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Home»Finance»What to know before open enrollment
Finance

What to know before open enrollment

September 18, 2026No Comments4 Mins Read
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What to know before open enrollment
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Over 70 million Medicare enrollees will head into the annual open enrollment period from Oct. 15 through Dec. 7, with several key decisions to make. While the Centers for Medicare & Medicaid Services (CMS) hasn’t yet announced all the official details that will take effect in 2027, early forecasts offer a preview of what’s likely coming.

If you’re enrolled in a Medicare Advantage program, watch for your Annual Notice of Change from your plan provider in your mailbox or email inbox by Sept. 30. 

Read more: Medicare open enrollment: How to add or adjust your coverage

Summary of 2027 projected Medicare changes

A quick summary of the 2027 changes that matter most:

  • The Part A hospital deductible is forecast to decrease to between $1,788 and $1,810 per benefit period.

  • The Part B premium is projected to increase by $6.60 to $209.50.

  • The Part B deductible will rise from $283 in 2026 to a projected range between $292 and $310.

  • The Part D standard deductible is forecast to increase from $615 to $700. This is a significant 14% increase, though some plans may offer a lower deductible. 

  • The Part D out-of-pocket cap will rise $300 to $2,400. Once you reach the cap, covered prescriptions have no out-of-pocket costs for the rest of the calendar year.

  • The federal subsidy program for stand-alone Part D drug program (PDP) premiums is ending. The subsidies reduced PDP premiums by $16 in 2026. 

  • Negotiated drug prices: 15 additional drugs will see lower prices, including GLP-1s and cancer and diabetes medications. However, your copay may impact savings. 

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Again, changes will be official only once CMS confirms 2027 guidance in November.

Read more: Should you buy a Medicare Advantage plan from Costco? What to know.

Medicare Advantage 2027 changes

Major providers continue to scale back Medicare Advantage program options because of rising costs and shrinking profits.  

“For 2027, the change I would watch most closely is the Medicare Advantage market itself,” Josh Schultz, head of government affairs at Softheon, told Yahoo Finance. “Some beneficiaries may see changes to their available plan options as plans adjust their offerings, leave certain markets, or are no longer available. That means many people will need to actively review their options during the Annual Enrollment Period rather than assuming their current plan will continue unchanged.”

Schultz said that when a plan changes or is no longer offered, enrollees have more to consider than simply finding a replacement with a similar premium. 

“Beneficiaries should look at the doctors and hospitals they use, prescription drug coverage, pharmacy access, and total costs. The right plan depends on someone’s health needs and the care they expect to use during the year,” he said.

He offered these tips:

  • Check your prescriptions and see how each is covered by the plans you are considering. “Don’t stop at confirming that the drug appears on the formulary. Look at the tier, what you would pay, and if there is a prior authorization requirement. A drug can be covered and still cost much more under one plan than another.”

  • Confirm your preferred doctors and hospitals are in-network.

  • Review the pharmacy network too. “Most Medicare Advantage plans include Part D prescription drug coverage, so you are usually choosing your medical plan and the prescription coverage that comes with it. A $0 or low monthly premium can be attractive, but the better comparison is what someone could pay over the course of the year and whether the plan covers the care and prescriptions they expect to use.”

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Don’t overlook out-of-pocket caps

Schultz also noted that many first-time Medicare enrollees may not realize that Original Medicare does not have an annual out-of-pocket cap. 

“That creates potential financial exposure if someone needs a lot of care. Medicare Advantage is one option that can provide an annual out-of-pocket limit for covered services. Understanding how different Medicare options work and how they fit your health needs can help you decide which approach makes sense for you,” he added.

Free Medicare assistance is available

New Medicare enrollees who need help can use free counseling from State Health Insurance Assistance Programs (SHIP) available in every state. Volunteer counselors can help beneficiaries understand plan options and compare coverage.

Also read: Medicare will cover GLP-1 weight-loss drugs for $50 per month. How you could save.

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