Medicare 2027: Your Top Questions Answered

Medicare's Annual Enrollment Period (AEP) opens October 15 and closes December 7, 2026, and 2027 brings real changes worth acting on early — a higher Part D out-of-pocket cap, the end of a temporary drug-premium subsidy, and new limits some Medicare Advantage plans can place on enrollment. Below are straight answers to the questions beneficiaries and their caregivers ask us most as they review coverage.

When is Medicare Annual Enrollment for 2027 coverage?

AEP runs October 15 to December 7, 2026, and any changes you make take effect January 1, 2027. During AEP you can switch between Original Medicare and a Medicare Advantage plan, change Medicare Advantage plans, or join, switch, or drop a Part D drug plan (CMS). Your enrollment request must reach the plan by December 7 — enrolling earlier does not create an earlier start date; every approved change begins January 1.

Do I have to do anything if I'm happy with my plan?

Not necessarily — but you should still review it. Your plan's Annual Notice of Change (ANOC) spells out next year's changes to premiums, deductibles, copays, drug coverage, and provider networks, and plans must send it by the end of September. A plan that worked well in 2026 can look different in 2027, so compare that notice against the care you actually expect to use before AEP opens.

What should I check before I decide?

Four things. First, your doctors and hospitals — are they still in the plan's network? Second, your prescriptions — are they still covered, and at what cost tier? Third, your total costs: add up premiums, deductibles, copays, and drug costs rather than comparing only the monthly premium. Fourth, your deadline — make your decision by December 7. Because some 2027 Medicare Advantage plans can set enrollment caps and may close to new members before that date, starting early helps.

What are enrollment caps, and why do they matter?

For 2027, CMS is allowing certain Medicare Advantage plans to set hard limits on how many members they'll accept. Preliminary data reported by industry press shows 15 payers have capped 65 plans in 11 states. Once a capped plan is full, it can close to new enrollees even in the middle of AEP; current members aren't affected. If you're considering switching or enrolling for the first time, it's one more reason not to wait until late November.

What's changing with Medicare Part D drug coverage in 2027?

The big number is the out-of-pocket cap. The annual limit on what you pay for covered Part D drugs is $2,400 in 2027, up from $2,100 in 2026 — once you reach it, you owe no further cost sharing for those drugs for the rest of the year. The standard Part D deductible is $700, though individual plans may set lower deductibles. CMS also set the 2027 national base beneficiary premium at $41.33, up from $38.99 in 2026 (MedigapSeminars). The government's Part D premium stabilization demonstration — a temporary subsidy that cushioned standalone drug plans — is ending after 2026, and analysts expect many beneficiaries to see higher premiums. Your own plan's premium and deductible can differ, so check your ANOC.

What is the Medicare Prescription Payment Plan?

It lets you spread your out-of-pocket drug costs over the year in monthly payments instead of paying large amounts at the pharmacy. It doesn't lower your total costs, but it can make them easier to manage. Ask your plan how to sign up.

Will Medicare Advantage plans change in 2027?

They might. CMS's 2027 payment rate for Medicare Advantage plans increases by about 2.48%, which CMS says will equate to $13 billion in additional payments in 2027 (Forbes Advisor). A payment increase doesn't guarantee better benefits — plans may still adjust premiums, copays, supplemental benefits, drug formularies, and networks. Review your plan's notice and compare.

What's the difference between Original Medicare and Medicare Advantage?

Original Medicare (Parts A and B) lets you see any provider that accepts Medicare nationwide. It has deductibles and 20% coinsurance for many Part B services, with no annual out-of-pocket maximum. Most people add a Part D drug plan and often a Medicare Supplement (Medigap) plan.

Medicare Advantage (Part C) is offered by private insurers. These plans include Parts A and B, usually include drug coverage, and often include extras such as dental, vision, or hearing. They use networks, may require referrals or prior authorization, and have an annual out-of-pocket maximum.

Neither is right for everyone. It depends on your doctors, prescriptions, health needs, budget, and how much you travel.

Can I switch Medicare Supplement (Medigap) plans during AEP?

You can apply, but there's no annual Medigap open enrollment. Outside your initial Medigap window or certain special situations, insurers in most states can review your health history before approving you, and the rules vary by state. Check whether you qualify before you drop any coverage.

What if I change my mind after January 1?

If you're in a Medicare Advantage plan, you have the Medicare Advantage Open Enrollment Period, January 1 to March 31, 2027. You can make one change, such as switching plans or returning to Original Medicare; it doesn't apply if you're in Original Medicare. There's also a 5-star Special Enrollment Period (December 8, 2026 to November 30, 2027) that allows one switch into a 5-star plan if one is available where you live.

What is the Part D late enrollment penalty?

If you go without Part D or other creditable drug coverage for 63 days or more after you're first eligible, you may owe a penalty. It's 1% of the national base beneficiary premium for each full month you went without coverage, and it's added to your premium for as long as you have Part D. If you have limited income, Extra Help can change this, so ask.

What will Part B cost in 2027?

The 2027 Part B premium and deductible hadn't been announced as of this writing. For reference, the 2026 standard premium is $202.90 a month, with a $283 annual deductible. CMS typically announces next year's amounts in the fall, and higher-income beneficiaries pay more.

Can I get help paying for Medicare?

Possibly. Medicare Savings Programs, Medicaid, and Extra Help (the Part D Low-Income Subsidy) can lower premiums and drug costs for people with limited income and resources. If your income changed, such as losing Supplemental Security Income, ask your state Medicaid office and the Social Security Administration what you still qualify for.

Does it cost more to work with a licensed agent?

Agents are typically paid by the insurance companies, and using one generally doesn't add to your plan premium. We can explain the plans we offer, walk through your doctors and prescriptions, and help you enroll. We don't offer every plan available in your area, which is why we also point you to Medicare.gov and 1-800-MEDICARE.

Where else can I get unbiased help?

Three places: the Medicare.gov Plan Finder to compare plans in your ZIP code, 1-800-MEDICARE (1-800-633-4227), and your state's State Health Insurance Assistance Program (SHIP), which offers free, unbiased counseling.

Key Dates at a Glance

Talk to Gilman Agency

If you'd like help comparing your options for 2027, we're glad to walk through them with you. Questions? Call (800) 927-9326 or email marc@gilmanagency.com, or visit gilmanagency.com.

Sources: Centers for Medicare & Medicaid Services 2027 Part C and D announcements, including the July 28, 2026 Part D national average bid release; UnitedHealthcare, "How Medicare Part D is changing in 2027"; Bob Carlson, "An Early Look at What to Expect in Medicare's 2027 Annual Enrollment Period," Forbes, August 21, 2026; Medicare Rights Center, 2027 enrollment dates; industry press reports of preliminary CMS enrollment cap data.