medicareresources.org outlines 5 things beneficiaries should watch as they prepare to choose 2027 coverage
Medicare 2027: 5 changes to watch
Minneapolis, MN, Sept. 16, 2026 (GLOBE NEWSWIRE) — Medicare beneficiaries preparing for the annual enrollment period this fall should be ready for higher prescription drug costs, potential premium increases and changes to Medicare Advantage and Part D plans, according to analysts at medicareresources.org.
Medicare’s annual enrollment period runs from Oct. 15 through Dec. 7, allowing beneficiaries to switch Medicare Advantage plans, change Part D prescription drug plans or move between Medicare Advantage and Original Medicare. Coverage selections take effect Jan. 1, 2027.
“Even if you’ve been happy with the same Medicare coverage for years, you need to pay close attention to what’s changing with your plan,” said Louise Norris, health policy analyst for medicareresources.org. “Premiums, out-of-pocket costs, drug coverage, provider networks and plan availability can all change from one year to the next.”
Among the changes beneficiaries should watch:
1. Part D beneficiaries will face higher out-of-pocket costs. The standard Medicare Part D deductible will increase from $615 in 2026 to $700 in 2027. The annual cap on beneficiaries’ out-of-pocket Part D spending provides important protection for people who use expensive medications, but that cap will increase $300 to $2,400 in 2027.
2. Part D premiums could increase significantly for some beneficiaries. A temporary federal program designed to limit increases in stand-alone Part D premiums is ending after 2026. The program provided financial support to participating insurers while limiting year-over-year premium increases.
Final 2027 premiums and plan availability are not yet known, but beneficiaries should be prepared to compare their options rather than assuming their current plan will remain the best fit.
“We’re already seeing indications that some stand-alone Part D premiums could increase substantially,” said Jenny Chumbley Hogue, health policy analyst for medicareresources.org. “People really need to look at the whole plan — the premium, whether their drugs are covered, what those drugs will cost, if the pharmacy network has changed and any prior authorization requirements.”
3. Medicare Advantage plans may change premiums, benefits or service areas. Some insurers are adjusting their Medicare Advantage offerings for 2027, including reducing their presence in some markets. For example, Humana said in July it would exit certain markets, impacting about 600,000 members. Beneficiaries could also see premiums added to some plans that previously had a $0 premium.
Every Medicare Advantage and Part D enrollee should carefully review the Annual Notice of Change sent by their insurer rather than assuming their 2026 coverage will remain unchanged.
4. A Medicare Advantage plan termination can create an important Medigap opportunity. Beneficiaries whose Medicare Advantage plan leaves Medicare or stops offering coverage in their area have options beyond simply choosing another Medicare Advantage plan.
If they switch to Original Medicare, they may have guaranteed-issue rights that allow them to purchase certain Medigap plans without medical underwriting.
That is an important distinction because Medicare’s annual enrollment period is not a Medigap open enrollment period. In most states, beneficiaries who voluntarily leave Medicare Advantage after their initial enrollment protections have ended may be subject to medical underwriting to purchase Medigap coverage.
“People often assume they can move freely between Medicare Advantage and Medigap during annual enrollment, but that isn’t necessarily the case,” Norris said. “If your Medicare Advantage plan is terminating, you may have protections you wouldn’t otherwise have, so it’s important to understand all of your options before selecting replacement coverage.”
5. More Medicare-negotiated drug prices will take effect in 2027. Negotiated prices for another group of high-cost medications will take effect Jan. 1. This includes several GLP-1 drugs, which are covered under Part D for people with certain health conditions – but not for weight loss.
Lower negotiated prices could reduce costs for Medicare and prescription drug plans and may help some beneficiaries. But people who take expensive medications throughout the year may still reach the $2,400 Part D out-of-pocket limit even with lower negotiated prices.
Beneficiaries should also pay attention to plan-specific coverage requirements. A medication may appear on a plan’s formulary but still require prior authorization or other steps before the plan will cover it.
As always, when reviewing 2027 coverage options, beneficiaries should check the “fine print,” including whether their doctors and hospitals will be in-network and whether their prescription drugs are covered.
Additional information about Medicare enrollment, Medicare Advantage, Part D and Medigap coverage is available at medicareresources.org.
Medicareresources.org has been an online source of in-depth information about Medicare for consumers since 2011. The site, owned by HealthInsurance.org, LLC, provides an overview of the basics of Medicare coverage options, enrollment and eligibility; coverage FAQs; state-specific Medicare information; and a glossary of Medicare terms. Medicareresources.org is not connected with or endorsed by the U.S. government or the federal Medicare program.
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- Medicare 2027: 5 changes to watch
CONTACT: medicareresources.org mromedia@afmcommunications.com
