Medicare Open Enrollment 2027: What You Need to Know Before December 7

Medicare plans and costs are changing for 2027.Heres what to review, how to compare your coverage options, and where to find help making an informed decision.If youre enrolled in Medicare, October 15 through December 7, 2026 is an important time to take another look at your health insurance coverage.Even if youre satisfied with your current plan, changes coming in 2027 could affect what you pay, which doctors you can see, and how your prescription medications are covered.During Medicares annual Open Enrollment Period, beneficiaries can change Medicare Advantage plans, switch prescription drug plans, or move between Original Medicare and Medicare Advantage.

Changes made during this period take effect January 1, 2027.The good news? You dont have to change plans if your current coverage continues to meet your needs.But taking the time to review your options could help you avoid unexpected expenses.Whats Changing for Medicare in 2027?Several changes are worth understanding before making a decision.Prescription drug costs: The annual out-of-pocket limit for covered Medicare Part D prescription drugs increases from $2,100 in 2026 to $2,400 in 2027.Once you reach that threshold, you generally wont pay additional out-of-pocket costs for covered Part D drugs for the remainder of the year.The maximum deductible for the standard Part D benefit also rises from $615 to $700, although individual plans may charge a lower deductible.Medicare Advantage premiums: The Centers for Medicare & Medicaid Services (CMS) projects that average monthly Medicare Advantage premiums will decline approximately 16.5%, from $14.37 in 2026 to $12 in 2027.

However, premiums and other costs vary considerably by plan and location.Prescription drug plan premiums: CMS projects that average monthly premiums for stand-alone Part D plans will increase by less than $1.Individual plans may have much larger changes.These national averages are useful, but what matters most is how your particular coverage will change.For more information, see the CMS announcement on 2027 Medicare Advantage and prescription drug plans.Original Medicare vs.Medicare Advantage: Whats the Difference?One of the most important decisions is choosing how you receive your Medicare benefits.Original Medicare is the traditional federal government program.

It includes Part A (hospital insurance) and Part B (medical insurance).With Original Medicare, you can generally visit any doctor or hospital in the United States that accepts Medicare.You typically dont need referrals to see specialists.However, Original Medicare doesnt cover all health care expenses.Beneficiaries generally pay deductibles and coinsurance, and there is no annual out-of-pocket limit for Part A and Part B services.Many people purchase Medicare Supplement Insurance, commonly called Medigap, to help cover these expenses.

Prescription drug coverage is usually purchased separately through a Part D plan.Medicare Advantage (Part C) is an alternative way to receive Medicare benefits through private insurance companies approved by Medicare.These plans must cover all medically necessary services covered by Original Medicare.Most include prescription drug coverage and may offer additional benefits such as routine dental, vision, or hearing services.Some Medicare Advantage plans have low or $0 additional monthly premiums, although beneficiaries generally must continue paying their Medicare Part B premium.There are trade-offs.Medicare Advantage plans often have provider networks, meaning you may need to use participating doctors and hospitals for nonemergency care.

Referrals or prior authorization may also be required for certain services.Unlike Original Medicare alone, Medicare Advantage plans have an annual out-of-pocket spending limit for covered Medicare services.Which is better? Neither option is automatically the best choice for everyone.Original Medicare may appeal to people who value flexibility in choosing physicians, particularly if they travel frequently or receive care in different parts of the country.Medicare Advantage may appeal to those who prefer bundled coverage, additional benefits, and predictable copayments for certain services.One important caution: If youre considering switching from Medicare Advantage to Original Medicare, investigate whether you can obtain Medigap coverage before making the change.Outside certain enrollment periods and special circumstances, insurers may be permitted to consider your health history or deny coverage, depending on state law.Medicare provides a helpful side-by-side comparison of Original Medicare and Medicare Advantage.Five Things to Check Before December 7Before deciding to keep or change your coverage, take a few minutes to review these important details.Read your Annual Notice of Change.If youre enrolled in a Medicare Advantage or Part D plan, your insurer sends information explaining changes to your coverage, costs, and benefits for the coming year.Check your doctors and hospitals.

If you have Medicare Advantage, confirm that your preferred providers will participate in your plans network in 2027.Dont assume that participation will continue automatically.Review your prescription drugs.Make sure your medications remain on your plans list of covered drugs, known as its formulary.

Check copayments, deductibles, and whether your pharmacy remains preferred or in-network.Compare total costs, not just premiums.A plan with a low monthly premium isnt necessarily the least expensive option.Consider deductibles, copayments, coinsurance, and annual out-of-pocket limits.Evaluate extra benefits.

Dental, vision, hearing, fitness, and other benefits can be useful, but look closely at coverage restrictions and spending allowances before making them a deciding factor.Could You Qualify for Help With Medicare Costs?Some beneficiaries may qualify for programs that help pay Medicare expenses.Medicare Savings Programs can help eligible individuals pay certain premiums and other costs.The Part D Low-Income Subsidy, also called Extra Help, assists qualifying beneficiaries with prescription drug expenses.The nonprofit National Council on Aging (NCOA) offers a free resource, BenefitsCheckUp.org, to help people identify programs for which they may qualify.Eligibility depends on factors including income, resources, and state requirements.Where to Get Free, Unbiased Medicare AssistanceYou dont have to navigate Medicare decisions alone.The official Medicare.gov website provides a plan comparison tool that lets you review available plans, estimate prescription drug expenses, and compare coverage options in your area.You can also call 1-800-MEDICARE (1-800-633-4227) for assistance.For free, personalized counseling, contact your states State Health Insurance Assistance Program (SHIP).SHIP counselors provide objective information without selling insurance plans.Be cautious about unsolicited calls, advertisements, or anyone pressuring you to switch coverage immediately.

Never share your Medicare number with an unfamiliar caller.Make an Informed DecisionMedicare coverage isnt something to choose once and forget.Plans, costs, health care needs, and personal circumstances can change from year to year.Whether youre happy with your current coverage or considering something different, a little research now can help you make a more confident decision about the year ahead.Remember: Medicare Open Enrollment ends December 7, 2026.Any changes you make during this period generally take effect January 1, 2027.