Medicare open enrollment is under way, and the 2027 numbers are moving: the annual out-of-pocket cap on Part D drug coverage rises to $2,400 from $2,100 in 2026, according to ABC News and the Associated Press. The window runs from Oct. 15 to Dec. 7, 2026, and most changes take effect Jan. 1. Here is what is changing and a six-step way to check your plan. This is general information, not individualized advice.
Medicare open enrollment 2027: the key dates
Medicare open enrollment runs Oct. 15 through Dec. 7, 2026, per ABC News and the AP. It is the yearly chance to choose between traditional Medicare and a private Medicare Advantage plan, and to pick or change a Part D drug plan.
Most of the changes discussed below start Jan. 1, 2027. If you do nothing, your current coverage generally continues, but your plan may look different next year.
That is why this period matters even if you are happy with what you have. Plans can change premiums, drug lists, pharmacy networks and benefits from one year to the next.
In general terms, traditional Medicare lets you see any provider that accepts Medicare, while Medicare Advantage plans are run by private insurers and usually rely on provider networks. Drug coverage is either a separate Part D plan or built into an Advantage plan. Each path has trade-offs, and the right one depends on your health needs, your doctors and your budget.
If you are weighing a switch, remember that rules about changing coverage and about supplemental policies can differ by situation and by state. A counselor can explain how they apply to you before you commit.
What changes in 2027 for drug coverage
Several Part D numbers shift next year, according to the AP report carried by ABC News:
- Out-of-pocket cap: $2,400 in 2027, up from $2,100 in 2026.
- Standard deductible: $700, up from $615.
- Premium subsidy: the temporary Part D premium subsidy is ending early, at the end of this year, according to the Trump administration.
The Centers for Medicare & Medicaid Services (CMS) projects only modest price increases for most people. But averages hide a lot of variation.
KFF Health News’ Oct. 19 morning briefing cited NBC in reporting that some Part D plan premiums will rise by $50 or more a month next year. If you take several medications, that is worth a close look.
Negotiated drug prices arrive on Jan. 1
Medicare-negotiated prices take effect for 15 drugs next year, including Ozempic, Rybelsus and Wegovy, per the AP. Medicare also begins covering several more drugs on Jan. 1, including Xtandi and Ibrance.
CMS estimates the effect at $685 million. The AP report does not say how that figure will translate into what any individual patient pays, and that will depend on the plan and the drug.
If you take one of those medicines, check your plan’s 2027 formulary for the drug’s tier and cost-sharing. A negotiated price does not automatically mean a lower bill at the pharmacy counter.
The same caution applies to the new $2,400 cap. It limits what you pay out of pocket for covered drugs in a year, but it does not cover premiums, and it applies only to drugs your plan covers. Knowing where you stand against the cap, and how far into the year you are likely to reach it, helps you compare plans realistically.
Social Security raise and the $90 payment
The cost-of-living picture is a little brighter. Social Security recipients get a 3.6% cost-of-living increase in 2027, which the AP puts at about $75 more per month. Our earlier guide on the Social Security COLA 2027 estimate covers how forecasts led up to that figure.
There is also a one-time boost for some. The AP reports one-time $90 payments announced for more than 20 million Part B enrollees, at a cost of about $2 billion. Roughly 35 million Medicare Advantage enrollees are not eligible.
The reports reviewed here do not spell out how or when the payments will be delivered. Watch for official notices from CMS or Medicare rather than responding to calls, texts or emails offering to “release” a payment.
The raise and the payment are separate from your plan choice, but they feed into your budget. A higher premium or a bigger drug deductible can take back part of a cost-of-living increase, so it is worth comparing the two figures when you decide.
Medicare Advantage plans are shifting
Some Medicare Advantage plans are leaving certain areas, cutting benefits such as dental coverage and raising cost-sharing, according to the AP. David Lipschutz of the Center for Medicare Advocacy warned that some enrollees could face greater coverage disruptions because of plan withdrawals and benefit cuts.
Nancy LeaMond of AARP said “higher healthcare costs are making it harder for older Americans to afford the care they need.”
For a look at how Advantage premiums and $0 drug plans are changing, see our post on Medicare open enrollment 2027 premiums.
KFF Health News also noted a proposed CMS rule that would require Medicare Advantage provider directories to be verified every 90 days, starting in 2028. It is only a proposal, so it does not help you this enrollment season. It does underline how often directories can be out of date today.
Medicare open enrollment checklist: 6 steps to review your plan
Juliette Cubanski, KFF’s Medicare policy director, described open enrollment as “an opportunity to evaluate the coverage they have and see if there might be better options.” Here is a practical way to use it. These steps are general guidance, not advice for your situation.
- Find your Annual Notice of Change. Your plan sends it each fall. It lists what is changing in premiums, deductibles, benefits and networks for 2027. Read it, even though it is long.
- Check the drug formulary. Confirm each of your medications is still covered, at what tier, and whether new rules such as prior authorization apply.
- Check your pharmacy network. A drug can cost more at an out-of-network or non-preferred pharmacy. Confirm your usual pharmacy still works with your plan.
- Check your doctors. If you are in Medicare Advantage, make sure your doctors, specialists and hospitals are in the plan’s network for 2027. Call their offices to confirm rather than relying only on the online directory.
- Compare total annual cost, not just the premium. Add the premium, deductible, copays and coinsurance you expect to pay, plus the drug-cap rules. A low premium can come with high costs when you use care.
- Use the Medicare Plan Finder and ask for help. The tool at medicare.gov lets you enter your drugs and pharmacy and compare plans. Free counseling is also available from your State Health Insurance Assistance Program (SHIP).
Common mistakes to avoid during Medicare open enrollment
Picking the lowest premium without looking at the drug list is the most common trap. Another is assuming that last year’s plan will behave the same way this year.
A third is waiting until the last week. Plan comparisons take time, and counselors get busy near the Dec. 7 deadline.
Another is forgetting to update the pharmacy and medication list you enter into comparison tools. If you started a new prescription this year, or your dose changed, the results you see may not reflect what you will really pay.
It also helps to ask a family member to look over your final choice. A second set of eyes can catch a missing doctor or a drug that moved to a higher tier.
Finally, be careful about who you talk to. Use official sources and counselors you contact yourself. Be wary of unsolicited calls or mailers promising big savings.
What to do this week
You have until Dec. 7, so there is time, but not unlimited time. Start by locating your Annual Notice of Change, then list your medications and doctors so you can compare plans quickly.
If your costs are likely to rise, or your plan is leaving your area, compare at least two alternatives before deciding. Our flu shot guide for adults is also worth a look while you are reviewing what your coverage pays for this fall.
Things we do not yet know: how the early end of the Part D premium subsidy will play out plan by plan, and exactly how the $90 payments will reach enrollees. Check your own plan’s notice and the official Medicare website for details that apply to you. For the underlying report, see the ABC News/AP story on the new Medicare season.
Stay tuned to USA One News for updates as more details emerge. This article is for general information only and is not medical, legal or financial advice.
