Newsroom · Sioux Falls

CMS Says Medicare Advantage Premiums Are Falling for 2027. Sioux Falls Just Found Out Otherwise.

The national headline is real. So is your Annual Notice of Change. They are not describing the same plan.

Big Sioux Benefits Data Desk

Published October 14, 2026 · 19 min read · Sourced from CMS.gov

If you saw a headline this fall saying Medicare Advantage premiums are falling, and then opened your own Annual Notice of Change and saw the opposite, you didn't misread anything. Both things are true at the same time, because they're answering two different questions. This guide walks through exactly what CMS announced for 2027, why a national average can fall while a specific Sioux Falls plan rises, the real plan-by-plan numbers for Minnehaha County, and what to actually check before this year's December 7 deadline.

Every figure below comes from a primary source fetched or directly parsed this session, October 14, 2026: CMS's own September 28, 2026 press release on 2027 Medicare Advantage and Part D projections, and the official CY2026 and CY2027 CMS Medicare Advantage and Part D Landscape files, downloaded and read directly rather than summarized from a news report. No numbers from memory, and no numbers from a secondhand article when the original federal file was available.

Why this question comes up

Every fall, right around the time the Annual Enrollment Period opens, two things land in a Sioux Falls mailbox at almost the same time. One is the news: a wire story, a local TV segment, or a line in a retirement newsletter saying Medicare Advantage premiums are dropping nationally, sometimes with a specific percentage attached. The other is the plan's own Annual Notice of Change (ANOC) — the letter every Medicare Advantage and Part D plan is required to send by September 30 each year, spelling out exactly what's different about next year's version of your specific plan.

Most years, those two documents don't contradict each other loudly enough to notice. This year, in Minnehaha County, they do. The national story is a real number from a real federal agency. The ANOC is also a real number, for a real plan, that a specific person actually has. When a reader calls or emails asking "didn't I just hear premiums were going down?" after opening a letter that says the opposite, the honest answer isn't that one of the two sources is wrong — it's that they were never measuring the same thing.

This is also exactly the kind of mismatch that makes people set the ANOC aside instead of reading it, which is its own quiet risk. If the news said premiums are falling, and you assume your plan is one of the ones that benefited, you can walk straight past a real increase — in premium, in your out-of-pocket maximum, or both — without ever noticing it changed.

What CMS actually announced for 2027

On September 28, 2026, the Centers for Medicare & Medicaid Services published its annual projection for the coming plan year, covering both Medicare Advantage and Part D. The headline figures, taken directly from that release:

• The weighted-average Medicare Advantage premium (across all Medicare Advantage plans, including those with drug coverage and Special Needs Plans) is projected to fall from $14.37 a month in 2026 to $12.00 in 2027 — a decline of 16.5%.
• The average standalone Part D premium is projected to rise slightly, from $35.09 in 2026 to $36 in 2027.
• For Medicare Advantage plans that bundle drug coverage, the average Part D portion of the premium (after rebates) is projected to fall from $11.32 to $7, a drop of about 38%.
• Medicare Advantage enrollment is projected to reach 34 million people in 2027, about 47.4% of everyone on Medicare.
• More than 99% of Medicare beneficiaries nationally will have access to at least one Medicare Advantage plan, and 97% will have access to 10 or more plan choices.
• CMS also states that roughly eight in 10 Medicare Advantage enrollees nationally will be able to stay in their current plan at the same or a lower premium for 2027.

None of that is wrong, and none of it is spin — it's CMS's own methodology, applied consistently from one year to the next, and it's a genuinely useful way to track the overall health of the Medicare Advantage program. The problem isn't the number. It's what people assume the number is telling them about their own plan.

Read that sentence carefully and it already contains the hedge most headlines drop: eight in 10, not everyone. That leaves roughly one in five Medicare Advantage enrollees nationally outside that reassurance — and, as it turns out, two of Sioux Falls's most-enrolled plans are sitting in that smaller group.

Why a falling average doesn't mean your premium fell

CMS's 16.5% figure is a weighted average: every Medicare Advantage plan's premium is multiplied by how many people are actually enrolled in that plan, those numbers are added together, and the total is divided by nationwide Medicare Advantage enrollment. That weighting matters enormously. A single plan with a few million enrollees and a falling premium can move the national number by itself, even if hundreds of smaller, regional plans — the kind South Dakota mostly has — go the other direction and barely move the total at all.

