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CMS Finalizes 2.48% Medicare Advantage Pay Increase for 2027

The move resets insurer expectations as enrollment keeps climbing.

Overview

  • CMS said Monday it will raise 2027 payments to Medicare Advantage plans by an average 2.48%, which it estimates equals more than $13 billion and about a 4.98% effective increase when risk‑score trends are included.
  • The agency will keep using its 2024 method for risk adjustment rather than adopt the new model it proposed in January.
  • Diagnoses found only in chart reviews that are not linked to a patient visit will no longer count toward payment risk scores, with an exception for people who switch plans.
  • For Medicare’s drug benefit (Part D), the standard deductible will rise to $700 in 2027 and the amount a person must spend before catastrophic coverage begins will move to $2,400.
  • Insurer shares jumped in Tuesday premarket trading after the announcement, with Humana up about 10.7%, UnitedHealth up 6.9%, and CVS, Elevance, Centene and Molina up roughly 3.6% to 6%.