Quick answer
Medicare open enrollment runs from October 15 to December 7, 2026, and any change you make starts January 1, 2027. Before you let your plan renew, check that your drugs are still covered at a price you can live with, that your doctors are still in network, and what your total costs will be. For 2027, the Part D out-of-pocket cap rises to $2,400, and some stand-alone drug plan premiums may jump because a federal premium subsidy is ending.
Key takeaways
- Open enrollment is October 15 to December 7, 2026. Changes take effect January 1, 2027.
- The most you’ll pay out of pocket for covered Part D drugs rises from $2,100 to $2,400 in 2027, and the maximum drug deductible rises to $700.
- A temporary program that held down stand-alone drug plan premiums ends after 2026, so compare drug plans carefully.
- Medicare’s negotiated prices for 15 more drugs, including Ozempic and Wegovy, start January 1, 2027.
- Free, unbiased help is available from your State Health Insurance Assistance Program (SHIP).
On this page
Key dates
- By September 30: Your Medicare Advantage or drug plan sends its Annual Notice of Change, listing what’s different for 2027.
- Early October: 2027 plans show up in Medicare’s online Plan Finder, and new star ratings come out.
- October 15 to December 7, 2026: Open enrollment. You can switch Medicare Advantage plans, switch drug plans, or move between Original Medicare and Medicare Advantage. See Medicare Advantage vs. Medigap.
- January 1, 2027: Your new coverage starts.
- January 1 to March 31, 2027: If you’re in a Medicare Advantage plan, you get one more chance to switch plans or go back to Original Medicare.
If you’re new to Medicare, your enrollment windows work differently; see who is eligible for Medicare.
What’s changing for 2027
| 2026 | 2027 | |
|---|---|---|
| Part D out-of-pocket cap | $2,100 | $2,400 |
| Highest Part D deductible allowed | $615 | $700 |
| Medicare Advantage in-network out-of-pocket limit | $9,250 | $9,850 |
| Medicare Advantage combined in- and out-of-network limit | $13,900 | $14,800 |
| Standard Part B premium | $202.90 | About $209.50 (projected) |
Drug plan premiums may rise more than usual
For 2025 and 2026, CMS ran a temporary program that held down premiums for stand-alone Part D drug plans. It ends after 2026. KFF warns that some people in stand-alone drug plans could see larger premium increases for 2027. If you have Original Medicare and a separate drug plan, don’t assume last year’s plan is still the best deal.
Lower prices for 15 more drugs
Starting January 1, 2027, Medicare’s negotiated prices take effect for 15 drugs: Austedo, Breo Ellipta, Calquence, Ibrance, Janumet, Linzess, Ofev, Otezla, Ozempic, Rybelsus and Wegovy (one listing), Pomalyst, Tradjenta, Trelegy Ellipta, Vraylar, Xifaxan and Xtandi. What you save depends on your plan’s cost sharing, so check the price in Plan Finder.
What to check before you renew
Your drugs
Look up every prescription on the plan’s formulary for 2027. Check the tier, whether you’ll need prior authorization or step therapy, and the price at your pharmacy. Plans change their drug lists every year. Insulin stays capped at $35 a month in Medicare drug coverage; see does health insurance cover insulin.
Your doctors and hospitals
If you’re in a Medicare Advantage plan, confirm your doctors, specialists and hospital are in the 2027 network. Networks can shrink, and some plans are ending altogether.
Your total costs
Add up the premium, the deductible, your usual copays and the out-of-pocket limit. A $0 premium plan isn’t cheaper if your drugs cost more there.
Extra benefits
Dental, vision, hearing and other extras in Medicare Advantage plans change often. Check what’s actually covered and how much, not just whether a benefit is listed.
Prior authorization
Almost everyone in Medicare Advantage is in a plan that requires approval before some services. In six states (Arizona, New Jersey, Ohio, Oklahoma, Texas and Washington), Original Medicare also started reviewing a short list of services in advance in 2026 under a pilot program: your provider gets prior approval, or the claim is reviewed before it’s paid.
Star ratings
Plans are rated from 1 to 5 stars. You can switch into a 5-star plan once between December 8 and November 30 of the following year, outside of open enrollment.
Medicare Advantage or Original Medicare?
Open enrollment is also your chance to switch between the two. Medicare Advantage plans often have lower premiums and extra benefits, but use networks and prior authorization. Original Medicare lets you see any doctor who takes Medicare, and a Medigap policy can cover most of what’s left.
Be careful before leaving Medigap or switching from Medicare Advantage back to Original Medicare. In most states, Medigap insurers can turn you down or charge more because of your health once your first enrollment window has passed. A few states have extra protections. Minnesota, for example, now lets people 65 to 70 buy a Medigap policy without health questions during Medicare open enrollment. Each person can use it once, and insurers can charge more for it.
Get help paying
- Extra Help pays most drug costs for people with limited income and savings. In 2026, the limits are $23,940 in yearly income and $18,090 in resources for one person, or $32,460 and $36,100 for a married couple. With Extra Help, 2027 copays are no more than $5.80 for generics and $14.40 for brand-name drugs.
- Medicare Savings Programs through your state can pay your Part B premium.
- The Medicare Prescription Payment Plan spreads your drug costs into monthly payments. It doesn’t lower costs, and if you’re in it, it renews automatically unless you change plans or opt out.
- The GLP-1 Bridge. If you get Wegovy, Zepbound or Foundayo for weight loss through Medicare’s $50-a-month program, it continues through December 31, 2027. See will health insurance pay for weight loss programs.
Where to get unbiased help
Your State Health Insurance Assistance Program (SHIP) gives free one-on-one counseling and doesn’t sell plans. You can also compare plans yourself on Medicare.gov’s Plan Finder or call 1-800-MEDICARE. Be wary of anyone who calls you out of the blue about your Medicare plan, and never give your Medicare number to a caller you don’t know.
For more on coverage after 65, see health insurance for the elderly. If your spouse is under 65 and on your job-based plan, see what happens to my wife’s health insurance when I go on Medicare.
Have a family member under 65 who needs coverage? Compare individual plans by ZIP code.
Frequently asked questions
When is Medicare open enrollment for 2027?
October 15 to December 7, 2026. Changes you make take effect January 1, 2027.
What happens if I don’t do anything during open enrollment?
In most cases, your current plan renews automatically with its 2027 benefits and costs. If your plan is ending, you’ll get a notice and a special enrollment period to pick a new one.
What is the Part D out-of-pocket maximum for 2027?
$2,400. Once your out-of-pocket spending on covered drugs reaches that amount, you pay nothing more for covered drugs for the rest of the year.
Can I change Medicare Advantage plans after December 7?
Yes, once. From January 1 to March 31, people in Medicare Advantage can switch to another Advantage plan or go back to Original Medicare.
Sources
- Medicare.gov: How much does Medicare drug coverage cost?
- CMS: Medicare Part D 2027 national average monthly bid amount information
- CMS: Selected drugs and negotiated prices
- Medicare.gov: Help with drug costs (Extra Help)
- Medicare.gov: Special Enrollment Periods
- SHIP: State Health Insurance Assistance Programs
This article is general information, not insurance advice, and it isn’t affiliated with Medicare or any plan. Plan benefits and costs vary by area. Last reviewed September 2026.