Medicare Open Enrollment 2027: Plan Changes to Check

If you have Medicare, there is a good chance a thick envelope or an email from your plan has already landed. It is easy to set it aside, because it looks like routine paperwork. But for many people it is the single most useful document of the year, because it spells out how your coverage is changing before the new year begins.

This post is general education, not personal advice. It covers what has been reported about 2027 changes, how the Annual Notice of Change works, and why the cheapest-looking plan is not always the cheapest one in practice. Because plan details vary by county and by insurer, the figures that matter most are the ones for your own plan, and we point to where to confirm them.

The Medicare Annual Enrollment Period, often called open enrollment, runs from October 15 to December 7. During this window, people with Medicare can generally switch between Original Medicare and Medicare Advantage, change from one Medicare Advantage plan to another, or join, drop, or change a standalone Part D prescription drug plan. Choices made now take effect January 1, 2027.

A few clarifications address common misconceptions:

• Plans change every year. Drug lists, networks, copays, and premiums can all be different from one January to the next, even if you stay with the same insurer and plan name.
• Staying put is a choice too. If you do nothing, your coverage generally continues with the plan's new terms, which is why reviewing those terms matters.
• This is not the same as the ACA marketplace. Medicare has its own calendar. If you are younger than 65 and shopping for individual coverage, our ACA open enrollment checklist for early retirees covers that separate process.
• People in Medicare Advantage have a second window. The Medicare Advantage Open Enrollment Period, January 1 to March 31, lets those already in a Medicare Advantage plan switch plans or move to Original Medicare. It is narrower than the fall window, and rules differ, so Medicare.gov is the place to verify eligibility.

Part D out-of-pocket cap. Since the Inflation Reduction Act, Part D has included an annual cap on what enrollees pay out of pocket for covered drugs. For 2026 that cap is $2,100. The reported figure for 2027 is $2,400. Two details are easy to miss. First, premiums do not count toward the cap. Second, drugs your plan does not cover do not count either. So the cap is not a ceiling on everything spent on prescriptions, only on covered drug costs under the plan's rules.

Part D deductible. The maximum standard deductible is reported to rise from $615 in 2026 to $700 in 2027. Plans can set lower deductibles, and some set none, so the amount in your plan's notice may differ from the maximum.

Smoothing drug costs. The Medicare Prescription Payment Plan lets enrollees spread out-of-pocket drug costs across the year in monthly payments instead of paying at the pharmacy counter. It does not lower the total, but some people find it helps with cash flow. Details are on Medicare.gov.

Medicare Advantage out-of-pocket limits. Medicare Advantage plans must cap what enrollees pay for Part A and Part B services, and the in-network limit for 2027 can be as high as $9,850. Many plans set a lower limit, and the limit generally does not include Part D drug costs, which follow their own cap. A plan's limit is a worst-case in-network scenario, not a prediction of what the average enrollee will pay.

Fewer drug-plan options in some counties. KFF analysis reports more counties with no Medicare Advantage drug plans available for general enrollment in 2027 than in 2026. That means in some places the range of choices is narrowing, which makes it even more worthwhile to check what is actually offered in your county rather than assume last year's options remain.

The Part B premium. The standard Part B premium is set by the Centers for Medicare & Medicaid Services (CMS) each autumn. As of November 2, 2026, CMS had not announced the 2027 figure. Once it is published, it will appear on Medicare.gov and in CMS announcements. For a look at how Social Security cost-of-living adjustments interact with Medicare costs, see our piece on what the 2027 COLA actually buys.

The Annual Notice of Change (ANOC) is a document Medicare Advantage and Part D plans send to their members, generally by the end of September, summarizing changes for the coming year. It is often paired with the Evidence of Coverage, which is the full rulebook. Think of the ANOC as the "what's different" page and the Evidence of Coverage as the contract behind it.

