To review your Medicare coverage before December 7, start by reading your plan’s Annual Notice of Change for 2027. Then check three things: whether your doctors and pharmacies are still in the network, how each of your prescriptions is covered, and what your total yearly cost would be in a healthy year and a bad one. Compare at least two alternatives on Medicare.gov’s plan finder, then switch or stay by December 7, 2026. Changes take effect January 1.
Key takeaways
- Medicare open enrollment runs October 15 to December 7, 2026, for coverage starting January 1, 2027 (Medicare & You 2027).
- In 2027, out-of-pocket costs for covered Part D drugs are capped at $2,400, up from $2,100 in 2026. The maximum standard drug deductible rises to $700 (CMS, as of October 2026).
- In the example, a $0-premium Medicare Advantage plan is $2,528.96 cheaper in a low-use year. Original Medicare with Medigap Plan G is $3,621.04 cheaper in a high-use year.
- If you leave Medigap for Medicare Advantage, you may not be able to buy Medigap again later without health questions. Make that move deliberately.
The dates that matter
- October 15 to December 7, 2026: Open enrollment. You can join, switch or drop a Medicare Advantage plan or a drug plan, or return to Original Medicare. Medigap isn’t tied to this window. You can apply at other times of year, subject to the rules described below.
- January 1, 2027: New coverage starts. If you made no change, your current plan’s 2027 costs and benefits take effect.
- January 1 to March 31, 2027: The Medicare Advantage Open Enrollment Period. If you are in a Medicare Advantage plan, you can switch to a different one or go back to Original Medicare and join a drug plan. You can’t use this window to move from Original Medicare into Medicare Advantage, or to change stand-alone drug plans (Medicare & You 2027).
Step 1: Read the Annual Notice of Change
Medicare Advantage and drug plans must send an Annual Notice of Change by September 30. It lists changes to premiums, deductibles, copays, provider networks and service area for the coming year. The Evidence of Coverage, which has the full plan rules, follows by October 15 (Medicare & You 2027). If you didn’t get either one, call the plan.
Read it with a highlighter and look for these items:
- Premium and deductibles. Has the monthly premium, medical deductible or drug deductible changed?
- Drug list (formulary). Is each of your drugs still covered? Has any moved to a higher tier, or does it now need prior authorization or step therapy?
- Network. Are your doctors, hospital and preferred pharmacy still in network for 2027? Confirm with each office as well.
- Out-of-pocket limit. For Medicare Advantage, has the yearly in-network maximum gone up?
- Extra benefits. Dental, vision, hearing or fitness allowances are often trimmed from year to year. Check the dollar limits, not just whether the benefit is still listed.
Step 2: Understand the two paths
Most decisions come down to Original Medicare, usually with a Medigap policy and a separate drug plan, or a Medicare Advantage plan that bundles everything. Each path trades something away.
| Feature | Original Medicare + Medigap + Part D | Medicare Advantage (Part C) |
|---|---|---|
| Doctors and hospitals | Any provider in the U.S. that takes Medicare | Usually a network and service area, except in emergencies |
| Referrals and prior approval | In most cases, no referral to see a specialist and no prior approval | May need referrals and prior authorization |
| Premiums | Part B, plus Medigap, plus drug plan | Part B, plus the plan premium (some are $0); drug coverage usually included |
| Yearly cost cap on medical care | None without supplemental coverage; Medigap fills most gaps | Every plan has a yearly in-network limit, which varies by plan |
| Drug costs | Separate Part D plan; $2,400 cap in 2027 | Usually built in; $2,400 cap in 2027 |
| Extra benefits | Original Medicare doesn’t cover most routine dental, vision or hearing | Many plans add some dental, vision and hearing benefits |
| Travel outside the U.S. | Generally not covered by Medicare; some Medigap plans pay part of emergency care abroad | Generally not covered; some plans offer an emergency benefit |
| Switching later | Can move to Medicare Advantage at the next open enrollment | Can return to Original Medicare, but buying Medigap may require health questions |
What’s changing in 2027
- Drug cost cap goes up. The Part D out-of-pocket threshold rises from $2,100 to $2,400. Once you reach it, you pay $0 for covered drugs for the rest of the year. The maximum standard deductible rises from $615 to $700 (CMS CY 2027 Rate Announcement, April 6, 2026). Plans may charge less.
- Drug premium support ends. CMS is ending the temporary Part D premium stabilization demonstration after 2026. The national base beneficiary premium for 2027 is $41.33 a month (CMS, July 28, 2026). Stand-alone drug plan premiums vary widely around that figure, so compare yours.
- More negotiated drug prices. Negotiated prices for 15 more Part D drugs take effect January 1, 2027. Ask your plan how they affect your copay.
- Part B premium. As of October 19, 2026, CMS had not announced the 2027 Part B premium and deductible. The 2026 figures are $202.90 a month and $283 a year (CMS). If you have Social Security, the premium is usually deducted from your benefit, so watch your 2027 benefit letter.
Insulin stays capped at $35 for a one-month supply of each covered insulin, with no deductible (Medicare & You 2027). The Medicare Prescription Payment Plan, which lets you spread drug costs over the year, renews automatically if you stay in the same plan. It doesn’t lower your costs, only spreads them out.
