U.S. States by Average Medicare Advantage Plan Premium, 2026
Average Medicare Advantage Plan Premiums by State in 2026
North Dakota has the highest CMS-published average Medicare Advantage plan premium for 2026 at $73.51 per month. Minnesota ranks second at $72.34, followed by South Dakota at $57.85. CMS publishes comparable 2026 averages for 49 states; Alaska has no Medicare Advantage average premium listed in the state fact sheet used for this ranking.
The metric is the average monthly Medicare Advantage plan premium published by the Centers for Medicare & Medicaid Services for plan year 2026. Values are shown in U.S. dollars per month, and higher published averages rank higher.
All 49 ranked state premiums are published directly by CMS. None are calculated values, official forecasts, or modeled projections, and no missing state value has been estimated by StatRanker.
The ranking uses one primary numeric source: the CMS 2026 Medicare Advantage and Part D State-by-State Fact Sheet. Additional CMS and Medicare.gov materials are used only to explain national premium context and how Medicare Advantage costs should be interpreted.
North Dakota has the highest published 2026 average among states in the CMS table.
Vermont has the lowest published average, but its Medicare Advantage market is unusually limited.
Alaska is excluded because CMS does not list a comparable 2026 Medicare Advantage average premium.
Plan year 2026; all ranked values come from the same CMS state fact sheet.
What this Medicare Advantage premium ranking measures
The ranking compares the average monthly Medicare Advantage plan premium that CMS publishes for each included state. It is a state-level market measure rather than the price of one identical insurance product sold nationwide.
That distinction matters because Medicare Advantage markets differ in insurer participation, available plans, provider networks, prescription drug coverage, supplemental benefits, service areas and cost-sharing rules. A difference between two state averages therefore should not be interpreted as a direct price comparison between identical plans.
CMS separately estimated the nationwide average monthly premium across all Medicare Advantage plans at $14.00 for 2026, compared with $16.40 in 2025. That national estimate is included only as context and is not used to calculate the state rankings.
Premium is only one part of Medicare Advantage cost
A low monthly plan premium does not necessarily mean a plan will have the lowest overall cost. Medicare Advantage beneficiaries generally continue to pay the Medicare Part B premium, and plans can differ in deductibles, copayments, coinsurance, prescription costs and annual out-of-pocket limits.
Top 10 states with the highest average Medicare Advantage premiums
North Dakota and Minnesota are the only states with published averages above $70 per month. South Dakota, Hawaii and Wyoming complete the top five, with all five states above $48 per month.
Highest CMS-published average monthly Medicare Advantage plan premiums for 2026
| Rank | State | Average premium | 2025 comparison |
|---|---|---|---|
| 1 | North Dakota | $73.51 | 2025 average: $44.84. |
| 2 | Minnesota | $72.34 | 2025 average: $61.51. |
| 3 | South Dakota | $57.85 | 2025 average: $36.74. |
| 4 | Hawaii | $52.34 | 2025 average: $45.90. |
| 5 | Wyoming | $48.61 | 2025 average: $22.07. |
| 6 | New York | $40.49 | 2025 average: $39.59. |
| 7 | Massachusetts | $38.03 | 2025 average: $32.74. |
| 8 | Rhode Island | $32.32 | 2025 average: $22.79. |
| 9 | Oregon | $26.04 | 2025 average: $25.38. |
| 10 | Maryland | $25.68 | 2025 average: $28.48. |
All 2025 and 2026 values in this table are published directly by CMS. The ranking is based only on the 2026 premium.
Top 20 states by average Medicare Advantage premium
The chart uses the same values as the full ranking. The distribution is steepest at the top: the two leading states are above $70 per month, while the twentieth-ranked state, Montana, is below $18.
Methodology
Metric
The ranking uses the average monthly Medicare Advantage plan premium published by CMS for each state in its 2026 state-by-state fact sheet.
Unit and ranking direction
Values are nominal U.S. dollars per month. States are ranked from the highest published average premium to the lowest.
Year
All ranked values refer to plan year 2026. The ranking does not mix premiums from different target years.
Primary source
The sole numeric source for the state ranking is the CMS 2026 Medicare Advantage and Part D State-by-State Fact Sheet.
Coverage
The ranking includes 49 U.S. states. Alaska is excluded because the CMS fact sheet used for this study does not list a comparable 2026 average Medicare Advantage plan premium for Alaska. A missing value is not treated as zero and is not estimated from another source.
