Medicare open enrollment is running right now. It opened on October 15, 2026 and closes on December 7, and whatever you decide in that window becomes your coverage on January 1, 2027.
Most people let it pass. Year after year, surveys find that the large majority of Medicare beneficiaries never compare plans during open enrollment — they simply roll over. That is understandable, and it is also how people end up paying for a drug plan that dropped their medication in October without them noticing.
This guide covers what the window actually lets you change, what is going up in 2027, what is still only a projection, and a 30-minute process for checking whether your current plan is still the right one.
The dates that matter
| Window | Dates | What you can do |
|---|---|---|
| Medicare Open Enrollment | Oct 15 – Dec 7, 2026 | Switch Medicare Advantage plans, change or join a Part D plan, move from Advantage back to Original Medicare, or from Original Medicare into Advantage |
| Coverage begins | January 1, 2027 | Whatever you chose takes effect |
| Medicare Advantage Open Enrollment | Jan 1 – Mar 31, 2027 | If you are already in an Advantage plan, one more chance to switch plans or return to Original Medicare |
| General Enrollment | Jan 1 – Mar 31, 2027 | For people who missed their initial Part B sign-up |
The December 7 deadline is real and it is not generous about lateness. Miss it and, unless you qualify for a Special Enrollment Period, you are in your current plan until the following year.
There is a page-by-page version of this guide in our Medicare open enrollment web story.
What 2027 is expected to cost
Here is where honesty matters more than confidence. As of mid-October 2026, CMS has not published the official 2027 Medicare figures. The numbers circulating come from the Medicare trustees’ projections, and CMS usually confirms the real ones in late October or November.
| Cost | 2026 (actual) | 2027 (projected) | Change |
|---|---|---|---|
| Part B standard premium | $202.90/month | about $209.50/month | about +$6.60 |
| Part B deductible | $283/year | about $292/year | about +$9 |
| Part A hospital deductible | — | roughly $1,788–$1,810 per benefit period | forecast to fall slightly |
Every 2027 figure above is a projection, not an announcement. We will update this page when CMS publishes the official numbers.
Two things are worth pulling out of that table. First, the Part B increase is small relative to the 3.6% Social Security COLA, so for most people the January raise survives the premium rise comfortably — which has not been true in every recent year. Second, the Part A hospital deductible is forecast to go down, which is unusual and genuinely good news for anyone facing an inpatient stay.
If you earn above the IRMAA thresholds, you pay a surcharge on top of the standard Part B and Part D premiums, based on your tax return from two years earlier. For 2027 that means your 2025 income. A one-off event in 2025 — selling a house, cashing out a retirement account — can push you into a surcharge bracket for a year, and you can appeal it with Form SSA-44 if the income was caused by a life-changing event such as retirement, divorce or a spouse’s death.
The one piece of post you should not have thrown away
By the end of September, every Medicare Advantage and Part D plan must send its members an Annual Notice of Change. It is dull, it looks like junk mail, and it is the single most useful document in this entire process, because it lists exactly what is different about your plan next year.
Four things in it decide whether you should move:
- The formulary. Is every drug you take still covered, and still on the same tier? A drug moving from tier 2 to tier 3 can change your cost by hundreds of dollars a year.
- The pharmacy network. Plans change which pharmacies count as “preferred”. Same drug, same plan, different counter, different price.
- The provider network (Advantage plans). If your cardiologist left the network, that is in here.
- Premiums, deductibles and copays. Including the maximum out-of-pocket, which is the number that matters in a bad year.
If you binned it, you can see all of the same information in the Medicare Plan Finder.
A 30-minute check, start to finish
This is the whole process. It is genuinely about half an hour if you have your medication list to hand.
- Write down every drug you take — name, dose, and how often. Include the ones you only take occasionally.
- Go to medicare.gov/plan-compare and enter your ZIP code. You can do this without logging in, but logging in pulls in the drugs you already filled this year, which saves time and catches things you forgot.
- Enter your pharmacies. Add your usual one plus a mail-order option; the price difference is often larger than the difference between plans.
- Sort by total annual cost, not premium. This is the step that matters most. The cheapest premium is very often not the cheapest year.
- Check the star rating and the max out-of-pocket on any Advantage plan you are considering.
- Confirm your doctors are in network — call the practice, not just the plan’s online directory, which is frequently out of date.
- Enrol directly through medicare.gov or the plan itself. You do not need to cancel your old plan; joining a new one does it automatically.
If you would rather have a person walk you through it, every state has a SHIP — a State Health Insurance Assistance Program — offering free, unbiased, one-to-one counselling. They do not sell anything and they are not paid on commission, which cannot be said of everyone who will call you this autumn. Find yours at shiphelp.org or call 1-800-MEDICARE.
Original Medicare or Medicare Advantage?