A few structural forces can all push a weighted national average down in the same year a specific local plan goes up:

None of that makes the national figure fake. It makes it exactly what it says it is — a description of the Medicare Advantage program nationwide — and a poor substitute for reading your own plan's paperwork.

The real Sioux Falls Medicare Advantage landscape for 2027

Here's the comparison this guide is built around: every Medicare Advantage row CMS's own landscape files list for Minnehaha County, for 2026 and again for 2027, read directly from the two files rather than from any summary. First, 2026:

Source: CMS CY2026 Medicare Advantage / Part D Landscape File (September 2026 release), Minnehaha County rows. (South Dakota's Medicare Advantage market also includes separate Dual-Eligible and Institutional Special Needs Plans, and Medica Medicare Cost plans, not shown in this standard-PPO comparison — see our full 15-plan Sioux Falls roster for those.)

Now the same county, from the official 2027 file:

Source: CMS CY2027 Medicare Advantage / Part D Landscape File (September 2026 release), Minnehaha County rows. Star ratings for 2027 plans were not yet published in the September 2026 file. Aetna's naming and contract numbers shifted between the two files — see the note below.

The two Sanford Align plans, before and after

Of everything in those two tables, the clearest story belongs to Sanford Health Plan's own Align products — the two plans a healthy chunk of Sioux Falls chose specifically because they carried no premium at all, or close to it.

Sanford's second Align plan moved the same direction, from a different starting point. Align ChoiceElite's $66 premium became Align SecureChoice Gold's $100 — a 51.5% increase — while its maximum out-of-pocket rose from $3,500 to $6,500, an increase of $3,000, the largest MOOP jump of any plan in the county for 2027.

Put the four plans that exist in both years side by side — Wellmark's plan is excluded here because it simply has no 2027 row to compare against — and the local average premium among them rose from $29.50 in 2026 to $55.00 in 2027, an increase of roughly 86% — in the same year CMS's national weighted average fell 16.5%.

Source: CMS CY2026 and CY2027 Medicare Advantage / Part D Landscape files, Minnehaha County, matched by carrier and contract. This four-plan average is this guide's own simple calculation, not a CMS-published figure, and it is not enrollment-weighted the way CMS's national number is.

Wellmark's exit, and what it does to the math

There's a second force at work alongside the Align repricing: Wellmark Advantage Health Plan isn't in the 2027 picture at all. CMS's own CY2027 landscape file — the full, official plan list for next year — contains no Wellmark Medicare Advantage rows anywhere in South Dakota, not just Minnehaha County, confirmed directly from that file for this guide. In 2026, Wellmark's $80-a-month Blue Medicare Advantage Enhanced PPO was the single most expensive standard PPO in the county.

That matters for the "average premium" conversation in a subtle way: when the most expensive plan in a county simply disappears, any simple average calculated across the remaining plans can look better on paper even if every surviving plan charges the same or more than before. It's a mechanical effect of the math, not a sign that costs actually came down for anyone. We cover everything a Wellmark enrollee needs to do about this — including Special Enrollment Period rights and the Medigap guaranteed-issue window it opens — in a dedicated guide, linked in the FAQ and in Keep Reading below.

It's not just the premium: MOOP and Part D deductibles moved too

A premium is the easiest number to notice because it's the one that shows up every month. It is not the only number that changed. The maximum out-of-pocket (MOOP) — the hard annual ceiling on what you can owe for in-network medical care under a Medicare Advantage plan — rose on every single standard Minnehaha County plan checked for this guide, by at least $400 and as much as $3,000:

Source: CMS CY2026 and CY2027 Medicare Advantage / Part D Landscape files, Minnehaha County.

The Part D side tells a parallel story at the national level. CMS's own data, read directly from the 2027 landscape file, shows the Part D annual out-of-pocket cap rising from $2,100 in 2026 to $2,400 in 2027, and the standard Part D deductible ceiling climbing from $615 to $700 over the same period. Those two figures apply nationwide, not just locally, and they sit entirely outside the "premium is falling" headline — a $2,100-to-$2,400 jump in the most you could pay out of pocket for drugs in a year is a real cost change that a premium-only comparison never shows.

The statewide picture, and its limits

Zooming out from Minnehaha County to all of South Dakota tells a more mixed story than either the national headline or the Sioux Falls specifics alone — and it's worth showing exactly how this guide calculated it, so the limits are visible rather than hidden.

