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

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Vlada / Medicare Advantage / Pennsylvania / Philadelphia County

Medicare Advantage plan exits 2027 in Philadelphia County, PA

1,705 of the 150,263 Medicare Advantage members in Philadelphia County (1.1%) are in a plan that is not sold in the county for 2027: 7 of the 88 plans sold there in September 2026 end, from the CMS 2027 Landscape and crosswalk. Pennsylvania: 6.9%; the nation: 10.6%.

Period: plan year 2027 against September 2026 members · Updated 2026-10-20 · Next: CMS January 2027 enrollment (February 2027): where the members landed

members, Sept 2026
150,263
members, Sept 2026
must pick for 2027
1,705
must pick for 2027
share of members
1.1%
share of members
plans end
7 of 88
plans end

Medicare Advantage members in Philadelphia County, 2015 to 2026

MA enrollment in September each year, with MA penetration (members over Medicare eligibles) at the top of each bar, from the CMS state-county penetration file. Navy: the last two years. 98 plans are listed for the county for 2027 against 97 for 2026.

041k81k122k162k43%201543%44%201744%46%201948%51%202154%56%202359%60%202560%

The plans that end for 2027

Every plan sold in Philadelphia County in September 2026 with members whose plan is not sold there for 2027: how it went (terminated, or its service area reduced so it continues elsewhere), the members the same company offers a new or renumbered plan of the same type, and the members whose company sells nothing in the county next year.

PlanCompanyTypeMembersTerminatedService area reducedOffered a new or renumbered planCompany gone
Jefferson Health Plans Flex Pro (PPO) H1619-003Thomas Jefferson UniversityRegular PPO56456405640
Personal Choice 65 Plus Rx (PPO) H3909-018Independence Health Group, Inc.Regular PPO476476000
Aetna Medicare Premier (HMO-POS) H3931-004CVS Health CorporationRegular HMO35735703570
Aetna Medicare Enhanced (PPO) H5521-122CVS Health CorporationRegular PPO126126000
Jefferson Health Plans Flex Plus (PPO) H1619-002Thomas Jefferson UniversityRegular PPO10110101010
Wellcare Patriot Giveback (HMO-POS) H2915-013Centene CorporationRegular HMO6161000
Humana Gold Choice H8145-163 (PFFS) H8145-163Humana Inc.REGULAR OTHER2020000
7 plans1,7051,70501,0220

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.

By company in Philadelphia County

CompanyMembers, Sept 2026PlansPlans endingMust pickShare of own membersOffered a new or renumbered planCompany gone
Thomas Jefferson University17,164926653.9%6650
CVS Health Corporation33,9161124831.4%3570
Independence Health Group, Inc.40,4251314761.2%00
Centene Corporation4,20551611.5%00
Humana Inc.15,474131200.1%00
Health Care Service Corporation20,4207000.0%00
UnitedHealth Group, Inc.10,26813000.0%00
Devoted Health, Inc.4,1308000.0%00
Highmark Health2,4484000.0%00
UPMC Health System1,1071000.0%00
Clover Health Holdings, Inc.3411000.0%00
Rifkin Managed Care Holding, LLC3221000.0%00
Risant Health, Inc.432000.0%00

Philadelphia County against Pennsylvania and the nation

MeasureCountyPennsylvaniaUnited States
Must pick for 2027, share of members1.1%6.9%10.6%
Must pick for 20268.7%10.1%
Must pick for 2025, members2,253 of 142,192
Must pick for 2026, members12,913 of 147,700
Must pick for 2027, members1,705 of 150,263

State and national figures: the Pennsylvania hub and the national report.

Star Ratings 2027 in Philadelphia County

Measure20272026Change
Members in contracts rated 4+ stars40.2%61.6%-21.4 pts
Member-weighted average star3.603.77-0.17
Rated contracts with members here3835

Members by star, 2027: 5.0: 521 · 4.5: 9,737 · 4.0: 54,377 · 3.5: 52,696 · 3.0: 43,626; 0 in unrated contracts. Each contract's 2027 overall star (CMS, released 2026-10-08) weighted by its 2026-09 members in the county, individual and group; 2026 by 2025-09 members.

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 (and the two Septembers before, for the series).
  • CMS MA state-county penetration file, September of each year (eligibles, enrollment, penetration).
  • CMS Star Ratings 2027, released 2026-10-08. Page object written 2026-10-20.

Receipts: athena(table=medicare_semantic.exits_cells_county_2027_v1, block=plans) 042eb472aa7d…; athena(table=medicare_semantic.exits_cells_county_2025_v1, medicare_semantic.exits_cells_county_2026_v1, medicare_semantic.exits_cells_county_2027_v1, block=series) ee9fd56a8632…; athena(table=medicare_semantic.ma_spine_county_market_v20261012b, block=market) e6c1b5ce62c0…; athena(table=medicare_semantic.ma_spine_contract_stars_v20261012b, weights=medicare_semantic.ma_spine_enroll_plan_county_v20261012a, block=stars) c39711c388e0…. Suppressed cells count as zero in every count.

Cite: Vlada Health (2026). Medicare Advantage plan exits 2027 in Philadelphia County, PA. https://www.vladahealth.com/medicare-advantage/pa/philadelphia. 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 county for 2027; members CMS moves to a successor in the county are not counted.
  • Terminated: the plan is gone from every county. Service area reduced: the plan continues elsewhere but not here. Offered a new or renumbered plan: the same company sells, in this county, the same name under a new number or a new plan of the same HMO or PPO and special needs type. Company gone: no plan of any type from that company in the county.
  • Stars: each contract's overall star weighted by its September members in the county; unrated contracts counted apart, never as zero stars. Penetration: the CMS file's own eligibles and MA enrollment.
  • 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 and the national tables: How we counted, and how to check it.

Questions

How many Medicare Advantage members in Philadelphia County must pick a new plan for 2027?
1,705 of 150,263 members (1.1%): their plan is not sold in the county for 2027 according to the CMS crosswalk and Landscape. Pennsylvania as a whole: 6.9%; the nation: 10.6%.
Which plan in Philadelphia County ends with the most members?
Jefferson Health Plans Flex Pro (PPO) (H1619-003, Thomas Jefferson University): 564 members in September 2026, terminated; the company offers them a new or renumbered plan of the same type in the county.
Which company ended the most plans in Philadelphia County for 2027?
Thomas Jefferson University: 665 of its 17,164 members in the county (3.9%), 2 of its 9 plans.
What share of Philadelphia County's Medicare eligibles are in Medicare Advantage?
60.0% in September 2026: 162,302 of 270,349 eligibles, from the CMS state-county penetration file.
How are Philadelphia County's members rated for 2027?
40.2% of members are in contracts rated 4 stars or more for 2027 (61.6% the year before); the member-weighted average star is 3.60 over 38 rated contracts.
How does 2027 compare with 2026 in Philadelphia County?
12,913 members (8.7%) had to pick a new plan for 2026; for 2027 it is 1,705 (1.1%), a change of -11,208 members.

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