2027 Medicare Open Enrollment: Why a Lower Premium May Cost More Overall

A lower national average is not your plan's price

Medicare's annual open enrollment for 2027 coverage runs October 15 through December 7, 2026; changes generally take effect January 1. During this period, eligible people can review or change Medicare Advantage and Part D drug coverage, and can move between Medicare Advantage and Original Medicare under the applicable rules. The Medicare open-enrollment page explains the choices and deadline.

CMS projects the weighted average Medicare Advantage plan premium will decline from $14.37 a month in 2026 to $12.00 in 2027. It projects the average stand-alone Part D premium will move from $35.09 to $36.00. These are national estimates across plans and enrollees, not quotes for a person in a particular ZIP code. A zero-premium Medicare Advantage plan does not generally eliminate the Medicare Part B premium. CMS's September 28 release provides the dated figures.

The main question is whether a plan's total annual cost and access to care improve for you. A $5 monthly premium reduction saves $60 in a year. One higher specialist copay, a nonpreferred pharmacy, or a changed drug tier can erase that amount quickly. This guide gives you a repeatable comparison method using your doctors, prescriptions, likely services, and tolerance for a high-cost year.

Read the Annual Notice of Change first

If you are already in a Medicare Advantage or Part D plan, find its Annual Notice of Change, often called the ANOC. Plans send it each fall to describe next year's changes in coverage, costs, and other terms. Medicare says to contact the plan if the notice does not arrive. Read the sections on premiums, deductibles, copays, covered drugs, pharmacy network, provider network, and extra benefits. The official ANOC explanation describes what the notice contains.

Do not assume the plan you liked in 2026 will remain identical in 2027. Even if the name stays the same, a deductible or formulary can change. Make a short list of every change that affects your own care. If the notice says a doctor or drug may change status, verify it through the plan's current 2027 directory or formulary and directly with the office or pharmacy.

Put your current plan into the comparison alongside at least two realistic alternatives. The question is not whether the market's average premium went down; it is whether the available alternatives in your county provide a better fit. Medicare's Plan Finder accepts your ZIP code and can use your saved drugs and pharmacies to estimate costs.

Build an annual-cost worksheet

Add twelve months of premiums to your estimated medical and prescription spending. Include the Part B premium, any Medicare Advantage plan premium, any stand-alone Part D premium, and any Medigap premium if you have or are considering one. Then estimate deductibles, primary-care and specialist visits, hospital services, therapies, and drugs. If you are comparing alternatives with different coverage arrangements, put the *whole package* on each side of the worksheet.

For a simple illustration, Plan A might charge $0 in additional plan premium but produce $1,900 in expected copays and covered-drug costs. Plan B might charge $35 a month, or $420 annually, while producing $1,300 in expected copays and drug costs. Ignoring the common Part B premium, Plan B's illustration totals $1,720, versus $1,900 for Plan A. The higher-premium plan is $180 cheaper under those fictional care assumptions. If your care pattern changes, the result may change.

Use a second worksheet for high-use care. Ask what you might owe after a hospital stay, a series of specialist visits, or a more expensive drug. Medicare Advantage plans have an annual out-of-pocket limit for covered Medicare services, although premiums and some other costs are separate. Original Medicare generally has no annual out-of-pocket limit unless you have supplemental coverage. These different risk structures deserve as much attention as the expected-cost estimate.

Compare doctors, hospitals, and care rules

With Original Medicare, you generally can use any doctor or hospital in the United States that takes Medicare, subject to the relevant rules. A Medicare Advantage plan may require in-network providers for nonemergency care, referrals, or prior authorization for some services. Some plans permit out-of-network care at higher cost. The Medicare comparison page sets out these differences.

Check your primary doctor, specialists, hospital, and any dialysis, therapy, imaging, or other facility you use regularly. Search the exact 2027 plan; a provider's participation in the insurer's other products does not prove participation in yours. Then call the provider's billing office to confirm. Keep a note of the date and the plan name. Direct confirmation is especially valuable when a treatment is already scheduled.

Care management can matter as much as the network. Look for prior-authorization rules, referral requirements, and coverage conditions for the services you are likely to need. If you travel or live in more than one place, assess nonemergency access away from home. Emergency coverage and routine care are different questions. A low premium is less valuable if your preferred care is unavailable or administratively difficult to obtain.

Price every prescription in the right pharmacy

List each drug's name, strength, dosage, and frequency. In Plan Finder, enter the exact drugs and the pharmacies you would use. Compare the total projected yearly drug cost, not just the Part D premium. Check the plan's formulary tier, deductible, copay or coinsurance, preferred-pharmacy arrangements, quantity limits, prior authorization, and step therapy. If a medicine is not covered, ask your prescriber and the plan about clinically appropriate alternatives or an exception process.

For 2027, Medicare says the Part D out-of-pocket threshold for covered drugs is $2,400, and the maximum allowed drug-plan deductible is $700; a particular plan can have a lower deductible. The details of what counts toward the threshold and how costs are calculated matter, so use Medicare's current Part D cost guidance and the plan estimate. A cap on covered Part D drug spending is not a cap on premiums or every type of health expense.

The Medicare Prescription Payment Plan may help spread covered-drug out-of-pocket costs across the calendar year. It changes timing, not necessarily the total price of a drug. If a large January pharmacy bill would be difficult to pay, ask your plan about this option and compare it with any low-income assistance you might qualify for. Do not assume it will make a high-cost plan the cheapest plan overall.