Reading every South Dakota row in both CMS landscape files directly, and averaging the listed premium across every Medicare Advantage plan with drug coverage (the "MA-PD" category CMS uses, the closest match to what most people mean by "a Medicare Advantage plan with drugs included"), the simple, unweighted statewide average rose from $59.16 across 211 county-plan listings in 2026 to $93.04 across 159 listings in 2027 — an increase, not a decrease, of roughly 57%.

One structural reason the South Dakota count shrank from 211 to 159 MA-PD listings is plan exits like Wellmark's, which remove rows rather than changing a surviving plan's price. That's a reminder that "fewer, pricier options" and "the same options at a higher price" can produce similar-looking statewide averages for very different underlying reasons — one more argument for checking your own plan's ANOC instead of any statewide or national number.

What the 2027 Part B premium still doesn't tell you

One number this guide deliberately leaves out of its tables: the 2027 Medicare Part B premium. As of this writing, CMS had not yet made its official announcement, which typically lands in mid-to-late November. Several outlets have published a projected figure based on the 2026 Medicare Trustees Report, but a Trustees Report projection and a CMS final announcement are not the same thing, and this guide only reports numbers confirmed directly from a primary federal source. We track the official 2027 Part B premium the moment CMS posts it in a separate, dedicated guide — worth bookmarking if your own budget planning depends on that number, since it affects everyone on Medicare regardless of which Advantage plan, or none, you choose.

How to check your own 2027 numbers before December 7

None of this requires an agent, and the method is the same one used to build this entire guide — just aimed at one plan instead of a whole county.

1. Find your 2027 Annual Notice of Change. Every Medicare Advantage and Part D plan is required to mail it by September 30; if you can't find your copy, your plan's member services line (the number on your plan ID card) can resend it or read you the key figures.
2. Compare three numbers against this year: the monthly premium, the maximum out-of-pocket limit, and the Part D deductible. All three can move independently of each other.
3. Check your specific drugs against the 2027 formulary — the plan's list of covered drugs and the cost tier each one sits in — since a formulary change can cost far more than a premium change if a drug you take moved tiers or dropped off the list.
4. Confirm your doctors and hospital are still in-network for 2027, not just for 2026 — Sioux Falls runs on two competing systems, Sanford and Avera, and a plan's network can shift between plan years.
5. If anything changed enough to matter, compare it against what else is available in Minnehaha County for 2027 using Medicare's own Plan Finder or the tool on this page, before the December 7 deadline.

How a local advisor helps with this

Every step above is something you can do yourself with public information. Where a conversation with us tends to help is the part that takes the most time: actually reading a specific plan's Annual Notice of Change and Evidence of Coverage side by side, matching last year's plan to this year's renamed version when a carrier shuffles its lineup the way Aetna and Sanford both did for 2027, and running your real drug list against the new formulary — rather than guessing from a headline either way.

Big Sioux Benefits is a licensed independent insurance agency based in Sioux Falls. We don't work for CMS or any single carrier — carriers pay us, not you, so the conversation costs nothing. We do not offer every plan available in your area; any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

What to watch before December 7

1. This year's Open Enrollment runs October 15 through December 7, 2026, for coverage starting January 1, 2027, per Medicare.gov — mark the deadline, not just the opening date.
2. Watch for the official 2027 Part B premium announcement, expected in mid-to-late November, which affects your total Medicare cost regardless of which Advantage plan you choose.
3. If you're on a Wellmark plan, confirm your Special Enrollment Period and Medigap guaranteed-issue rights before assuming you'll be auto-moved into something comparable.
4. If you're on an Align or Aetna plan, confirm which 2027 contract number actually applies to you — the landscape file shows naming and contract overlaps that your own ANOC will resolve.
5. Don't let a national headline substitute for your own ANOC — this year, in Minnehaha County, they're telling two different stories.

How we know all this: Big Sioux Benefits runs every article through a data desk that cross-references CMS's own national Medicare Advantage and Part D press releases with the full CMS Medicare Advantage / Part D Landscape files, downloaded and parsed directly rather than taken from a secondhand summary — built by Strategic AI Architects. Every figure on this page was fetched or calculated from its primary source on October 14, 2026 and carries the plan year it covers. This is education, not financial or legal advice; confirm your own plan's 2027 numbers with your plan's member services line, Medicare.gov, or a licensed agent. We take no payment from any carrier to feature a plan.