2027 Medicare Advantage in the Midlands: What the CMS Numbers Show
By Jennifer Mauldin (SC License #6422562) and Ben Mauldin (SC License #21612911), Mauldin Insurance Group. Updated November 2026.
You may have seen headlines this fall about insurance companies pulling Medicare Advantage plans out of whole counties. In parts of the country, that's real. KFF counted 193 counties nationwide with no general-enrollment Medicare Advantage plans with drug coverage for 2027, up from 123 in 2026.
We wanted to know what that means for people here, so we went to the source. Ben spent nearly 30 years in regional planning and research before joining the agency, and he counted the plans county by county using the plan files CMS publishes every fall.
The short answer
In the Midlands, the number of Medicare Advantage plans held steady for 2027.
- Plan counts stayed the same or went up in Lexington, Richland, Saluda, Newberry, Kershaw and Fairfield counties. Calhoun County has one fewer plan.
- The number of plans with a $0 monthly premium went up in all seven counties.
- Statewide, South Carolina has 68 Medicare Advantage plans for 2027, compared with 69 in 2026. Plan counts went up or held steady in 41 of 46 counties, and every county still has plans to choose from. See every county.
- Steady totals don't mean nothing changed. A handful of plans in our area ended, and new ones replaced them. If yours was one that ended, see what to do below.
Medicare Advantage plans by county, 2026 vs. 2027
| County | 2026 plans | 2027 plans | Change | $0 premium plans, 2026 → 2027 |
|---|---|---|---|---|
| Lexington | 37 | 37 | No change | 17 → 18 |
| Richland | 38 | 39 | +1 | 17 → 19 |
| Saluda | 42 | 44 | +2 | 20 → 24 |
| Newberry | 39 | 41 | +2 | 18 → 22 |
| Kershaw | 41 | 42 | +1 | 19 → 21 |
| Fairfield | 45 | 45 | No change | 22 → 24 |
| Calhoun | 37 | 36 | −1 | 17 → 19 |
Counts are Medicare Advantage plans open to anyone with Medicare who lives in the county. They don't include Special Needs Plans or employer and union retiree plans. Source: CMS Medicare Advantage Landscape files for 2026 and 2027. See "How we counted" below.
Every South Carolina county, 2026 vs. 2027
We ran the same count for all 46 counties. Plan counts went up in 30 counties, stayed the same in 11 and dropped in 5. Cherokee County lost the most, with 7 fewer plans. Anderson has 2 fewer, and Calhoun, Charleston and Pickens each have 1 fewer.
Plans with a $0 monthly premium went up in 45 of 46 counties and stayed the same in Cherokee. Darlington County has the fewest plans for 2027 (28), and Greenville and Spartanburg have the most (51 each). In Anderson, Calhoun, Cherokee, Greenville and Pickens counties, one insurance company stopped offering Medicare Advantage plans for 2027. In Colleton and Marion counties, one company started offering them.
| County | 2026 plans | 2027 plans | Change | $0 premium plans, 2026 → 2027 |
|---|---|---|---|---|
| Abbeville | 37 | 39 | +2 | 16 → 20 |
| Aiken | 38 | 40 | +2 | 16 → 19 |
| Allendale | 38 | 39 | +1 | 19 → 22 |
| Anderson | 49 | 47 | −2 | 24 → 26 |
| Bamberg | 41 | 43 | +2 | 19 → 23 |
| Barnwell | 38 | 40 | +2 | 17 → 21 |
| Beaufort | 32 | 32 | No change | 13 → 15 |
| Berkeley | 47 | 47 | No change | 23 → 25 |
| Calhoun | 37 | 36 | −1 | 17 → 19 |
| Charleston | 47 | 46 | −1 | 23 → 25 |
| Cherokee | 48 | 41 | −7 | 23 → 23 |
| Chester | 34 | 35 | +1 | 14 → 17 |
| Chesterfield | 29 | 30 | +1 | 10 → 13 |
| Clarendon | 31 | 33 | +2 | 14 → 17 |
| Colleton | 44 | 47 | +3 | 22 → 25 |
| Darlington | 27 | 28 | +1 | 11 → 13 |
| Dillon | 34 | 35 | +1 | 15 → 17 |
| Dorchester | 47 | 47 | No change | 23 → 25 |
| Edgefield | 40 | 42 | +2 | 18 → 22 |
| Fairfield | 45 | 45 | No change | 22 → 24 |
| Florence | 32 | 32 | No change | 14 → 16 |
| Georgetown | 42 | 44 | +2 | 19 → 23 |
| Greenville | 51 | 51 | No change | 24 → 27 |
| Greenwood | 34 | 36 | +2 | 15 → 19 |
| Hampton | 38 | 40 | +2 | 18 → 22 |
| Horry | 39 | 41 | +2 | 17 → 21 |
| Jasper | 42 | 44 | +2 | 19 → 23 |
| Kershaw | 41 | 42 | +1 | 19 → 21 |
| Lancaster | 34 | 34 | No change | 12 → 13 |
| Laurens | 40 | 41 | +1 | 20 → 23 |
| Lee | 34 | 36 | +2 | 15 → 18 |
| Lexington | 37 | 37 | No change | 17 → 18 |
| Marion | 36 | 42 | +6 | 16 → 23 |
| Marlboro | 32 | 33 | +1 | 13 → 15 |
| McCormick | 37 | 39 | +2 | 17 → 21 |
| Newberry | 39 | 41 | +2 | 18 → 22 |
| Oconee | 39 | 40 | +1 | 18 → 20 |
| Orangeburg | 35 | 35 | No change | 15 → 17 |
| Pickens | 50 | 49 | −1 | 24 → 26 |
| Richland | 38 | 39 | +1 | 17 → 19 |
| Saluda | 42 | 44 | +2 | 20 → 24 |
| Spartanburg | 50 | 51 | +1 | 24 → 27 |
| Sumter | 31 | 34 | +3 | 14 → 17 |
| Union | 37 | 38 | +1 | 17 → 20 |
| Williamsburg | 44 | 44 | No change | 22 → 24 |
| York | 48 | 48 | No change | 23 → 25 |
What the numbers mean for you
More plans doesn't automatically mean a better plan for you. What matters is whether a plan works with your doctors, your hospital and your prescriptions, and what you'd pay over a full year when you actually use care.