How values were handled
Every state premium shown in the ranking is reproduced from the CMS publication. StatRanker does not calculate an average from individual plan records, apply its own enrollment weights, substitute a commercial estimate, or extrapolate missing values from prior years.
Ranking and rounding
States are ordered directly by the published 2026 monthly premium value. CMS reports the state averages to two decimal places, and the ranking preserves that precision.
2025 comparisons
The 2025 figure beside each state comes from the same CMS fact sheet. These historical values provide year-over-year context only and do not affect the 2026 ranking.
Important limitation
The ranking compares statewide averages, not identical insurance products. States have different mixes of plans, insurers, service areas, provider networks and benefit designs. A lower state average therefore does not mean every Medicare beneficiary in that state will have a lower-cost plan.
What the metric does not measure
The ranking does not measure total annual health-care spending, Medicare Part B premiums, deductibles, copayments, coinsurance, prescription expenses, provider-network quality, Star Ratings, supplemental benefits or annual out-of-pocket limits.
Full ranking: Medicare Advantage premiums by state
The table includes every state for which CMS publishes a comparable 2026 average Medicare Advantage plan premium in the source fact sheet.
49 states ranked by CMS-published 2026 average monthly Medicare Advantage plan premium
| Rank | State | Average premium | 2025 comparison |
|---|---|---|---|
| 1 | North Dakota | $73.51 | 2025 average: $44.84. |
| 2 | Minnesota | $72.34 | 2025 average: $61.51. |
| 3 | South Dakota | $57.85 | 2025 average: $36.74. |
| 4 | Hawaii | $52.34 | 2025 average: $45.90. |
| 5 | Wyoming | $48.61 | 2025 average: $22.07. |
| 6 | New York | $40.49 | 2025 average: $39.59. |
| 7 | Massachusetts | $38.03 | 2025 average: $32.74. |
| 8 | Rhode Island | $32.32 | 2025 average: $22.79. |
| 9 | Oregon | $26.04 | 2025 average: $25.38. |
| 10 | Maryland | $25.68 | 2025 average: $28.48. |
| 11 | New Hampshire | $25.44 | 2025 average: $13.16. |
| 12 | New Jersey | $25.23 | 2025 average: $22.50. |
| 13 | Wisconsin | $23.44 | 2025 average: $22.86. |
| 14 | Idaho | $23.21 | 2025 average: $18.32. |
| 15 | Pennsylvania | $22.99 | 2025 average: $24.26. |
| 16 | Maine | $21.90 | 2025 average: $11.94. |
| 17 | Nebraska | $21.58 | 2025 average: $21.80. |
| 18 | Connecticut | $18.66 | 2025 average: $19.19. |
| 19 | Washington | $18.20 | 2025 average: $21.91. |
| 20 | Montana | $17.67 | 2025 average: $16.57. |
| 21 | Delaware | $17.11 | 2025 average: $17.16. |
| 22 | Michigan | $16.56 | 2025 average: $15.88. |
| 23 | Indiana | $15.40 | 2025 average: $17.34. |
| 24 | Iowa | $15.11 | 2025 average: $12.38. |
| 25 | West Virginia | $14.14 | 2025 average: $17.50. |
| 26 | California | $13.99 | 2025 average: $12.61. |
| 27 | Oklahoma | $13.62 | 2025 average: $17.48. |
| 28 | Ohio | $13.54 | 2025 average: $14.26. |
| 29 | Louisiana | $13.35 | 2025 average: $21.63. |
| 30 | Colorado | $12.91 | 2025 average: $11.41. |
| 31 | North Carolina | $12.86 | 2025 average: $17.17. |
| 32 | Tennessee | $12.83 | 2025 average: $16.89. |
| 33 | Utah | $10.97 | 2025 average: $11.12. |
| 34 | Mississippi | $10.80 | 2025 average: $20.21. |
| 35 | Alabama | $10.62 | 2025 average: $15.76. |
| 36 | Kentucky | $10.25 | 2025 average: $15.60. |
| 37 | South Carolina | $10.16 | 2025 average: $13.70. |
| 38 | Kansas | $10.11 | 2025 average: $9.54. |
| 39 | Virginia | $9.19 | 2025 average: $10.96. |
| 40 | Missouri | $8.56 | 2025 average: $10.66. |
| 41 | Illinois | $8.51 | 2025 average: $8.10. |
| 42 | Georgia | $6.74 | 2025 average: $13.76. |
| 43 | Arizona | $4.82 | 2025 average: $7.23. |
| 44 | Texas | $4.35 | 2025 average: $6.14. |
| 45 | New Mexico | $3.65 | 2025 average: $5.86. |
| 46 | Arkansas | $2.28 | 2025 average: $7.11. |
| 47 | Florida | $2.11 | 2025 average: $4.09. |
| 48 | Nevada | $1.06 | 2025 average: $2.30. |
| 49 | Vermont | $0.00 | 2025 average: $22.41. |
All 2025 and 2026 premiums shown in the ranking come from the CMS state fact sheet. Alaska is not ranked because the source does not publish a comparable 2026 state average.
