5 Medicare Changes and Updates to Review Before Choosing Your 2027 Coverage

Medicare Open Enrollment is underway, and if you haven't reviewed your coverage for 2027, now is a good time to do it.

There are several Medicare changes and updates worth knowing about before the new year. Some could affect how much you pay for prescriptions, while others involve Medicare Advantage premiums, provider networks, and benefits.

Even if you're happy with your current plan, it's worth checking what's changing before deciding whether to keep your coverage or explore other options.

Here are five things to review before Open Enrollment ends December 7.

1. Medicare Advantage Premiums Are Expected to Decrease in 2027

There's some encouraging news for Medicare Advantage members.

According to the Centers for Medicare & Medicaid Services (CMS), the national weighted average monthly Medicare Advantage premium is projected to decrease from $14.37 in 2026 to $12.00 in 2027. That's a reduction of approximately 16.5%.

However, that doesn't mean everyone's premium will decrease.

Medicare Advantage plans are offered by private insurance companies, and costs vary depending on where you live and which plan you choose. Your monthly premium is also only one part of what you might pay for healthcare.

A plan with a low or $0 premium may still have deductibles, copays, coinsurance, and other out-of-pocket costs.

What to check: Review your plan's Annual Notice of Change (ANOC) and compare your 2027 premium, deductibles, copays, and maximum out-of-pocket limit.

2. Medicare Prescription Drug Costs Are Changing in 2027

Prescription drug coverage is one of the more important areas to review this year.

For 2027, the annual out-of-pocket spending limit for covered Medicare Part D drugs will increase from $2,100 to $2,400. The maximum deductible allowed under Part D will also increase from $615 to $700, although some plans may have lower deductibles or none at all.

CMS also projects that the average monthly premium for standalone Part D plans will increase slightly, from $35.09 in 2026 to $36 in 2027.

For Medicare Advantage plans that include prescription drug coverage, the average Part D premium component is projected to decrease from $11.32 to $7 per month.

These are national averages, so your actual costs will depend on your plan and medications.

It's also important to remember that insurance companies can change their formularies, which are the lists of medications covered by their plans. A medication that was affordable under your 2026 plan could have different costs or coverage requirements in 2027.

What to check: Compare your prescriptions, dosages, pharmacy network, deductible, and estimated annual drug costs under your current plan and other available options.

You can review the updated prescription drug cost limits on Medicare.gov.

3. Your Doctors and Hospitals May Not Be in the Same Network

Another important thing to check is whether your doctors, specialists, and hospitals will still be covered by your plan in 2027.

Provider networks can change when insurance companies and healthcare systems negotiate new contracts. Sometimes those negotiations result in hospitals or physician groups leaving an insurance network.

One recent example involves Kettering Health in Ohio.

Kettering Health announced that its contract with Anthem Medicare Advantage, including Anthem MyCare, is scheduled to end January 1, 2027, unless a new agreement is reached.

For affected patients, this could mean losing in-network access to their current doctors and hospitals or paying more to continue receiving care.

We covered the announcement in more detail in our article, Kettering Health to Drop Anthem Medicare Advantage in 2027: What Happens Next?.

Provider networks aren't the only thing that can affect access to care. Certain services under Original Medicare are also subject to new prior authorization requirements in six states as part of the WISeR program. We covered those requirements in our article, New Medicare Changes in 2026: Prior Approval Required for These 17 Services.

Even if your insurance company isn't involved in a major contract announcement, it's still important to verify your providers for next year.

What to check: Contact both your Medicare Advantage plan and your healthcare providers to confirm their network participation for 2027. Don't assume that a doctor who was covered this year will automatically be covered next year.

4. Extra Medicare Advantage Benefits May Change

Many Medicare Advantage plans offer benefits beyond those covered by Original Medicare, including dental, vision, hearing, fitness programs, and certain other supplemental services.

CMS expects supplemental benefit offerings to remain generally stable in 2027. However, that doesn't mean every plan will offer exactly the same benefits as it did in 2026.

Your plan may change how much it covers for dental services, which hearing aids are included, or the amount available for certain allowances.

It's also worth reviewing the details rather than simply checking whether a benefit is advertised.

For example, two plans might both include dental coverage, but one could have a lower annual benefit limit or a smaller network of participating dentists.

Some benefits may also have eligibility requirements or restrictions on how they can be used.

What to check: Review the specific benefits you use, their coverage limits, provider restrictions, and any eligibility requirements for 2027. Compare what each plan actually covers, not just the benefits listed in its advertising.

5. Medicare's 2027 Star Ratings Are Available

Medicare has released its updated Star Ratings for 2027, giving beneficiaries another way to compare available plans.

These ratings help measure the quality and performance of Medicare Advantage and Part D prescription drug plans.

Plans are rated on a scale of one to five stars, with five stars representing the highest performance. Ratings consider factors such as customer service, member experiences, access to care, and prescription drug services.

According to CMS's 2027 Star Ratings report, approximately 37% of Medicare Advantage contracts that include prescription drug coverage earned four stars or higher for 2027.

CMS also reports that approximately 71% of current Medicare Advantage prescription drug plan enrollees are in contracts receiving four stars or higher for 2027.

These ratings can help you compare plan quality, but they shouldn't be the only factor in your decision.

A highly rated plan may still have a provider network that doesn't include your doctors or prescription coverage that doesn't meet your needs.

What to check: Compare the Star Ratings of plans available in your area alongside their costs, benefits, provider networks, and prescription drug coverage.

Don't Wait Until December to Review Your Medicare Coverage

Medicare Open Enrollment runs from October 15 through December 7, 2026, with changes generally taking effect January 1, 2027.

During this period, eligible Medicare beneficiaries can make several types of coverage changes, including switching Medicare Advantage plans, changing Part D prescription drug plans, or moving between Original Medicare and Medicare Advantage.

If you're considering switching from Medicare Advantage to Original Medicare, keep in mind that you may not automatically qualify to purchase a Medicare Supplement (Medigap) policy without medical underwriting. Rules vary depending on your circumstances and state. Some insurers have also changed their enrollment requirements, as we explained in our article about 2026 Medicare Supplement Plan N and switching plan changes.

You don't necessarily need to change plans every year. If your current plan is still available and meets your needs for 2027, you can generally keep it without re-enrolling.

However, reviewing your options can help you avoid unexpected costs or coverage issues when the new year begins.

The important thing is making sure your coverage still fits your healthcare needs, prescriptions, and budget.

Need Help Reviewing Your 2027 Medicare Options?

With changes to prescription drug costs, Medicare Advantage premiums, provider networks, and plan benefits, comparing Medicare coverage can be confusing.

Medicare Resource Center can help you understand your current coverage, review available plans, and compare options based on the doctors, medications, and benefits that matter most to you.

Talk with a licensed Medicare Pro to review your 2027 Medicare coverage before Open Enrollment ends December 7.