A $0 monthly premium doesn't mean $0 cost, either. Plans still have copays, deductibles and a yearly out-of-pocket limit, and those vary a lot from plan to plan.
In Calhoun County, one insurance company stopped offering Medicare Advantage plans for 2027. In the rest of our area, the same companies are offering plans in 2027 as in 2026, though some individual plans changed.
Did your plan end, or just change?
Your plan should have mailed you a letter this fall. The type of letter tells you which situation you're in.
Your plan changed
Most people get an Annual Notice of Change. It means your plan is coming back for 2027 with some changes. If you do nothing, you stay in it. Read it closely anyway, because premiums, copays, drug lists and doctor networks can all change.
Your plan was merged into another plan
Sometimes a company combines plans. If your letter says you'll be moved into a different plan from the same company, that happens automatically on January 1. You don't have to do anything, but you should check that your doctors and prescriptions work with the new plan.
Your plan is ending
If your letter says your plan won't be offered in 2027, you need to choose new coverage. You have more options and more time than most people realize.
If your plan is ending: your options
Choose a new plan by December 7
Pick a new plan during Annual Enrollment and it starts January 1 with no gap.
Use your extra time
Because your plan is ending, you get a special window from December 8 through the last day of February to choose a new plan. Coverage starts the first of the month after you sign up, so signing up by December 31 avoids a gap.
Go back to Original Medicare
If you don't choose anything, you'll have Original Medicare on January 1. You won't have drug coverage unless you join a drug plan. Going too long without drug coverage can lead to a Part D late penalty.
Buy a Supplement without health questions
When your Medicare Advantage plan ends, you have a limited right, up to 63 days after that coverage ends, to buy certain Medicare Supplement plans without answering health questions. We can walk you through which plans qualify.
Got a letter from your plan?
Text a photo of it to Ben and we'll tell you what it means and whether you need to do anything. When you call or text, you get Jennifer or Ben. Every year.
There's no cost to work with us. Please don't text your Medicare number or Social Security number.
Common questions
Are Medicare Advantage plans leaving South Carolina in 2027?
Not in large numbers. CMS plan files show 68 Medicare Advantage plans in South Carolina for 2027, compared with 69 in 2026, and every county still has plans. In the Midlands, plan counts held steady or went up in every county except Calhoun, which has one fewer plan.
How do I know if my Medicare Advantage plan is ending?
Your plan is required to mail you a letter in the fall if it won't be offered next year. If you got an Annual Notice of Change instead, your plan is coming back with changes. If you're not sure which letter you have, text a photo of it to Ben at 803-920-8827.
What happens if my plan ends and I don't do anything?
You'll be in Original Medicare on January 1. You won't have drug coverage unless you join a drug plan, and you may want a Medicare Supplement to help with what Original Medicare doesn't pay.
How long do I have to pick a new plan if mine is ending?
You can choose during Annual Enrollment through December 7. After that, you have a special window from December 8 through the last day of February. Coverage starts the first of the month after you sign up.
Which South Carolina counties have fewer Medicare Advantage plans for 2027?
Five counties have fewer plans for 2027 than for 2026: Cherokee (7 fewer), Anderson (2 fewer), and Calhoun, Charleston and Pickens (1 fewer each). Plan counts went up in 30 counties and stayed the same in 11.
Can I switch to a Medicare Supplement if my Advantage plan ends?
Yes. For up to 63 days after your Medicare Advantage coverage ends, you have the right to buy certain Medicare Supplement plans without health questions. After that window, insurance companies in South Carolina can usually ask health questions.
How we counted
We used the CMS Medicare Advantage Landscape files for 2026 (September 2026 version) and 2027 (October 2026 version). We counted each Medicare Advantage plan available to the general public in each county, with or without drug coverage. We left out Special Needs Plans, which are only for people with certain conditions or who also have Medicaid, and employer or union retiree plans, which aren't in these files. A "$0 premium plan" is a plan with a $0 combined monthly premium for medical and drug coverage. You still pay your Part B premium.
Plan counts can change slightly during the year. Medicare.gov's Plan Finder always has the current list for your ZIP code.
Sources
- CMS: Medicare Advantage and Part D Landscape files, 2026 and 2027
- Medicare.gov: Special Enrollment Periods
- KFF: Medicare Advantage Plan Availability Varies Widely by County for 2027 (October 2026)
- Center for Medicare Advocacy: Your Rights When Your MA Plan Doesn't Renew (October 2026)
- Medicare.gov Plan Finder
Read how we write and check our content in our editorial standards.
We do not offer every plan available in your area. Currently we represent 6 organizations which offer 52 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
Mauldin Insurance Group is a licensed independent insurance agency based in Lexington, SC. We are not connected with or endorsed by the U.S. government or the federal Medicare program.
