2027 open enrollment. 3.15M must pick a new plan.

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Vlada / Medicare Advantage / Iowa

Medicare Advantage plan exits 2027 in Iowa, by county

50,956 of Iowa's 225,472 Medicare Advantage members (22.6%) are in a plan that is not sold in their county for 2027, measured from the CMS 2027 Landscape and crosswalk against September 2026 enrollment. Nationally the share is 10.6%.

Period: plan year 2027 against September 2026 members · Updated 2026-10-19 · Next: CMS January 2027 enrollment (February 2027): where the members landed

members, Sept 2026
225,472
members, Sept 2026
must pick for 2027
50,956
must pick for 2027
share of members
22.6%
share of members
counties
99
counties

Members who must pick a new plan each year, 2016 to 2027

Members of individual Medicare Advantage plans in Iowa whose plan is not sold in their county the next year, by plan year; the share of all members at the top of each bar. Orange: the last three years.

013k25k38k51k3.2%20161.9%20170.3%20180.1%20190.2%20200.7%20210.0%20220.0%20230.0%202413.1%202518.8%202622.6%2027

Every Iowa county, 2027

Members in September 2026; those whose plan is not sold in their county for 2027; their share; of those, the members offered a new or renumbered plan by their own company in the county, and the members whose company sells no plan there for 2027. Sorted by members who must pick. Each county links to its own page: the plans that end, the companies, enrollment and penetration since 2015, the Stars.

CountyMembers, Sept 2026Must pick for 2027ShareOffered a new or renumbered planCompany gone
Polk37,6738,71223.1%4,1214,272
Linn21,9093,77517.2%03,126
Story4,0342,51162.2%6811,347
Scott15,6052,25714.5%02,046
Woodbury8,7602,22325.4%01,694
Johnson7,7892,02326.0%01,741
Dallas5,8851,72629.3%677957
Black Hawk10,6211,66015.6%01,493
Warren4,5511,30728.7%573702
Marshall3,6791,16131.6%451652
Marion2,51281632.5%0654
Jefferson2,12476636.1%0574
Jasper3,66375720.7%369353
Webster2,72573627.0%0682
Pottawattamie9,1866947.6%0413
Cerro Gordo3,02864421.3%0644
Clinton4,50359413.2%0551
Jones2,14955625.9%0509
Des Moines3,03455418.3%0445
Greene83353764.5%93172
Clayton94953356.2%0510
Dickinson94252755.9%0527
Butler96049451.5%73188
Madison1,39746433.2%171293
Plymouth1,52044929.5%0430
Clarke79843254.1%0419
Muscatine3,15142713.6%0355
Benton2,26642518.8%0381
Washington1,71241524.2%0344
Boone1,98837618.9%0334
Mahaska1,80237620.9%0274
Hardin1,26233926.9%0324
Fayette1,42533323.4%0317
Iowa1,35732924.2%0329
Harrison99532732.9%0102
Delaware1,24831225.0%0271
Howard36630182.2%0290
Buchanan1,48829820.0%0298
Cedar1,46729019.8%0262
Grundy89429032.4%0278
Lee2,00628714.3%0287
Mitchell34628181.2%0281
Chickasaw55727549.4%0263
Mills1,07026825.0%016
Floyd92526628.8%0240
Clay70626537.5%0265
Henry1,24326421.2%0238
Poweshiek1,25026321.0%0242
Tama1,43124917.4%0220
O'Brien54424745.4%48199
Davis43424656.7%0218
Van Buren55924443.6%0228
Pocahontas41724358.3%29112
Louisa76722729.6%3391
Cherokee62722636.0%0210
Page1,00221321.3%00
Monona87821224.1%0175
Montgomery79020926.5%095
Lyon25220681.7%1360
Appanoose1,34620515.2%0184
Sac36519854.2%3953
Shelby70418025.6%0161
Jackson1,13016414.5%0151
Audubon25616464.1%0152
Buena Vista75816321.5%0137
Lucas72716222.3%0133
Kossuth60816226.6%0162
Hamilton82916019.3%0140
Carroll1,06615714.7%0139
Taylor23215667.2%0156
Wapello2,7491545.6%00
Calhoun61815424.9%0154
Cass85314717.2%00
Emmet36514740.3%0147
Wright64914121.7%0141
Monroe49213928.3%0120
Palo Alto30513343.6%0133
Dubuque1,9361256.5%00
Keokuk83812014.3%096
Winnebago53111621.8%0116
Franklin35711431.9%0114
Crawford79910713.4%078
Decatur59310417.5%090
Worth3439527.7%095
Humboldt4469320.9%093
Fremont4339020.8%00
Osceola1348664.2%086
Hancock3608523.6%085
Wayne5108216.1%067
Sioux6147011.4%700
Bremer1,337685.1%038
Winneshiek6386710.5%011
Ida3215717.8%042
Ringgold1974623.4%046
Allamakee709365.1%00
Guthrie967293.0%00
Adams792936.7%140
Union809141.7%00
Adair41500.0%00
Iowa, 99 counties225,47250,95622.6%7,57836,253

Download this table (CSV, CC BY 4.0) · cells under 11 members are suppressed by CMS and count as zero, so every count is a floor.

