Medicare Open Enrollment Starts Thursday: What’s Changing in 2027 Drug Coverage and Advantage Plans

(Source: CMS.gov, KFF via AJMC, Medicare Rights Center, Medicare Resources, SmartMatch, Kimbrough Law)

Medicare’s Annual Enrollment Period begins Thursday, October 15. This year’s changes include a higher Part D spending cap, a lower projected average Medicare Advantage premium, and the end of a federal subsidy for stand-alone drug plans.

Open Enrollment runs October 15 through December 7, 2026, and during that time people with Medicare can compare 2027 coverage options at Medicare.gov. Changes take effect January 1, 2027, and the plan must receive the enrollment request by December 7. If someone makes more than one change during the window, the last one before the deadline is the one that counts.

What’s changing in Part D

• The Part D out-of-pocket cap rises from $2,100 to $2,400 on January 1, and the maximum standard deductible rises from $615 to $700.
• Deductibles, copayments and coinsurance on covered drugs count toward the cap. After reaching it, a person pays nothing more for covered Part D drugs for the rest of the year. Premiums are not part of the cap.
• CMS set the 2027 Part D base beneficiary premium at $41.33, up from $38.99 in 2026. The base premium is a benchmark, not what an individual plan charges.
• CMS has also announced the end of the Part D Premium Stabilization Demonstration, a voluntary program for stand-alone drug plans that began in 2025.

Premiums: stand-alone drug plans vs. Medicare Advantage

CMS projects that the average premium for stand-alone Part D plans will rise by less than $1 a month in 2027. That is an increase from $35.09 to $36. For Medicare Advantage plans that include drug coverage, CMS projects the average monthly Part D premium will fall from $11.32 to $7. KFF attributes part of the gap between the two to Advantage sponsors’ ability to use rebates to lower drug coverage premiums.

Medicare Advantage and Medicare Prescription Drug Programs Expected to Remain Stable in 2027

The weighted average Medicare Advantage premium, including plans with drug coverage and Special Needs Plans, is projected to fall from $14.37 in 2026 to $12.00 in 2027, a decline of 16.5%. The number of available Advantage plans nationally is expected to stay relatively stable, going from 5,553 to about 5,532. CMS says about eight in 10 Advantage enrollees will be able to stay in their current plan with the same or a lower premium.

The tradeoff to check

An analysis of the CMS landscape file by SmartMatch found that the median in-network out-of-pocket limit for Advantage plans rose from $6,500 to $7,100, and the average drug deductible in Advantage plans with Part D rose from about $434 to $525. A lower premium does not necessarily mean lower total costs, so enrollees should compare each plan’s out-of-pocket limit, drug deductible, network and formulary, not just the monthly premium.

Part B figures still pending

The 2027 Part B premium has not been announced yet. CMS is expected to announce the Part B premium and the Part A and Part B deductibles in late October or early November. The standard Part B premium is $202.90 a month in 2026. The Part B premium applies to people in Original Medicare and in Medicare Advantage.

New Insights on 2027 Medicare Advantage and Part D Offerings - Medicare Rights Center +2

New in 2027: enrollment limits on some Advantage plans

Beginning in 2027, certain Medicare Advantage plans may use enrollment capacity limits set through the bidding process. An affected plan that reaches its limit may stop accepting new members even while Open Enrollment is still underway. These limits are optional and do not apply to stand-alone Part D plans. Beneficiaries who decide on a specific Advantage plan may not want to wait until the final days of the window.

Kimbrough Law

What to do now

• Annual Notices of Change should have arrived by September 30. People who haven’t received one should contact their plan.
• List current drugs, doctors and pharmacies, and check each against the plan’s 2027 drug list and network.
• Free, unbiased help is available through State Health Insurance Assistance Programs (SHIPs) at shiphelp.org.
• People in Medicare Advantage also get a separate change opportunity from January 1 to March 31.

Sources: CMS.gov: 2027 MA and Part D press release | CMS.gov: Part D 2027 bid fact sheet | AJMC (citing KFF) | Medicare Rights Center | Medicare Resources | SmartMatch | Gentle Medicare Guide | Kimbrough Law | MedicareLens | Kiplinger