MEDICARE, or a licensed agent before making a decision.