Medicare Open Enrollment Begins October 15: What You Need to Know For 2027
Medicare Open Enrollment Begins October 15: What You Need to Know for 2027
Every year, from October 15 through December 7, people already enrolled in Medicare have an opportunity to review and make changes to their coverage for the coming year. Changes made during this period generally take effect January 1, 2027.
Even if you were happy with your Medicare coverage this year, it’s worth taking another look. Plans change, prescription drug costs change, provider networks change—and your own health needs may have changed too. Simply allowing last year’s choices to roll over may not always be the best approach.
How to Evaluate Your Medicare Options
One of the best places to start is with the Annual Notice of Change (ANOC) you receive from your current plan. This document outlines changes to premiums, deductibles, copays, drug formularies, provider networks and other benefits for the coming year.
Pay particular attention to the things you actually use. Are your doctors still in-network? Are your prescriptions still covered and on the same formulary tier? Has your preferred pharmacy’s status changed? What will your premiums, deductibles and other out-of-pocket costs look like in 2027?
You can also use Medicare’s Plan Finder to compare available plans, call 1-800-MEDICARE, or contact your local State Health Insurance Assistance Program (SHIP) for personalized assistance.
Birch Street clients also have access to Move Health, a resource that can help evaluate Medicare coverage options based on your individual needs. Move Health can help compare available plans and look at factors such as your prescriptions, doctors and expected health care needs.
Even if your health hasn’t changed, your plan may have.
We think of Medicare Open Enrollment as an annual checkup rather than something you only need to pay attention to when there’s a problem.
Who Can Make Changes—and When?
The October 15 through December 7 Medicare Open Enrollment Period is for people who are already enrolled in Medicare. During this period, you can generally switch Medicare Advantage plans, move between Medicare Advantage and Original Medicare, or join, drop or change a Medicare Part D prescription drug plan.
If you’re approaching age 65 and enrolling in Medicare for the first time, you have a separate Initial Enrollment Period. There are also Special Enrollment Periods that may apply in certain circumstances.
There’s another enrollment period worth knowing about as well. People already enrolled in a Medicare Advantage plan generally have a Medicare Advantage Open Enrollment Period from January 1 through March 31, during which they can make one permitted change.
What Can You Change During Medicare Open Enrollment?
During the October 15 through December 7 window, you can generally:
- Switch from one Medicare Advantage plan to another.
- Switch from Original Medicare to Medicare Advantage.
- Switch from Medicare Advantage back to Original Medicare.
- Join, drop or switch a Medicare Part D prescription drug plan if you’re eligible.
One important caution involves Medigap. The annual Medicare Open Enrollment Period does not automatically give you the right to buy or switch Medigap policies. Depending on where you live and your circumstances, medical underwriting may apply unless you are within your Medigap Open Enrollment Period or have a guaranteed-issue right.
This can be particularly important if you’re considering leaving Medicare Advantage for Original Medicare. Before dropping existing coverage, make sure you understand whether you’ll be able to obtain the supplemental coverage you want.
To make the review a little easier, you can also download our Medicare Open Enrollment Checklist. It walks through many of the key issues worth reviewing before making a change.
What’s Changing for 2027?
There are several Medicare changes worth paying attention to this year, particularly when it comes to prescription drug coverage.
The Part D deductible is increasing. For 2027, the standard Medicare Part D deductible increases to $700, up from $615 in 2026. Individual plans may have a lower deductible or no deductible.
The Part D out-of-pocket threshold is increasing to $2,400. In 2026, the annual out-of-pocket threshold for covered Part D prescription drugs is $2,100. For 2027, it increases to $2,400. Once you reach the applicable threshold, you generally pay no additional cost sharing for covered Part D drugs for the remainder of the year.
The redesigned Part D structure continues. The old coverage gap, often called the “donut hole,” has been eliminated, and beneficiaries continue to have no cost sharing for covered Part D drugs once they enter the catastrophic phase.
More negotiated prescription drug prices take effect. Medicare-negotiated prices for a second group of high-cost Part D medications take effect January 1, 2027. The new negotiated prices apply to 15 medications used to treat conditions including diabetes, cancer and asthma.
All of this makes reviewing your actual prescriptions particularly important. The plan that was the best fit in 2026 may not necessarily be the best fit in 2027.
Medicare Advantage plans can also change their premiums, provider networks, cost sharing and supplemental benefits from year to year. Rather than assuming a benefit you used this year will continue unchanged, check your plan’s 2027 documents carefully.
Don’t Forget About IRMAA
For higher-income Medicare beneficiaries, there’s another piece of the puzzle: the Income-Related Monthly Adjustment Amount, or IRMAA.
IRMAA can increase what you pay for Medicare Part B and Part D based on your income. Because Medicare generally looks back two years, your 2025 income generally determines whether you’ll be subject to IRMAA in 2027.
That makes Medicare costs part of a larger tax-planning conversation. Roth conversions, capital gains, large IRA withdrawals and other income decisions can potentially affect future Medicare premiums, so we like to consider Medicare costs alongside the tax consequences when doing retirement income planning.
As of September 2026, the final 2027 Part B premium, Part B deductible and 2027 IRMAA amounts have not yet been released. We’ll know more about those costs later this year.
What to Do Before December 7
Start by reviewing your Annual Notice of Change and comparing it with how you actually used your coverage this year. Make a current list of your medications, dosages, doctors and preferred pharmacies, and use those details when comparing plans.
Don’t look only at the monthly premium. A plan with a lower premium isn’t necessarily less expensive once you factor in deductibles, copays, coinsurance, prescription costs and provider networks.
Most importantly, don’t assume that because your current plan worked well in 2026, it will automatically be the best fit for 2027.
How Birch Street Can Help
Medicare decisions don’t happen in isolation. They can intersect with your retirement income, taxes, Roth conversions and other financial decisions.
At Birch Street, we can help you look at Medicare as part of your broader retirement plan, including how health care costs fit into your retirement income needs and how decisions such as Roth conversions, capital gains and retirement account withdrawals could affect future IRMAA surcharges.
We can also connect Birch Street clients with Move Health to help evaluate and compare Medicare coverage options based on their individual circumstances.
We don’t sell Medicare insurance or receive compensation for recommending a particular Medicare plan. Our role is to help you understand how Medicare fits with the rest of your financial life—and make sure these decisions aren’t being considered in a vacuum.
Medicare Open Enrollment runs from October 15 through December 7. Even if you ultimately decide to keep exactly what you have, taking the time to review your coverage can help make sure it still fits your needs for the year ahead.
