Medicare · Annual Enrollment

Medicare Changes for 2027: What's Different, and What to Check Before December 7

Every fall, Medicare resets. Some of the 2027 numbers are already locked in, some are still projections, and one of them — your prescription costs — is moving more than the rest. Here's the plain-language version.

Viva Insurance Group · North Miami, FL · Updated for the October 15 – December 7, 2026 enrollment period

If you have Medicare, you get a version of the same letter every September. It is easy to set aside. But the changes it describes take effect January 1, and the only window to do anything about them runs October 15 through December 7, 2026.

So let's go through what actually changes in 2027 — and, just as important, what nobody knows yet.

The short version

• Prescription costs are the big story. The most a Part D plan can charge as a deductible rises to $700, and the annual out-of-pocket cap moves to $2,400.
• Part B is going up, but the official number isn't out. What you've seen published so far is a projection.
• Your specific plan is changing too. Drug lists, doctor networks, and extra benefits get rewritten every year, and some plans leave certain counties entirely.

1. Part D: a higher deductible, and a higher ceiling

This is the change that will show up in real money for people who take regular medications.

Two things to understand about those numbers.

The deductible is a ceiling, not a price. $700 is the most a plan is allowed to charge. Plenty of plans charge less, and some charge nothing at all on certain drug tiers. It is a limit on what can happen to you, not a bill you're guaranteed to get.

The out-of-pocket cap is a real stop sign. Once your covered prescription spending hits $2,400 in 2027, you pay $0 for covered drugs for the rest of the calendar year. That protection exists and it is not going away. What changed is where the line sits — $300 higher than in 2026.

For most people, that difference is modest. For someone on a specialty medication who reaches the cap in February, it means paying up to $300 more before the ceiling kicks in. If that's you, it's worth an actual comparison this year rather than an automatic renewal.

The coverage gap — what people used to call the "donut hole" — is gone. Part D now runs in three phases: deductible, initial coverage, then catastrophic, where covered drugs cost you nothing.

Also unchanged for 2027: insulin covered by your plan costs no more than $35 for a month's supply (or 25% of the negotiated price, whichever is lower), and adult vaccines recommended by federal guidelines are $0 under Part D. The Medicare Prescription Payment Plan still lets you spread your out-of-pocket drug costs across the year in monthly installments. It does not lower what you owe — it only changes when you pay it.

2. Part B: expect an increase, but wait for the official number

Here is where we want to be careful with you, because a lot of what's circulating online right now is being presented as fact when it isn't.

The 2027 Part B premium has not been officially announced. CMS publishes the real figure in the fall. Until then, the numbers you see are projections from the Medicare Trustees Report.

Two notes worth knowing. If your income is above certain thresholds, you pay an income-related surcharge on top of the standard Part B premium — and your 2027 surcharge is based on the tax return you filed for 2025. If your income dropped since then because you retired, sold a business, or lost a spouse, you can ask Social Security to reconsider. Most people never do.

Second: the Part B premium usually comes out of your Social Security check. When the premium rises faster than the cost-of-living adjustment, your deposit can shrink even though your benefit went up. That surprises people every January.

3. Part D premiums: the base is rising about 6%

The national base beneficiary premium — the reference figure Medicare uses in its calculations — is $41.33 for 2027, roughly 6% higher than 2026.

That is not what you'll pay. Actual Part D premiums vary widely by plan and by county. But the base matters for one specific thing: if you owe a Part D late enrollment penalty, it's calculated off that number, so the penalty rises with it. More on that in our turning-65 guides.

4. The change most people miss: your own plan

Everything above is program-wide. But the change most likely to affect you personally isn't in the national numbers — it's in your individual plan, and it happens quietly.

Every year, plans are permitted to revise:

• The drug list (formulary). A medication covered in 2026 can move to a higher cost tier in 2027, require prior authorization, or come off the list.
• The provider network. Doctors and hospitals join and leave. Your cardiologist being in-network last year does not carry over.
• Extra benefits. Dental, vision, hearing, over-the-counter and transportation allowances get adjusted — sometimes up, sometimes down.
• Copays and the plan's own out-of-pocket maximum.

And occasionally a plan stops being offered in a county altogether. If that happens to you, you'll receive a separate non-renewal notice, and it opens a special enrollment window so you're not left without coverage. That letter is time-sensitive. If one arrives, don't file it — call someone.

What to actually do between now and December 7

1. Find the letter. Your Annual Notice of Change arrives by late September. It's the document that spells out what your plan is doing differently in 2027.
2. Write down your medications. Exact names, doses, and how often. This is the single step that changes the answer most often.
3. List the doctors you actually see. Primary care, specialists, and the hospital you'd want to use.
4. Compare on total cost, not premium. A lower premium with a drug you take on a high tier can cost more over twelve months than a higher-premium plan that covers it well.
5. Decide before December 7. After that date, your options narrow considerably until the following fall.

After December 7, your ability to change coverage becomes limited, and whether any option remains open to you depends on your situation. If you think you've missed the deadline, ask — don't assume.

A word about doing nothing

Staying put is a legitimate choice. Some years, the plan you have is still the right plan and the honest answer is "don't change anything." We tell people that regularly.

But staying put should be a decision you made, not a deadline you missed. Those are different things, and only one of them tends to end well.

Related: Part D in 2027 · Your Annual Notice of Change · All resources