By Marc Gilman
Questions?
Call (800) 927-9326 or email
Key Takeaways
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Some 2027 plans can close early. CMS can approve an enrollment cap, which lets a Medicare Advantage plan stop taking new members before the Annual Enrollment Period (AEP) ends on Dec. 7.
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Plan endings are still elevated. Deft Research reports that about 1.8 million Medicare Advantage members were affected in 2025 and 2.8 million in 2026, and expects more than 1 million for 2027.
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Existing members are not removed by a cap. A cap limits new enrollment. It does not cancel your current coverage.
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The practical advice is to start early. If you plan to change plans, don’t wait for the last week of AEP.
What Is an Enrollment Cap?
An enrollment cap is a limit on how many new members a plan will accept. A plan applies to CMS for the cap, and once the limit is reached, the plan can stop enrolling new members. Think of it as protection for the insurer against a surge of more members than it planned for, which is a bigger risk for smaller or regional plans.
CMS approves enrollment caps, and PSM Brokerage reports that plans request them during the annual bid process and that CMS only accepts a limit at or above the plan’s June 1, 2026 enrollment. Under CMS’s 2027 enrollment guidance, a plan with a cap must accept valid enrollment requests in the order they are received until the limit is reached. Requests received before the limit is reached must still be processed, requests received after are denied, and the plan must stay closed to all applicants until space opens up through natural attrition (normal member turnover). The caps apply to Medicare Advantage plans only; stand-alone Part D drug plans can’t use them. According to PSM Brokerage, one regional plan, Network Health, has announced limits on many of its 2027 plans.
When a plan closes for capacity reasons, it posts a public notice, and CMS’s model notice says the plan is limiting enrollment so members have greater access to providers and services, and that current members aren’t affected. Unlike a plan that closes only to certain open-enrollment elections but stays open from Oct. 15 through Dec. 7, a capacity closure is not tied to the AEP dates.
A cap affects people who want to join. If you’re already a member, a cap on your plan does not end your coverage. But if you were planning to switch into a capped plan and wait until early December, the plan may already be closed.
Why Are Caps and Terminations in the News?
According to Deft Research, a Medicare market research firm, insurers have been reducing their Medicare Advantage footprints. The firm reports that about 1.8 million members were affected by plan terminations in 2025 and 2.8 million in 2026, with another million or more expected for 2027. Deft also notes that smaller regional carriers are especially exposed if members move quickly to the plans that stay open.
You may also see the term “lemon dropping” used in this discussion. It describes insurers shedding members who are expected to be costly, the opposite of “cherry picking” healthier ones. Under Medicare rules, a plan generally can’t end an individual member’s enrollment because of health status. The concern analysts raise is that plan terminations, service-area reductions and benefit cuts can have a similar effect on the people who rely on those plans most.
Deft’s article is written for insurers, who may respond by marketing earlier in the year to reach their caps before the busy fall season. Earlier marketing is a business strategy. For you, the lesson is simpler: plans can close, so decide early.
What Happens If My Plan Is Ending?
If your plan is ending for 2027, your plan must notify you, and you generally have extra time to choose new coverage. You can pick a new plan during AEP (Oct. 15 to Dec. 7). Under CMS’s 2027 enrollment guidance, people whose plan is terminated or discontinued in their area also have a Special Enrollment Period that runs from Dec. 8 through the last day of February. Eligibility rules apply, so confirm before relying on it. Your options usually include:
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Another Medicare Advantage plan available in your county.
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Original Medicare with a Part D drug plan, sometimes with a Medicare Supplement (Medigap) plan. Medigap plans may require medical underwriting depending on when you apply, so ask about this before moving.
What Should I Do Now?
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Read your Annual Notice of Change. It was due by Sept. 30 and tells you whether your plan is changing or ending.
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Check your doctors, hospitals and prescriptions against the plan you’re considering.
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Compare total yearly costs, including premium, deductible, copays, out-of-pocket maximum and drug costs.
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Have a backup. If your first choice closes, you’ll want a second plan already reviewed.
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Decide early,* not on Dec. 7.
*Some 2027 Medicare Advantage plans can set enrollment caps and may close to new members before Dec. 7, so starting early helps.
Where Does Insurance Planning Fit In?
Comparing plans takes time, especially when you need to confirm doctors and medications. We can help you review the plans available in your area and explain what each choice would mean for your costs. Our post on why more Medicare Advantage members are reviewing their plans each fall explains the trend.
What To Do Next
If you’d like to review your options before Dec. 7, we’re happy to walk through your Annual Notice of Change with you.
Questions? Call (800) 927-9326 or email
Prefer we reach out to you instead? Complete our Permission to Contact form and a licensed Gilman Agency agent will follow up.
Sources: Deft Research, “Enrollment Caps and Lemon Dropping May Bring Back AEP Pre-Heat Marketing” (July 24, 2026). Deft figures are Deft Research’s estimates. PSM Brokerage, “Medicare Advantage Enrollment Caps Could Change the 2027 AEP” (Sept. 21, 2026); CMS, “CY 2027 C/D Enrollment and Disenrollment Guidance” and “CY 2027 MA appendices and exhibits” (Exhibit 23) (cms.gov).
We do not offer every plan available in your area. This article is for general educational purposes and is not an offer of coverage. Plan benefits, networks, enrollment caps and availability vary by plan and location and can change each year. For more information, contact Marc Gilman, licensed insurance agent, at (800) 927-9326, or call 1-800-MEDICARE for a full list of your options.
