What a Medicare Advantage plan is worth, and what members act on
The TRYNYTY plan value model puts a dollar value on every Medicare Advantage plan in every county, two ways. Benefit value prices a plan against Original Medicare plus a standalone drug plan with published assumptions. Market value weights the same features by how members actually moved in the 2026 Annual Election Period, December 2025 to February 2026. For 2027, members who stay in their plan keep about the same benefit value, $197.80 to $197.46 a month, as lost givebacks and supplemental benefits are offset by more expensive standalone drug plans.
What members act on
Each feature's effect on a plan's 2026 AEP share change, divided by the effect of $1 of monthly premium, holding the county and other features fixed. Individual plans; 81,126 plan and county observations in 2,710 counties. Effects with a t value under 3 are not distinguishable from zero. These are associations, not causes: star rating, for example, also carries brand and network.
| Feature | Per | Worth, $ a month of premium | t |
|---|---|---|---|
| Star rating | 1 star | +$104.80 | 25.1 |
| No drug coverage | yes | −$168.93 | -21.6 |
| Fitness | yes | +$58.88 | 9.1 |
| Part D deductible | $100 a year | −$10.38 | -8.7 |
| Specialist visit cost | $1 a visit | +$0.97 | 8.0 |
| Meals | yes | −$30.10 | -7.7 |
| Out-of-pocket max | $1,000 | −$7.81 | -7.0 |
| Eyewear maximum | $100 a year | +$6.43 | 4.1 |
| Primary care visit cost | $1 a visit | −$0.84 | -3.6 |
| Dental maximum | $100 a year | +$0.85 | 3.5 |
| PPO | yes | −$9.96 | -2.5 |
| ER visit cost | $10 a visit | −$1.90 | -1.8 |
| Five-day hospital stay cost | $100 | −$0.68 | -1.7 |
| Transportation | yes | −$6.60 | -1.5 |
| Hearing aid maximum | $100 a year | −$0.40 | -1.2 |
| Part B giveback | $1 a month | +$0.03 | 1.2 |
| SSBCI | yes | −$0.63 | -0.1 |
| OTC allowance | $1 a month | +$0.01 | 0.1 |
Benefit value for members who stay, 2026 and 2027
Dollars a month, enrollment weighted, for 18,895,434 members in individual plans that continue in their county.
| Part | 2026 | 2027 | Change |
|---|---|---|---|
| Premium and giveback | $7.11 | $4.08 | −$3.03 |
| Drug coverage | $73.41 | $88.53 | +$15.12 |
| Medical cost sharing | $16.18 | $12.41 | −$3.77 |
| Out-of-pocket cap | $48.32 | $44.54 | −$3.78 |
| Supplemental benefits | $52.77 | $47.90 | −$4.87 |
| Total | $197.80 | $197.46 | −$0.34 |
Worked example: Humana Total Complete (HMO), Cook County, IL
| Part | How it is calculated | $ a month |
|---|---|---|
| Premium and giveback | Part B giveback $0 a month less plan premium $0.00 | $0.00 |
| Drug coverage | National median standalone drug plan premium $75.80, plus the deductible difference ($700 for a typical drug plan vs $700 here) spread over 12 months | $75.80 |
| Primary care | 5 a year x (Original Medicare $21 less plan $0) / 12 | $8.75 |
| Specialist | 7 a year x (Original Medicare $28 less plan $10) / 12 | $10.50 |
| Emergency room | 0.6 a year x (Original Medicare $150 less plan $130) / 12 | $1.00 |
| Hospital stay | 0.22 a year x (Original Medicare $1,790 less plan $975) / 12 | $14.94 |
| Medical cost sharing (sum) | $35.19 | |
| Out-of-pocket cap | Expected cost sharing above the $2,150 in-network maximum, for a member averaging $2,100 a year (lognormal, sigma 1.25), / 12 | $80.81 |
| Supplemental benefits | OTC offered with no amount stated (not counted), dental 45% x $1,000 (no maximum stated, default used), eyewear 35% x $275, hearing aids 4% x $1,000 (no maximum stated, default used), meals $40, fitness $30, all a year, / 12 | $54.69 |
| Benefit value | Sum of the five parts | $246.49 |
Market value: $66.26 a month against the county's average of 48 individual plans.
Frozen 2027 AEP predictions
The same model applied to 2027 plans predicts each plan's net gain or loss over the 2027 AEP, county by county. The predictions were frozen on 2026-11-05 (123,982 plan and county rows, SHA-256 47402da630e16091) and will be scored against the February 2027 CMS files.
Sources: CMS landscape and plan benefit package files (2026 and 2027), plan crosswalks, and Monthly Enrollment by Contract/Plan/State/County (December 2025, February 2026, October 2026). An analytical index, not an actuarial valuation. See Methodology.