If you’re on Medicare, have a family member who is, or will be turning 65 in the coming year, now is the time to review your coverage. The annual Medicare Open Enrollment Period runs from October 15 through December 7, 2026, for coverage beginning January 1, 2027.
Don’t assume your current plan will remain the best choice next year. Premiums, prescription coverage, provider networks and other benefits can change, and some plans are being discontinued altogether. According to a recent KFF analysis, more than 4 million beneficiaries will have their Medicare Advantage or standalone prescription drug plans discontinued for 2027. Changes in federal support for prescription drug plans, along with rising healthcare and drug costs, are prompting insurers to reassess their offerings.
Take time now to read the mail from Medicare and your insurance company, compare your options and make any necessary changes. Starting early gives you time to find coverage that fits your needs rather than rushing to meet the December 7 deadline.
MEDICARE COVERAGE: TWO MAIN OPTIONS
There are two primary ways to receive Medicare coverage: Original Medicare or Medicare Advantage.
Original Medicare is the traditional government-administered program. It includes Part A (hospital insurance) and Part B (medical insurance). You can also purchase supplemental Medigap insurance to help cover certain out-of-pocket costs and a separate Part D plan for prescription drugs. These supplemental plans have their own premiums and coverage terms. Original Medicare and Medigap generally do not cover routine dental care, routine vision care, hearing aids or long-term custodial care.
An important consideration: If you’re 65 or older and enroll in Part B, you generally have a six-month Medigap enrollment period during which you can buy a policy without medical underwriting. After that, you may face underwriting or have fewer options unless you qualify for certain protections.
Medicare Advantage (Part C) is offered by private insurance companies as an alternative to Original Medicare. These plans cover Part A and Part B services and often include prescription drug coverage, along with additional benefits such as dental, vision and hearing services.
The trade-off is that many plans use provider networks and may require referrals or prior authorization for certain services. Your preferred doctors and hospitals may not participate in every plan. Premiums, out-of-pocket costs, prescription coverage, provider networks and other benefits can change annually.
Neither option is best for everyone. Your healthcare needs, budget, prescriptions and preferred providers should guide your decision.
WHAT SHOULD YOU REVIEW FOR 2027?
If you have Original Medicare: Pay particular attention to your Part D prescription drug plan. Plans can change premiums, deductibles, covered medications and preferred pharmacies. Check that your prescriptions will still be covered and compare your expected costs under other plans. A lower monthly premium doesn’t necessarily mean lower overall costs.
Also check the updated Medicare Part B premium and deductible for 2027. Higher-income beneficiaries may pay an additional income-related monthly adjustment amount (IRMAA).
If you have Medicare Advantage: By now, you should have received an Annual Notice of Change explaining changes to your coverage for 2027. Review it along with your plan’s Evidence of Coverage and check:
- Doctors and hospitals: Will your preferred providers remain in network?
- Prescriptions: Are your medications still covered, and will your costs change?
- Costs: Are premiums, deductibles, copayments or out-of-pocket limits changing?
- Benefits: Are services you rely on being reduced or eliminated?
- Plan availability: Will your plan still be offered in your area?
Don’t assume your plan will automatically remain the right fit. You don’t want to discover in January that your doctor is no longer in network or a medication costs significantly more than you expected.
CAN YOU CHANGE YOUR COVERAGE?
During the October 15–December 7 Open Enrollment Period, you can switch between Original Medicare and Medicare Advantage, change Medicare Advantage plans, or join, change or drop a Part D prescription drug plan, subject to the rules that apply to your coverage. Changes generally take effect January 1, 2027.
One important caution: If you switch from Medicare Advantage to Original Medicare, you are not automatically guaranteed the ability to buy a Medigap policy. Depending on your circumstances and applicable protections, you may have to pass medical underwriting or could be denied coverage. Understand your Medigap options before making the switch.
If you’re enrolled in Medicare Advantage, there is also a separate Medicare Advantage Open Enrollment Period from January 1 through March 31, 2027. During that period, you can switch to another Medicare Advantage plan or return to Original Medicare and join a separate Part D plan. However, don’t rely on this second opportunity as a reason to postpone your review.
DON’T WAIT UNTIL DECEMBER 7
Even if you’re happy with your current coverage, take the time to make sure it will still meet your needs in 2027.
Start by reading the mail from Medicare and your insurance company. Check your doctors, prescriptions, benefits and anticipated costs. If your plan is changing or no longer meets your needs, compare alternatives while you still have time to make an informed decision.
You can compare plans at Medicare.gov or call 1-800-MEDICARE (1-800-633-4227). Free, unbiased assistance is also available through your State Health Insurance Assistance Program (SHIP) at shiphelp.org.
Don’t let December 7 sneak up on you. Review your coverage early, make an informed decision, and head into 2027 with confidence that your Medicare plan is right for you.