Worked example: a healthy year vs. a bad year
One person compares two paths for 2027. The Part B premium uses the 2026 standard amount, because the 2027 figure isn’t out yet. It is the same on both paths. The Medigap premium, the Medicare Advantage plan’s costs and the drug spending are illustrative. Premiums for the same Medigap plan vary a lot by state, age and insurer.
- Path A: Original Medicare + Medigap Plan G at $175 a month + a drug plan at $41.33 a month (the 2027 national base premium, used as a stand-in). Plan G covers your cost-sharing except the Part B deductible.
- Path B: A $0-premium Medicare Advantage plan with drug coverage and a $6,500 in-network out-of-pocket limit.
| Cost item | A: Low use | B: Low use | A: High use | B: High use |
|---|---|---|---|---|
| Part B premium (12 × $202.90) | $2,434.80 | $2,434.80 | $2,434.80 | $2,434.80 |
| Medigap or plan premium | $2,100.00 | $0.00 | $2,100.00 | $0.00 |
| Separate drug plan premium | $495.96 | Included | $495.96 | Included |
| Medical cost-sharing | $283.00 | $350.00 | $283.00 | $6,500.00 |
| Drug costs | $400.00 | $400.00 | $2,400.00 | $2,400.00 |
| Total for the year | $5,713.76 | $3,184.80 | $7,713.76 | $11,334.80 |
In a healthy year, the Medicare Advantage plan saves $2,528.96. In a year with a hospital stay, it costs $3,621.04 more, because you pay up to its $6,500 limit while Plan G leaves you with only the Part B deductible. The paths cost the same when the Medicare Advantage plan’s medical cost-sharing reaches $2,878.96. That is the extra you pay each year on Path A for Medigap, the separate drug plan and the Part B deductible.
The bigger question is what you can afford in a bad year and whether you can switch back later. Medigap costs more every year, but it makes your medical costs predictable. Medicare Advantage is cheaper while you are healthy, but you carry more risk. Write down the plan’s out-of-pocket limit and make sure you could cover it from savings. The same budgeting habits in a budget that works apply on a fixed income.
Step 3: Compare on Medicare.gov
Enter every prescription, with dose and quantity, and your pharmacies into the Medicare.gov plan finder. It estimates yearly drug costs plan by plan, so compare those totals, not just premiums. Then call the plans you are considering and confirm your doctors. Free, unbiased help is available from your State Health Insurance Assistance Program (SHIP).
If money is tight, ask about Extra Help with drug costs and Medicare Savings Programs, which can help pay Part B premiums. Medical bills you already owe can sometimes be reduced. See how to negotiate a lower bill.
When switching is a bad idea
- Dropping Medigap for a $0-premium plan. You get your best chance to buy Medigap in the 6 months after you are 65 and first have Part B. After that, outside special situations, you may not be able to buy a policy or it may cost more. If you leave Medigap to try Medicare Advantage for the first time, a 12-month trial right may let you return (Medicare & You 2027). Some states give extra rights, so check with your state insurance department.
- Your doctors aren’t in the new network. A lower premium doesn’t help if you would need to change specialists in the middle of treatment.
- You travel or split the year between states. Plans with local networks may cover only emergency and urgent care away from home.
- You’re switching for extra benefits alone. A dental or grocery allowance worth a few hundred dollars isn’t worth a higher out-of-pocket limit or the loss of your doctors.
- You’re dropping drug coverage. Going without creditable drug coverage can trigger a permanent Part D late enrollment penalty if you sign up later.
Staying put is fine if the notice shows no meaningful changes and your plan still covers your drugs and doctors at a reasonable total cost. If health costs are crowding out other goals, such as paying off a mortgage before or during retirement, a predictable Medigap path can make planning easier, even though it costs more in healthy years.
FAQ
What happens if I miss December 7?
Your current coverage continues into 2027 with its new costs and benefits. If you are in Medicare Advantage, you get one more chance from January 1 to March 31. Otherwise, you generally need a Special Enrollment Period, for example after a move.
Does the $2,400 drug cap include premiums?
No. The cap counts what you pay for covered Part D drugs, such as deductibles, copays and coinsurance. Payments made for you by programs like Extra Help also count. Monthly plan premiums are separate and keep going after you reach the cap.
Can I buy Medigap if I’m in a Medicare Advantage plan?
No one may sell you a Medigap policy while you are in Medicare Advantage unless you are switching back to Original Medicare. When you do switch back, you may face health questions or higher prices unless you have a guaranteed right to buy, such as a trial right.
When will the 2027 Part B premium be announced?
CMS usually announces it in the fall. As of October 19, 2026, it had not. The 2026 standard premium is $202.90 a month, and people with higher incomes pay more.
Sources
- CMS, Medicare & You 2027 (official handbook), accessed Oct 2026
- Medicare.gov, Your Yearly Medicare Review: Open Enrollment October 15 – December 7, accessed Oct 2026
- CMS, Announcement of Calendar Year 2027 Medicare Advantage Capitation Rates and Part C and Part D Payment Policies (Apr 6, 2026), accessed Oct 2026
- CMS, Medicare Part D 2027 National Average Monthly Bid Amount Information (Jul 28, 2026), accessed Oct 2026
- CMS, 2026 Medicare Parts A & B Premiums and Deductibles, accessed Oct 2026
This article is general education, not individualized financial, tax or legal advice.