Compare the two coverage paths honestly

Original Medicare and Medicare Advantage organize costs and access differently. With Original Medicare, you may choose a separate Part D drug plan and may be able to buy a Medigap policy to help cover your share of approved costs. With Medicare Advantage, most plans include drug coverage, have plan networks and an annual limit on covered Medicare service costs, and may offer extra benefits. You cannot use Medigap to cover Medicare Advantage out-of-pocket costs. The value of either path depends on your doctors, drugs, finances, location, and coverage already available through an employer or retiree plan.

Be careful if you plan to leave Medicare Advantage for Original Medicare and expect to buy Medigap. Medigap purchase rights can be limited outside specific guaranteed-issue situations, and underwriting rules can vary by state. Review the rights that apply to your age, state, and enrollment history before dropping current coverage. Contact your State Health Insurance Assistance Program, or SHIP, for free, unbiased counseling if the transition is complicated.

Also check whether changing a Medicare plan could affect employer, union, or retiree coverage. Some arrangements have special rules and may be difficult to regain after dropping them. Ask the benefits administrator before enrolling in a different plan. A comparison that ignores valuable existing secondary coverage can give the wrong answer.

Put extra benefits in context

Dental, vision, hearing, fitness, transportation, and other supplemental benefits can be useful, but read the dollar limits, eligible services, provider rules, and frequency limits. A benefit advertised as “dental” may cover only a subset of services or impose a yearly allowance. Count the value you are likely to use, not the largest advertised benefit. If you would not otherwise buy a service, its dollar value to your budget may be lower than the brochure suggests.

An extra benefit also should not outweigh poor access to essential medical care or an expensive prescription. Put must-have services and drugs at the top of the worksheet. Only then use secondary benefits as a tiebreaker. This is the same discipline as comparing any insurance plan: coverage for your likely needs and protection in a bad year come before promotional features.

Finish the review before December 7

Use Medicare Plan Finder to save or print the estimates for your current plan and alternatives. Recheck your drugs, pharmacy, and providers. Read the plan's official materials, particularly for a service with a high potential cost. If you choose a change, submit the enrollment request before the December 7 deadline and save confirmation. Medicare says the plan must receive the request by then for the annual open-enrollment change.

If you decide to keep your current coverage, you generally do not need to reenroll, but still verify any 2027 changes. Confirm your January card, premium payment, and first pharmacy claim. If the plan's actual handling differs from what you expected, contact the plan promptly and ask about an appeal or coverage determination where applicable. Keep your notes and dated plan materials.

People with limited income and resources may qualify for Medicare Savings Programs or Extra Help with drug costs. Those programs can alter which plan is affordable, so check eligibility instead of ruling them out from a rough income impression. Medicare and your state SHIP can help you identify the right process.

A worked comparison for a frequent specialist visitor

Imagine a person who expects eight specialist visits in 2027 and takes two covered medicines. Plan C has no additional monthly premium, a $55 specialist copay, and projected drug costs of $900. Ignoring any other medical costs, that scenario adds to $1,340: eight times $55, plus $900. Plan D has a $25 monthly premium, a $25 specialist copay, and projected drug costs of $700. Its comparable total is $1,200: $300 in premiums, $200 in visit copays, and $700 for drugs. Plan D wins by $140 under those fictional assumptions even though its premium is higher.

Now imagine the person changes to a specialist who is outside Plan D's network. The comparison can reverse, and it may be impossible to estimate the cost simply by multiplying the listed copay. That is why a plan comparison should attach a provider check and drug list to the dollars. Ask each plan about the exact services and confirm that your doctors expect to participate in that plan next year. Save the response and review it again before a scheduled service.

If your health needs are uncertain, compare the most you could reasonably pay for covered, in-network care along with premiums. A plan with a slightly higher expected cost may still be attractive if its covered-care out-of-pocket limit is lower or its network better supports an unexpected illness. Conversely, a reassuring annual limit does not cover services the plan excludes or all out-of-network spending. Read the plan's Evidence of Coverage for the details.

Common questions

Does a $0 Medicare Advantage premium mean free Medicare?

No. You generally still pay the Part B premium and may owe deductibles, copays, coinsurance, drug costs, or charges for noncovered services. Compare the full annual amount and the high-use scenario.

Is the $12 national average my 2027 premium?

No. It is CMS's projected weighted average across Medicare Advantage plans. The plans and prices available to you depend on location and eligibility. Use your ZIP code and details in Medicare Plan Finder.

Can I change plans after December 7?

Different enrollment periods and special circumstances may allow some changes later, but the annual open-enrollment period has a December 7 deadline. Do not plan on a later opportunity without confirming that you qualify for it.

What is the quickest useful comparison?

Enter your drugs and pharmacies in Plan Finder, check your doctors in each plan's directory and with the offices, then compare annual premium plus expected care costs. Finally, check the highest plausible covered-care cost you could face.

Source note: Dates and plan-choice rules are from Medicare. National premium projections are from CMS's September 28, 2026 release. Drug thresholds and coverage-path differences come from Medicare's Part D cost guide and coverage comparison. Fictional plan examples illustrate the method, not 2027 quotes.