Medicare Open Enrollment 2027: What to Check by Dec 7

For Medicare open enrollment for 2027 coverage, the window runs from October 15 through December 7, 2026. The Affordable Care Act (ACA) Marketplace window runs from November 1, 2026 through January 15, 2027. Both deserve attention this year, so a short review of your plan is worth doing before those dates. 

How much will Medicare Part B cost in 2027, and does my income matter? 

The standard Part B premium (Part B is the part of Medicare that covers outpatient medical care) may increase from $202.90 in 2026 to $209.50 in 2027, according to the 2026 Medicare Trustees Report. The annual deductible is $292. The increase looks gentler than last year's. 

Official figures and Income-Related Monthly Adjustment Amount (IRMAA) brackets usually arrive in mid-November. IRMAA is the surcharge higher-income households pay on top of the standard premium. Higher-income households should note that the 2027 brackets use modified adjusted gross income from 2025 returns, a two-year look-back. 

If your income has since dropped because of a qualifying life-changing event, such as retirement, reduced work hours, or the death of a spouse, you can file Form SSA-44 with the Social Security Administration (SSA). You would ask that your surcharge be based on your more recent, lower income. 

Why it matters:

The surcharge looks back two years, so your 2027 bill may reflect income you no longer have. 

What changes for Medicare drug coverage in 2027? 

Drug coverage moves in both directions for 2027. The annual out-of-pocket cap on covered drugs rises to $2,400, and the standard Part D deductible rises to $700. Part D is the part of Medicare that covers prescription drugs. 

Meanwhile, Medicare-negotiated prices for 15 more brand-name drugs take effect January 1, 2027, including Ozempic and Wegovy. Savings are not automatic, since patients with fixed monthly copays might not see a direct benefit. 

Why it matters:

A lower negotiated price does not always lower your own copay, so check your actual drugs rather than the headline. 

What should I do if my Medicare Advantage plan is ending? 

If your Medicare Advantage plan is ending, you may qualify for Medigap "guaranteed issue" protections when returning to traditional Medicare. Medigap is a supplemental policy sold by private insurers. About 3.16 million individual enrollees, roughly 10.6% of the market, are in plans that are terminating or leaving their county. Humana is exiting plans covering roughly 600,000 members nationwide. 

During a limited window—starting up to 60 days before your plan coverage ends and extending up to 63 days after—insurers must sell you certain Medigap policies. They cannot deny you coverage or charge higher premiums because of pre-existing health conditions. 

Residents of New York and Connecticut have additional flexibility, since those states allow you to buy a Medigap policy year-round under continuous guaranteed-issue protections, regardless of health status. Original Medicare is not entirely free of gatekeeping either, as a prior authorization pilot continues for select outpatient services in Arizona, New Jersey, Ohio, Oklahoma, Texas, and Washington. 

Why it matters:

A plan exit is stressful, but the Medigap window gives you a path back to traditional Medicare without medical underwriting. 

Will Marketplace health insurance cost more in 2027? 

Yes, people who buy their own health insurance, such as early retirees and the self-employed, will pay more again next year. Typical premiums are rising about 13% for 2027, on top of large increases this year. A temporary expansion of government subsidies ended last year, so a single person earning more than about $64,000 now receives no assistance and pays full price. For background, see our earlier note on ACA premium subsidies. 

A new risk also looms at tax time. Subsidies are based on an estimate of your income, and if you earn more than projected, you must pay back the extra help. That repayment used to be capped. Under the One Big Beautiful Bill Act (OBBBA), the cap is gone starting with this year's coverage, so when you file your 2026 taxes next spring, you may owe the full excess amount. 

Why it matters:

An income estimate that runs low can turn into a substantial liability on your tax return, so estimate conservatively. 

What does OBBBA change for Medicaid after the midterm elections? 

Several of OBBBA's most consequential health provisions are scheduled to take effect after the midterm elections. Most apply to "expansion adults," meaning adults ages 19 to 64 with incomes up to 138% of the federal poverty level who qualify for Medicaid because their state expanded the program under the ACA. 

Starting December 31, 2026, these enrollees will have their eligibility rechecked every six months instead of once a year, and new work and community engagement requirements take effect at about the same time. Anyone who loses Medicaid coverage—whether due to rising income or procedural disenrollment from not meeting reporting or work requirements—qualifies for a Special Enrollment Period on the ACA Marketplace and can transition to subsidized private plans, provided their household income meets the statutory subsidy thresholds. 

More changes follow in October 2028, when expansion adults with incomes above the poverty line will start paying new cost-sharing amounts for some services. If you help support a parent, adult child, or other relative on Medicaid or Marketplace coverage, now is a good time to make sure their paperwork and income records are current. 

Why it matters:

The administrative changes take effect after the midterms, but establishing consistent documentation habits now protects against coverage gaps later. 

What are the key numbers for Medicare open enrollment 2027? 

Item	Figure	Period
Standard Part B premium (projected)	$202.90 to $209.50	2026 to 2027
Annual Part B deductible	$292	2027
Out-of-pocket cap on covered Part D drugs	$2,400	2027
Standard Part D deductible	$700	2027
Medicare Advantage enrollees in terminating plans	About 3.16 million (~10.6% of market)	2027
Humana plan exits	Roughly 600,000 members	2027
Typical Marketplace premium increase	About 13%	2027
Marketplace subsidy cutoff (single filer)	About $64,000	2027

What steps can prevent costly surprises before December 7? 

A few steps can prevent costly surprises during Medicare open enrollment 2027: 

1. Review the Annual Notice of Change (ANOC):

Verify whether your current provider networks, drug formularies, or cost tiers are changing. 

2. Re-enter prescriptions:

Input every medication and exact dosage into the Medicare Plan Finder at Medicare.gov to confirm coverage tiers and prior authorization rules for 2027. 

3. Cash-flow planning:

Budget roughly $2,500 per person annually for standard Part B premiums and up to $2,400 per person out-of-pocket for Part D prescription drugs. 

4. Act early on terminating Advantage plans:

Apply for a Medigap replacement policy as early as 60 days before your Medicare Advantage plan terminates, rather than waiting for coverage to lapse. 

5. Shop Marketplace plans actively:

Marketplace enrollees should avoid passive auto-renewal, submit selections by December 15 for coverage effective January 1, and benchmark income estimates conservatively to prevent uncapped subsidy clawbacks at tax time. 

Should you choose Original Medicare with Medigap or Medicare Advantage? 

RS continues to recommend Original Medicare paired with Medigap over Medicare Advantage for most households. This year's widespread plan terminations and carrier network contractions in the Medicare Advantage market reinforce the value and long-term stability of traditional supplemental coverage. 

If you would like to review your Medicare or Marketplace elections, reach out to your Wealth Manager to model out-of-pocket exposure and evaluate plan structures against your broader cash-flow plan. For a look at how this topic played out a year ago, see our 2025 Medicare commentary. 

Frequently Asked Questions