Iowa against the nation

MeasureIowaUnited States
Must pick a new plan for 202750,9563,153,512
Share of members22.6%10.6%
Share for 202618.8%10.1%

National figures: the Vlada report 3.15 million Medicare Advantage members must pick a new plan for 2027.

Star Ratings 2027, member-weighted

Measure20272026Change
Members in contracts rated 4+ stars74.4%64.7%+9.7 pts
Member-weighted average star3.873.97-0.10
Rated contracts30

Members by star, 2027: 4.5: 28,132 · 4.0: 129,864 · 3.5: 36,697 · 3.0: 5,442 · 2.5: 12,294; 13,840 in unrated contracts. CMS Star Ratings released 2026-10-08, each contract's overall star weighted by its 2026-10 members in Iowa (individual and group); rating year 2027 pays in 2028.

By company, 2027

CMS parent organizations with members in Iowa in September 2026: members whose plan is not sold in their county for 2027, as a share of the company's own members; how the plan went (terminated, or its service area reduced so it continues elsewhere but not in their county); of those members, how many the company offers a new or renumbered plan of the same type in the county, and how many are left with no plan from the company there.

CompanyMembersMust pickShare of own membersPlan terminatedService area reducedOffered a new or renumbered planCompany gone
Blue Cross Blue Shield of Michigan Mutual Ins. Co.33,04333,043100.0%33,0430033,043
UnitedHealth Group, Inc.55,7717,84414.1%7,0438017,0430
Humana Inc.32,2105,48917.0%4,2921,19700
CVS Health Corporation77,4453,3034.3%03,3033582,110
Centene Corporation12,4009167.4%09160916
Medica Holding Company184184100.0%18400184
Sanford Health177177100.0%17701770
Trinity Health Corporation7,81000.0%0000
Elevance Health, Inc.3,70500.0%0000
Mitchell Family Office1,39000.0%0000
Molina Healthcare, Inc.82700.0%0000
Devoted Health, Inc.30100.0%0000
University of Wisconsin Hospitals and Clincs Autho20900.0%0000

Sources

  • CMS Medicare Advantage/Part D Landscape, plan year 2027: landscape_cy2027-landscape-202609-1.zip (CMS, September 2026).
  • CMS plan crosswalk, CY2027; CMS monthly enrollment by contract, plan and county, 2026-09.
  • CMS Star Ratings 2027, released 2026-10-08.
  • Page object written 2026-10-19; the series 2016 to 2027 from the locked exits history of the Vlada report (independent audit 2026-10-13).

Receipts: athena(table=medicare_semantic.exits_cells_county_2027_v1, block=counties) bce72deb8c12…; athena(table=medicare_semantic.exits_cells_county_2027_v1, block=companies) 15de170f7bb5…; get_stars_rollup(group_by=state, limit=60) 2c1fa6b01add…; file(path=docs/research/plan-exits-2027/data/audited/by_year_state.csv) b2f25ce9152e…. Suppressed cells (under 11 members) count as zero in every count.

Cite: Vlada Health (2026). Medicare Advantage plan exits 2027 in Iowa, by county. https://www.vladahealth.com/medicare-advantage/ia. Data: CC BY 4.0.

Method

  • Population: members of individual Medicare Advantage plans (H and R contracts, plans 001 to 799, special needs plans included; employer group, Cost, MMP and PACE excluded) in the county in September 2026.
  • Must pick: the CMS crosswalk names no successor plan sold in the member's county for 2027; members CMS moves to a successor in their county are not counted.
  • Company: CMS's reported parent organization in September 2026; a company's share is over its own members in the state.
  • Stars: each contract's overall star weighted by its members in Iowa; unrated contracts counted apart, never as zero stars.
  • Suppression: CMS hides cells under 11 members; they count as zero, so every count is a floor and every share is not.

The full method, with the national tables: How we counted, and how to check it.

Questions

How many Medicare Advantage members in Iowa must pick a new plan for 2027?
50,956 of 225,472 members (22.6%): their plan is not sold in their county for 2027 according to the CMS crosswalk and Landscape. Nationally the share is 10.6% (3,153,512 members).
Which Iowa county has the most members who must pick?
Polk County: 8,712 of 37,673 members (23.1%). 0 of the 99 counties lose 90% or more of their members' plans; 1 lose none.
Which company ended the most plans in Iowa for 2027?
Blue Cross Blue Shield of Michigan Mutual Ins. Co.: 33,043 of its 33,043 Iowa members (100.0%) are in a plan it does not sell in their county for 2027.
How did Iowa's Star Ratings change for 2027?
74.4% of members are in contracts rated 4 stars or more for 2027, against 64.7% the year before; the member-weighted average star is 3.87, from 3.97, over 30 rated contracts.
How does 2027 compare with 2026 in Iowa?
41,807 members (18.8%) had to pick a new plan for 2026; for 2027 it is 50,956 (22.6%), a change of +9,149 members.

Ask this in Claude or ChatGPT

The free Vlada connector answers it from the same files, with the source and a response hash. Install in one minute.

Use Vlada. Which Iowa counties have the most Medicare Advantage members who must pick a new plan for 2027? Give me a table with the members in the market, the members who lose their plan and the share, then the source file, the data vintage and the response hash.

Behind it: get_landscape_exits (transition_year 2026, group_by county, state IA) and get_stars_rollup (group_by state).