Brief
Where Medicare Advantage choice is thin
American Factbook Research
Published
Data retrieved
CMS lists Medicare Advantage plans in 3,162 counties for contract year 2027. The median county has 42 of them; Hillsborough, Florida, has the most, 124. At the other end, 346 counties have fewer than ten — 10.9% of the counties CMS lists.
346 counties have fewer than ten Medicare Advantage plans listed; the median has 42
Counties by how many Medicare Advantage plans CMS lists in them for contract year 2027, in bands. Special Needs Plans are counted; stand-alone drug plans, sold statewide, are not.
Source: CMS
About this chart
The figures
| Plans listed | Counties |
|---|---|
| Fewer than 10 | 346 |
| 10 to 19 | 375 |
| 20 to 29 | 409 |
| 30 to 39 | 316 |
| 40 to 49 | 511 |
| 50 to 59 | 469 |
| 60 to 79 | 576 |
| 80 or more | 160 |
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Where the thin counties are
They are not spread evenly across the country. South Dakota has 46 of its 66 counties under ten plans, Minnesota 41 of its 87, and Kansas 36 of its 105. The file records where each plan is offered. It does not record why a plan is offered in one county and not the next, and this brief does not guess.
And in 5 states and territories — Alaska, American Samoa, Guam, Northern Mariana Islands, Virgin Islands — CMS lists no Medicare Advantage plan by county at all. There, the plans CMS lists are stand-alone Part D drug plans.
What a count of plans does not say
It is a count of plans listed, not of plans open to everyone. Special Needs Plans are in it, and they take only people who meet their criteria — a condition, an institution, or eligibility for Medicaid as well as Medicare. The number open to any one reader is smaller, and each county page says which plans are which.
It leaves out the drug-only plans. CMS lists a stand-alone Part D plan once for its state, because it is sold across a region rather than county by county, so every county can also choose among its state's drug plans. They are on each state's Part D page.
More plans is not better plans. A count says nothing about what a plan costs a given reader or how it is rated. Even among the top: 160 counties have eighty or more plans listed, and 77 counties have no plan listed with a zero premium.
Every county's plans, with the premium, deductible and star rating CMS published for each, are on the Medicare plans pages.
What this cannot show
- A count of the Medicare Advantage plans CMS lists in a county, not of people enrolled in them, which the plan landscape does not carry.
- Special Needs Plans are counted, and are open only to people who meet their criteria, so the number of plans open to a given reader is smaller than the count.
- Stand-alone Part D drug plans are not counted: CMS lists them once for each state, and every county can choose among its state's.
- The figures are the ones CMS approved for the contract year, which CMS says may change as contracts are finalized.
- CMS lists Connecticut by the eight counties the state used before 2022, which the Census Bureau no longer publishes; they are counted here as CMS lists them.
Sources
- CMS Medicare Advantage and Part D plan landscape, Centers for Medicare & Medicaid Services. U.S. Government work. CMS states on its website-policy page that CMS.gov "is a public domain web site" (https://www.cms.gov/about-cms/web-policies-important-links/about-website/link-to-us, read September 26, 2026), and the landscape file is served from that site. No CMS seal or logo is used, and nothing here presents itself as official Medicare information. Retrieved October 3, 2026.
Every figure above is the recorded result of a query checked into the repository alongside this text. Continuous integration re-runs those queries and refuses the change if a number here and a number there disagree. Read the methodology, or the datasets behind it.
Published by American Factbook LLC. An independent publication.