Key findings from the 2026 premium ranking
Key Insight
North Dakota and Minnesota form a clear top tier at $73.51 and $72.34 per month. South Dakota ranks third at $57.85, more than $14 below Minnesota.
Notable Pattern
Six states have published averages of at least $40 per month, while seven states are at $5 or below: Arizona, Texas, New Mexico, Arkansas, Florida, Nevada and Vermont.
Source Consistency
Every state value in the ranking comes from the same CMS publication, avoiding methodological differences that could arise from combining insurer data, broker estimates or unrelated commercial datasets.
Vermont Outlier
Vermont's $0.00 average needs context. CMS reports only three Medicare Advantage plans in the state for 2026, and Medicare Advantage availability is substantially more limited than in most state markets.
What the ranking means for Medicare shoppers
This ranking is most useful as a comparison of state Medicare Advantage markets. It shows where CMS reports higher or lower average premiums, but it does not identify the lowest-cost plan for a particular person.
A state with a high average may still offer $0-premium Medicare Advantage plans, while a state with a low average may have plans with higher cost sharing, narrower provider networks or different prescription drug coverage. Plan availability can also vary by county and service area.
The table should therefore be read as a comparison of published state averages, not as a ranking of the best Medicare Advantage states or the total cost of coverage.
Individual plan comparisons should consider the monthly premium together with provider networks, prescription coverage, deductibles, copayments, coinsurance, supplemental benefits, Star Ratings and the annual out-of-pocket limit.
FAQ
Which state has the highest average Medicare Advantage premium in 2026?
North Dakota ranks first at $73.51 per month, followed by Minnesota at $72.34 and South Dakota at $57.85.
Which state has the lowest published average premium?
Vermont has the lowest published average at $0.00 per month. Its Medicare Advantage market is unusually limited, so the figure should not be interpreted as evidence that all Vermont beneficiaries have broad access to $0-premium plans.
Why is Alaska missing from the ranking?
The CMS state fact sheet used for this study does not publish a comparable 2026 Medicare Advantage average premium for Alaska. No replacement value was estimated.
Are the state premium values published directly by CMS?
Yes. Every state value in the ranking is taken directly from the CMS 2026 Medicare Advantage and Part D State-by-State Fact Sheet. The state averages were not calculated by StatRanker.
Does a lower state average mean Medicare Advantage is cheaper there?
Not necessarily. State averages reflect different mixes of plans and benefits. Total beneficiary cost also depends on cost sharing, prescription coverage, provider networks and other plan features.
Does a $0 Medicare Advantage premium mean Medicare costs nothing?
No. Medicare Advantage members generally continue paying the Medicare Part B premium and may also face deductibles, copayments, coinsurance and prescription drug costs.
What is the national average Medicare Advantage premium for 2026?
CMS estimated the nationwide average monthly premium across all Medicare Advantage plans at $14.00 for 2026. That national estimate is separate from the state ranking and is not calculated from the 49 state values shown here.
Should the state average be used to choose a Medicare Advantage plan?
No. The state average is useful for market comparison, but an individual plan decision should consider local availability, provider networks, drug coverage, cost sharing, supplemental benefits and out-of-pocket limits.
Sources
CMS — 2026 Medicare Advantage and Part D State-by-State Fact Sheet
Primary numeric source for all 49 ranked state premiums, the 2025 comparison values, plan counts and state market context.
https://www.cms.gov/files/document/2026-ma-part-d-landscape-state-state-fact-sheet.pdf
CMS — Medicare Advantage and Medicare Prescription Drug Programs Expected to Remain Stable in 2026
Used for the nationwide 2026 Medicare Advantage premium estimate and broader program context.
Medicare.gov — Medicare Costs
Used to explain the relationship between Medicare Advantage plan premiums, the Medicare Part B premium and other beneficiary costs.
