Independent guide. The Health Advocate is not affiliated with Medicare, CMS or any insurer. This is general information, not insurance advice. Updated October 2026.
Your plan renews on its own. Its costs don’t stay the same.
What’s different for 2027, and the six things to check before the deadline.
✔ The Part D out-of-pocket cap rises to $2,400 in 2027, and plans can charge a drug deductible of up to $700.
✔ Negotiated Medicare prices take effect for 15 more drugs, including Ozempic, Wegovy and Rybelsus.
✔ Some Medicare Advantage plans are leaving areas or trimming extras. Read your Annual Notice of Change.
✔ If you do nothing, you usually stay in your current plan, even if it changed.
Every fall, people with Medicare get seven weeks to change how they get their coverage for the coming year. Open enrollment runs October 15 to December 7, and any change you make starts January 1.
Most people do nothing, and their plan renews. That’s fine if the plan still fits. But plans change their premiums, drug lists, networks and extras every year, and 2027 has more moving parts than usual. Here’s what’s new, and how to check whether your plan still works for you.
What you can change during open enrollment
- Switch from Original Medicare to a Medicare Advantage plan, or from Medicare Advantage back to Original Medicare
- Switch from one Medicare Advantage plan to another
- Join, switch or drop a Part D prescription drug plan
Medigap policies aren’t part of open enrollment. You can apply for one any time, but outside your initial Medigap window insurers in most states can ask health questions. If you’re thinking about leaving Medicare Advantage for Original Medicare, check whether you can get a Medigap policy before you switch.
What’s changing for 2027
| Item | 2026 | 2027 |
|---|---|---|
| Part D out-of-pocket cap | $2,100 | $2,400 |
| Maximum Part D deductible | $615 | $700 |
| National base beneficiary premium (Part D) | $38.99 | $41.33 |
| Medicare Advantage in-network out-of-pocket limit (maximum) | $9,250 | $9,850 |
| Part B standard premium | $202.90 | Not yet announced (projected about $209.50) |
Drug costs: a higher cap, and a higher deductible
Since 2025, Part D has had a yearly cap on what you pay out of pocket for covered drugs. In 2027 that cap rises to $2,400. Once you reach it, you pay nothing more for covered Part D drugs for the rest of the year. Plans can also charge a deductible of up to $700 before coverage starts, though many charge less or none for cheaper drug tiers.
If you take expensive medications, you may hit the cap early in the year. The Medicare Prescription Payment Plan lets you spread those costs into monthly payments instead of paying a large amount at the pharmacy in January. Ask your plan how to sign up for 2027.
Premiums: a federal discount is ending
For 2025 and 2026, a temporary CMS program reduced premiums for many stand-alone Part D plans. CMS decided not to extend it, so some drug plan premiums may rise for 2027. This is exactly why comparing matters: a plan that was the cheapest in 2026 may not be in 2027.
Lower prices for 15 more drugs
Medicare-negotiated prices take effect January 1, 2027, for a second group of 15 drugs. The list includes Ozempic, Rybelsus and Wegovy (a negotiated price of $274 for a 30-day supply), Trelegy Ellipta, Breo Ellipta, Linzess, Xifaxan, Tradjenta, Janumet and Otezla, among others. What you actually pay still depends on your plan’s tiers and deductible, but if you take one of these drugs, run your plan comparison again.
Medicare Advantage: higher caps and some pullbacks
CMS raised the maximum in-network out-of-pocket limit Medicare Advantage plans can set to $9,850 for 2027. Some insurers are also leaving certain counties or cutting back extras like dental allowances. If your plan won’t be offered in your area next year, you’ll get a letter, and you get a Special Enrollment Period to choose new coverage.
Telehealth stays available
Expanded Medicare telehealth flexibilities, including visits from home, have been extended through December 31, 2027.
Your pre-deadline checklist
1. Read your Annual Notice of Change
Plans had to mail it by September 30. Look for changes to the premium, deductible, copays, drug tiers and networks. Can’t find it? Your plan’s website or member services line can resend it.
2. Check every prescription
Confirm each drug is still on the formulary, which tier it’s on, and whether it now needs prior authorization or step therapy. Formularies change every year.
3. Confirm your doctors, hospitals and pharmacy
If you’re in Medicare Advantage, check that your doctors and preferred hospital are in network for 2027. Check whether your pharmacy is still “preferred,” which can lower what you pay.
4. Add up the total yearly cost
Premiums, plus the deductible, plus expected copays for your drugs and visits. Then look at the out-of-pocket maximum for a bad year. Don’t forget your Part B premium, which you pay with any option.
5. Look at extras with a critical eye
Dental, vision and hearing benefits can be useful, but they often have low annual caps or limited networks. Don’t let a gym membership decide your medical coverage.
6. Compare side by side on Medicare.gov
The Plan Finder lets you enter your drugs and pharmacies and see estimated yearly costs for every plan in your ZIP code.
A simple way to compare two plans
Say Plan A has a $0 premium, a $5,900 out-of-pocket cap and $45 specialist copays, and Plan B costs $39 a month with a $3,900 cap and $30 specialist copays. In a quiet year with eight specialist visits, Plan A costs $360 and Plan B costs $708 ($468 in premiums plus $240 in copays). In a year with a hospital stay that hits both caps, Plan A costs $5,900 and Plan B costs $4,368. Neither is “better” in every year. The point is to know which risk you’re choosing.
Example figures are hypothetical. Your plans’ actual costs will differ.
What if you miss December 7?
- Medicare Advantage Open Enrollment, January 1 to March 31: if you’re in a Medicare Advantage plan, you can switch to a different Medicare Advantage plan or go back to Original Medicare (and join a Part D plan) once.
- Special Enrollment Periods: moving, losing other coverage, moving into or out of a nursing home, or your plan leaving your area can all open a window.
- 5-star plans: you can switch to a plan rated 5 stars once during the year, if one is available where you live.
- Extra Help or Medicaid: people who qualify have more chances to change drug plans.
Watch out for open enrollment scams
- Medicare will not call you to sell a plan or ask for your Medicare number.
- Agents and plans aren’t allowed to make unsolicited “cold” calls to sell coverage.
- Be wary of TV ads promising “extra money back” on your Social Security. Ask exactly which plans offer it and what you give up.
- If in doubt, hang up and call 1-800-MEDICARE yourself.
Helping a parent through this? Our caregiver’s open enrollment checklist covers getting permission to speak for them and what to have ready before you call.
Quick answers
Do I have to re-enroll in Medicare every year?
No. If you do nothing, you usually stay in your current plan. You only need to act if you want to change, or if your plan is ending.
When will the 2027 Part B premium be announced?
CMS usually announces it in mid-November. The Medicare Trustees projected about $209.50 a month, up from $202.90 in 2026, but the official figure may differ.
If I switch plans, do I have to cancel my old one?
Usually not. Joining a new Medicare Advantage or Part D plan generally ends your old one automatically when the new one starts. Leaving Medicare Advantage for Original Medicare works the same way once you join a Part D plan.
Where can I get free help comparing plans?
Your State Health Insurance Assistance Program (SHIP) offers free, unbiased counseling. Find yours at shiphelp.org or call 1-800-MEDICARE.
Sources: CMS, CY 2027 Part D redesign program instructions and rate announcement; CMS, CY 2027 Part C benefit standards; CMS, Medicare Drug Price Negotiation Program (negotiated prices for 2027); Medicare.gov (enrollment periods); 2026 Medicare Trustees Report (2027 Part B projection). Plan details vary by location.
Find your Annual Notice of Change, list your drugs, and run the Plan Finder before December 7.
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