This is the biggest decision in the window, and there is no universally right answer — which is exactly why the advertising is so aggressive.
| Original Medicare + Part D (+ Medigap) | Medicare Advantage | |
|---|---|---|
| Doctor choice | Any provider that accepts Medicare, nationwide | Network only, usually local |
| Referrals | Not needed | Often needed (HMO plans) |
| Prior authorisation | Rare | Common |
| Extra benefits | None built in | Often dental, vision, hearing, gym |
| Monthly cost | Part B + Part D + Medigap premium | Often $0 premium on top of Part B |
| Worst-case cost | Unlimited without Medigap | Capped by the plan’s out-of-pocket maximum |
| Travel | Works anywhere in the US | Usually emergency-only outside the area |
The honest summary: Advantage plans usually cost less month to month and bundle in extras; Original Medicare with a Medigap policy costs more every month and asks fewer questions when you are ill. People who travel, who split the year between two states, or who have a complex condition and a specialist they trust tend to be happier with Original Medicare.
One trap deserves naming. Moving from Advantage to Original Medicare during open enrollment is always allowed. But buying a Medigap policy afterwards is not guaranteed — outside your one-time six-month Medigap open enrollment period, insurers in most states can refuse you or charge more based on your health. Check that you can actually get a Medigap policy before you leave an Advantage plan, not after.
What is changing with Part D
Part D is where the moving parts are this year. Reporting points to a higher out-of-pocket cap and a higher deductible for 2027, and to the end of temporary federal subsidies that had been holding some standalone drug-plan premiums down. The practical effect is that standalone Part D premiums are more volatile going into 2027 than usual.
That makes the “sort by total annual cost” step above more valuable this year than last. A plan whose premium looks unchanged may still cost you more because the deductible moved.
Ignore the adverts, and the phone calls
From mid-October the adverts arrive in volume, usually with a celebrity and a free-benefits promise. Some are legitimate brokers. Some are lead generators selling your details on.
- Medicare will never cold-call you to sell a plan. A caller claiming to be “from Medicare” offering a new card or extra benefits is a scam.
- Nobody needs your Medicare number to give you a quote. Treat it like a credit card number.
- “Free” extras are paid for somewhere. Usually in a narrower network or tighter prior authorisation.
- There is no new Medicare card you need to pay for, activate or verify.
If you hand over your Medicare number by mistake, report it at 1-800-MEDICARE and read our guide on what to do if your identity is stolen. Medical identity theft is slower to detect than financial fraud because the first sign is often a bill for care you never received.
Five mistakes that cost people real money
These are the patterns that come up again and again, in that order of frequency.
1. Comparing premiums instead of total annual cost. A plan with a $0 premium and a $590 deductible will cost more over a year than a $20 plan with no deductible, if you take regular medication. The Plan Finder calculates total annual cost for you; use that column and ignore the headline price.
2. Assuming your drugs are still covered. Formularies change every January. A medication can be dropped entirely, moved to a higher tier, or hit with a new prior-authorisation requirement. This is the single most expensive thing people discover in February.
3. Not entering pharmacies. Plans have preferred and standard pharmacies, and the same prescription at the same plan can differ by a meaningful amount depending on which counter you collect it from. Mail order is frequently cheapest for maintenance drugs.
4. Taking a broker’s shortlist as the market. Many brokers only sell the plans they are contracted with. That is not dishonest, but it is not the whole market either. Ask directly: “Are there plans in my area you cannot sell me?” A straight answer tells you what you are looking at.
5. Dropping Medigap without checking you can get it back. Outside your one-off six-month Medigap open enrollment period, insurers in most states can medically underwrite you — which means they can decline you or charge more. Moving to an Advantage plan is easy; moving back with a Medigap policy may not be.
If any of these apply to you, a free SHIP counsellor can work through the comparison without a commission riding on the answer. That is the whole reason the programme exists.
Frequently asked questions
When is Medicare open enrollment for 2027?
It runs from October 15 to December 7, 2026. Any change you make takes effect on January 1, 2027.
What can I change during open enrollment?
You can switch Medicare Advantage plans, join, switch or drop a Part D drug plan, move from Advantage back to Original Medicare, or move from Original Medicare into an Advantage plan.
How much will Medicare Part B cost in 2027?
The standard premium is projected at about $209.50 a month, up roughly $6.60 from $202.90 in 2026. CMS has not confirmed the official figure yet, so treat it as an estimate.
What happens if I do nothing?
Your current plan generally rolls over into 2027 with whatever changes it made to premiums, drug coverage and networks. If your plan is leaving your area you will get a separate notice and a Special Enrollment Period.
Do I need to re-enrol every year?
No. Enrolment rolls over automatically. Open enrollment is your chance to change your mind, not a requirement to re-apply.
Can I switch after December 7?
Only in limited cases. If you are in a Medicare Advantage plan you get a second window from January 1 to March 31. Otherwise you need a Special Enrollment Period, which requires a qualifying event such as moving or losing other coverage.
Is there free help comparing plans?
Yes. Every state runs a State Health Insurance Assistance Program (SHIP) offering free, unbiased counselling with no sales commission. Find yours at shiphelp.org or call 1-800-MEDICARE.
