The $526 on the Other Side of the Premium Cut

Your front desk takes a Medicare Advantage card in January. Same insurer as last year, same plan name, same specialist copay printed on the front.

The number that moved is not on the card.

CMS announced the 2027 landscape on September 28, and the announcement was a premium story start to finish: weighted average monthly MA premium down from $14.37 to $12.00, a 16.5% decline, with the drug half of MA-PD premiums down 38%. The words "out-of-pocket" appear in the release exactly once, inside the Extra Help boilerplate.

Two days later CMS posted the file the announcement was drawn from. We put the 2026 landscape source file beside it and weighted both by the September enrollment report.

The in-network out-of-pocket maximum went up $525.86 a head.

The arithmetic, in one pass

Take every non-SNP contract and plan that appears in both landscape files carrying one MOOP across its segments in each year, and weight each plan's in-network MOOP by its September enrollment.

That is 2,567 plans and 16,495,928 enrollees, about three quarters of all non-SNP MA enrollment.

Special needs plans are out on purpose. They crowd the statutory ceiling (808 of the 1,008 plans pinned at the cap in both years are SNPs), and their cost sharing mostly is not yours to collect from the member, so leaving them in flatters the number.

2026: $5,369.25. 2027: $5,895.11.

So +$525.86, or 9.79%, against a premium saving CMS put at $2.37 a month.

Annualize the premium side and it is $28.44. The ceiling moved 18 times further, in the other direction.

Run it across the panel and the increase in maximum in-network liability is $8.67 billion.