People who review these notices often look at several sections:

• Premiums and deductibles. Monthly premium, any medical deductible, and the Part D deductible.
• Medical copays and coinsurance. Primary care, specialists, emergency care, imaging, and hospital stays can each change independently.
• The out-of-pocket maximum. For Medicare Advantage, this is the in-network limit discussed above.
• Drug coverage changes. Tier placement, prior authorization, and quantity limits can change for specific drugs, even when a drug stays on the list.
• Extra benefits. Dental, vision, hearing, and over-the-counter allowances are sometimes reduced, expanded, or restructured.

If the notice is long or confusing, a free State Health Insurance Assistance Program (SHIP) counselor can walk through it. SHIPs are federally funded and listed at shiphelp.org, and Medicare.gov offers a 1-800-MEDICARE helpline.

Two items cause a large share of mid-year frustration: the drug list and the provider network.

The formulary is the plan's list of covered drugs. Many people compare it to a restaurant menu that gets reprinted each year, where some items move to a pricier section or disappear. Details that may be worth checking for each regular medication include whether the drug is covered, which tier it sits on, whether prior authorization or step therapy applies, and which pharmacies count as preferred. Because only covered drug costs count toward the Part D cap, a drug that is dropped from a formulary can matter more than the cap figure suggests.

The network is the set of doctors, hospitals, and facilities a plan contracts with. Medicare Advantage plans typically use networks, and costs can be higher or coverage unavailable outside them. People with long-standing relationships often confirm that their primary doctor, specialists, and preferred hospital are in-network for 2027. Plans can change network participation during the year, so some people also confirm directly with each provider's office.

Original Medicare works differently. It generally lets enrollees see any provider that accepts Medicare, and it has no annual out-of-pocket cap on Parts A and B, which is one reason some people pair it with a Medigap policy. Our guide on switching from Medicare Advantage to Original Medicare covers trade-offs such as Medigap underwriting rules, which can vary by state and timing.

A low monthly premium is the easiest number to compare, and the easiest to be misled by. Premiums are only one piece. A fuller picture typically adds together:

• Annual premiums (including the Part B premium, which applies regardless of plan)
• Deductibles
• Expected copays and coinsurance for visits, tests, and procedures
• Expected drug costs, up to the Part D cap for covered drugs
• The plan's out-of-pocket limit, as a worst-case reference for medical costs

A purely hypothetical illustration (numbers are made up for explanation only). Imagine two fictional plans. Plan A has a $0 monthly premium but a $600 drug deductible and higher specialist copays. Plan B has a $40 monthly premium ($480 per year), a $0 drug deductible, and lower specialist copays. A fictional enrollee who sees specialists often and takes several brand-name drugs might find Plan B costs less over the year, while a fictional enrollee who rarely uses care might find Plan A does. The point is not which plan wins, but that the answer depends on how each person actually uses care.

Looking at last year's actual usage, such as the number of specialist visits, the drug list, and any procedures, gives a rough basis for estimating next year. It will not predict a surprise hospital stay, which is why the out-of-pocket maximum is worth reading alongside the average-case estimate.

Income can also affect Medicare costs. Higher-income beneficiaries may pay income-related monthly adjustment amounts (IRMAA) on Part B and Part D, based on tax returns from two years earlier. Our post on the year-end Roth conversion window explains how income decisions can ripple into IRMAA, and it is a topic many people discuss with a tax professional.

The Medicare Plan Finder at Medicare.gov lets people enter their medications, pharmacies, and ZIP code to see plan options and estimated annual drug and premium costs for their own situation. It is the most direct way to confirm any figure mentioned in this article, including the Part D cap, deductible, and out-of-pocket limits for a specific plan. A Medicare account also lets people view their current coverage. Because plan data is updated as insurers finalize details, checking the tool directly beats relying on summaries, including this one.

One related point: people who go without creditable drug coverage can face lifelong Part D late enrollment penalties, so a gap in coverage is worth avoiding when switching or dropping plans. We cover how those work in our guide to Medicare Part B and Part D late enrollment penalties.

This article is general education only. fidser. is not a registered investment adviser or certified financial planner, and nothing here is personal advice. Medicare rules and plan details vary, so readers may wish to consult a qualified financial adviser, a licensed insurance professional, or a SHIP counselor before making decisions about coverage.