Selecting the best health coverage for your needs during Medicare’s annual open enrollment (Oct. 15 through Dec. 7) is never fun. But current headwinds and upcoming rule changes for 2027 will make this season’s decisions especially challenging.
Compounding the problem for many enrollees: confusion about the choices. While nearly nine in 10 beneficiaries say they are confident in their knowledge of Medicare options, only 13% know the definitions of the four basic types of coverage, which include government-run original Medicare, private Medicare Advantage plans, Part D prescription-drug plans and Medigap plans, according to a new survey from eHealth, an insurance marketplace.
The most basic decision you face — whether to sign up for original Medicare or an Advantage plan — will be especially fraught this year.
On the one hand, double-digit premium increases for Medigap plans, which help offset costs not covered by original Medicare, will likely make Advantage plans the less expensive option on a monthly basis. So will the Trump administration’s early end to subsidies for Part D drug-plan premiums for 2027 (monthly increases were capped at $50 this year), because drug coverage is usually included in Advantage plans. “That is going to steer more people toward Medicare Advantage,” says David Lipschutz, co-director of the Center for Medicare Advocacy.
But in other ways, these private plans will look less enticing for 2027. Some 70% of Medicare Advantage executives recently surveyed by consultants HealthScape Advisors said they expect to trim benefits for 2027. In addition, many Advantage insurers are eliminating out-of-network coverage or shutting plans entirely to cut costs. UnitedHealthcare, for example, is considering canceling more than 3,500 plans across the country for 2027, and Humana expects to shed about 600,000 members when it leaves certain markets.
“It’s really important that people evaluate their options through the lens of their own personal situation,” says Derrick Duke, CEO of eHealth, a Medicare broker.
Here’s what you need to know.
Look beyond premiums.
Some good news: Following last year’s nearly 10% hike in the cost of Part B, which covers medical, preventive and outpatient services, monthly premiums are projected to rise just 3% next year, to $209.50, up from $202.90. The benchmark base Part D premium is expected to rise about 6%, and Medicare Advantage premiums, paid in addition to Part B, will likely remain flat compared with 2026.
But premiums are only one piece of the puzzle. “You need to look at your total out-of-pocket expenses — premiums, co-payments, deductibles and, for Part D plans, that your drugs are covered,” says Kimberly Lankford, author of “Medicare 101.” You can see what your out-of-pocket costs would be for various Part D, Medigap and Medicare Advantage plans using Medicare’s Plan Finder tool (medicare.gov/plan-compare ).
Other costs to consider: For 2027, the maximum Part D annual deductible will rise to $700 from $615 this year, and the cap on your out-of-pocket costs will increase to $2,400 from $2,100. Meanwhile, annual out-of-pocket maximums for Advantage plans are expected to be $9,850 for in-network services and $14,800 for in- and out-of-network costs combined.
Bone up on coming changes. If you have a Part D or Advantage plan, read the Annual Notice of Change, mailed out in September, that lays out how your plan’s coverage and costs will change next year and whether your current plan will still be available. Expect to see fewer options for Part D as insurers look to cut costs. “In 2023, in most areas, there were 23 to 26 drug plans. Last year, there were 10 to 12. We’re going to see even fewer in 2027,” says Diane Omdahl, president of the Medicare advisory firm 65 Incorporated.
Part D plans change their rules annually on which medications they’ll cover and at what price, so make sure the plan you choose covers the drugs you take at an affordable cost. Other changes of note: Part D plans will be required to cover 15 more medications in 2027 as part of Medicare’s prescription-drug negotiation program for 2027, including ones for asthma, COPD, diabetes and cancer. And under a temporary program running until the end of next year, Medicare will also cover some GLP-1 drugs for weight loss, at a cost of $50 a month, for people who qualify and whose drug plans don’t cover them.
Check what is — and isn’t — covered.
If you’re considering a Medicare Advantage plan, review its 2027 list of in-network doctors and hospitals as well as its benefits. Doctors and hospitals who were in a plan’s network this year may not be in 2027.
Most Advantage plans will continue to offer some vision, dental and hearing coverage, which is not provided under original Medicare. But expect to see cutbacks in other Advantage benefits, such as coverage for over-the-counter pharmacy products, home-delivered meals, and rides to doctor’s offices or hospitals.
Considering a switch from Advantage to original Medicare? If so, you’ll likely want to buy a Medigap policy, sold year-round. But you can be denied by a Medigap insurer or charged steep premiums when leaving Medicare Advantage, so first check with plans sold in your area (locate them with Medicare’s Medigap Plan Finder) to get a sense of your eligibility and pricing.
Get free help.
Volunteers at State Health Insurance Assistance Programs (shiphelp.org), or SHIPs, can answer questions and offer guidance, though they can’t recommend specific plans. You can also get help choosing a Part D or Advantage plan via an independent agent or broker.
Just be on guard against pushy marketing. “It used to be that if you showed up for an educational event, you couldn’t be marketed particular products,” Lipschutz says. But the Trump administration has ended that rule. “Now they can say, ‘Hey folks, we’re shifting into a new phase of our program,’” Lipschutz notes.
Richard Eisenberg is a contributing writer at Kiplinger Personal Finance magazine. For more on this and similar money topics, visit Kiplinger.com.
©2026 The Kiplinger Washington Editors, Inc. Distributed by Tribune Content Agency, LLC.
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