En esta noticia
Medicare’s Annual Open Enrollment Period is underway, giving millions of Americans an opportunity to review their current health insurance and decide whether another option would better fit their medical needs and budget.
The deadline is December 7, 2026. Any changes made during this period will take effect on January 1, 2027. Beneficiaries can compare their existing coverage with available alternatives, including Original Medicare, Medicare Advantage and prescription drug plans under Part D.
However, choosing a plan should involve more than comparing monthly premiums. Drug costs, medical providers, pharmacy networks and additional benefits can also change from one year to the next.
What Medicare beneficiaries should review before December 7
The first step is to read the Annual Notice of Change (ANOC) and the Evidence of Coverage (EOC) sent by their current insurance provider. These documents explain changes to premiums, deductibles, covered services, prescription drugs and out-of-pocket expenses for the following year.
There are several important points to check before deciding whether to keep the same coverage:
- Monthly premiums: Check whether the amount paid for health or prescription drug coverage will increase or decrease in 2027.
- Prescription drug coverage: Verify that all medications currently prescribed remain covered and compare their copayments or coinsurance.
- Doctors and hospitals: Make sure preferred physicians, specialists and medical facilities remain within the plan’s network.
- Pharmacies: Check whether the pharmacies used regularly are still included and whether preferred pharmacy arrangements affect medication costs.
- Additional benefits: Review dental, vision and hearing coverage, particularly if the plan offers these services as supplemental benefits.
- Deductibles and out-of-pocket expenses: Compare how much beneficiaries must pay before coverage begins and what their potential annual expenses could be.
A plan that worked well in 2026 may not offer the same combination of benefits and costs next year. This is particularly important for people who take several prescription medications or regularly visit specialists.
Beneficiaries can use the official Medicare Plan Finder to compare available options according to their location, medical needs and budget.
What changes in Medicare in 2027?
Several adjustments will affect prescription drug coverage and the costs associated with Medicare. Some changes could reduce expenses, while others require beneficiaries to pay closer attention to their individual plans.
Part D out-of-pocket limit increases to $2,400
One of the most important changes concerns Medicare Part D, which provides prescription drug coverage.
In 2027, the annual out-of-pocket spending limit for covered Part D medications will increase from $2,100 to $2,400. This means beneficiaries will have a higher threshold before reaching catastrophic coverage.
The standard Part D deductible will also increase from $615 in 2026 to $700 in 2027. Individual plans can establish lower deductibles or offer coverage with no deductible, but they cannot exceed the federal maximum.
These adjustments make it especially important to compare prescription drug plans before the enrollment period closes, particularly for people with ongoing medication expenses.
Federal Part D premium stabilization program ends
Another relevant development is the conclusion of the Part D Premium Stabilization Demonstration, a temporary federal initiative designed to help control premium fluctuations in stand-alone prescription drug plans.
The program will end after 2026, and Medicare will return to traditional market conditions for these plans in 2027.
According to the Centers for Medicare & Medicaid Services (CMS), the average monthly premium for stand-alone Part D plans is projected to increase from $35.09 in 2026 to $36 in 2027, a rise of less than $1.
Meanwhile, the average monthly prescription drug premium for Medicare Advantage plans that include Part D coverage is projected to decrease from $11.32 to $7.
These are national averages, not guaranteed prices for individual beneficiaries. Actual premiums depend on the specific plan and location, making it important to check the available options before December 7.
Medicare negotiates lower prices for 15 prescription drugs
Starting January 1, 2027, negotiated prices will take effect for 15 prescription drugs covered under Medicare Part D.
The second round of negotiations includes medications such as Ozempic, Rybelsus and Wegovy, alongside treatments for cancer, diabetes and other medical conditions.
CMS estimates that the negotiated prices could generate approximately $685 million in out-of-pocket savings for Medicare beneficiaries in 2027.
The actual savings for each person will depend on the medication they use, their prescription drug plan and the applicable coverage conditions.
Will Medicare Advantage premiums decrease in 2027?
CMS also projects a reduction in the average monthly premium for Medicare Advantage, the privately administered alternative to Original Medicare.
The weighted average monthly premium across Medicare Advantage plans is expected to fall from $14.37 in 2026 to $12 in 2027, representing a 16.5% decrease.
The agency also expects supplemental benefits, including dental, vision and hearing coverage, to remain stable overall.
However, these national projections do not mean every beneficiary will pay less. Insurance companies can modify their offerings, provider networks and cost-sharing arrangements, and some plans may no longer be available in particular areas.
For that reason, beneficiaries should check whether their current Medicare Advantage plan will continue operating in their area and whether its benefits will remain suitable for their needs.
What happens if beneficiaries do not change their Medicare plan?
Changing coverage is not mandatory during the Annual Open Enrollment Period. People who are satisfied with their current plan and whose coverage will continue in 2027 generally do not need to take any action. Their existing enrollment will carry over into the following year.
However, doing nothing without reviewing the updated coverage information could mean overlooking higher premiums, changes to prescription drug coverage or the removal of preferred doctors and hospitals from a provider network.
Anyone who decides to switch plans must submit the enrollment request by December 7, 2026. The new coverage will generally become effective on January 1, 2027.
Beneficiaries can review their options through Medicare.gov, contact Medicare by calling 1-800-MEDICARE (1-800-633-4227) or seek free personalized assistance through their State Health Insurance Assistance Program (SHIP).