Medicare Changes Are Coming in 2027: What to Know Before Open Enrollment
Updated: 3 days ago
Updated September 30, 2026
Medicare Open Enrollment runs from October 15 through December 7, 2026. This is when people with Medicare can review their coverage and make changes that take effect January 1, 2027.
On September 28, CMS released the finalized 2027 Medicare Advantage and Part D information. The national headlines are fairly reassuring. But averages don’t tell you what will happen to your plan, and for many families, the details matter more than the headline.
The National Picture: Mostly Stable
According to CMS, the 2027 landscape looks like this:
Stand-alone Part D: The national average monthly premium is projected to rise only slightly, from $35.09 in 2026 to $36 in 2027.
Medicare Advantage: The average monthly premium is projected to fall 16.5%, from $14.37 to $12.00.
Drug coverage inside Medicare Advantage: For Medicare Advantage plans that include prescription coverage, the average Part D portion is projected to fall from $11.32 to $7.00 per month.
Extra benefits: Supplemental hearing, dental and vision benefits are expected to remain generally stable.
Availability: More than 99% of beneficiaries will have at least one Medicare Advantage option.
Here is the catch. CMS’s own numbers indicate that about one in five Medicare Advantage members may not be able to keep their current plan at the same or a lower premium. Averages can hide a lot of individual change.
What This Means in Georgia
For Georgians, the state-level CMS data shows:
The average Medicare Advantage premium falls from $6.55 to $2.99 per month.
Georgia will have 161 Medicare Advantage plans, down slightly from 166.
Nine stand-alone Part D plans will be offered.
The lowest stand-alone Part D premium is $5.30 per month.
Only 51.65% of current stand-alone Part D members will have access to a plan with a lower premium than they paid in 2026.
That last number deserves attention. Roughly half of Georgians with a stand-alone drug plan will not be able to find a cheaper premium than they pay now. A plan that worked well in 2026 may not be the best choice in 2027. Leaving it on autopilot could cost you.
The Part D Premium Stabilization Program Is Ending
When Medicare’s prescription drug benefit was redesigned in 2025, CMS created a temporary Premium Stabilization Demonstration for participating stand-alone Part D plans. For 2026, participating plans received a $10 reduction in the base beneficiary premium and agreed to limit year-over-year premium increases.
CMS has announced that the demonstration will end on December 31, 2026. According to CMS, Part D insurers now have enough experience with the redesigned benefit to price plans under ordinary market conditions. CMS’s July 2026 announcement confirms the program will not continue in 2027.
Ending the demonstration does not mean every premium will jump, and the national average is projected to rise only modestly. Premiums are set plan by plan, so some will increase more than others, and some will decrease.
The national base beneficiary premium, the figure used as a starting point when calculating monthly plan premiums, will be $41.33 in 2027, up from $38.99 in 2026. That is a different number from the average premium above. The Inflation Reduction Act limits increases in the base amount to 6% annually through 2029, but that protection does not necessarily cap the increase in what an individual plan charges. CMS explains the 2027 premium calculation here.
The Part D Deductible and Spending Cap Are Increasing
Two important Part D amounts rise in 2027:
The maximum standard Part D deductible goes from $615 in 2026 to $700.
The annual out-of-pocket cap on covered Part D prescriptions goes from $2,100 to $2,400.
The cap remains an important protection. Once you reach $2,400 in out-of-pocket costs for covered Part D drugs, you owe no additional cost-sharing on covered prescriptions for the rest of the year. Monthly premiums do not count toward the cap, and neither do drugs your plan doesn’t cover. That is why checking the plan’s formulary (its list of covered medications) matters so much.
Medicare Plan Finder Is Getting Better
CMS is also improving the Medicare Plan Finder. Beginning in October, it will offer:
Easier links to each plan’s formulary and Summary of Benefits
More detail on preventive benefits
Prominent notices about changes affecting your current plan
These updates should make comparing plans less of a scavenger hunt. Still, the tool is only as useful as the information you put in, so have your complete medication list and pharmacy on hand.
The Prescription Payment Plan Continues
The Medicare Prescription Payment Plan, sometimes called M3P or “prescription smoothing,” will remain available. It lets you spread out-of-pocket prescription costs across the remaining months of the year instead of paying a large amount at the pharmacy all at once.
It can make budgeting easier, especially when an expensive prescription is filled early in the year. It does not reduce what you owe. It changes when you pay, not how much. Participation is voluntary, and anyone expecting high drug costs may want to ask their plan whether it would help.
Some People May Qualify for $50 GLP-1 Medications
Beginning in July 2026, the Medicare GLP-1 Bridge gave certain Part D beneficiaries access to designated GLP-1 weight-loss medications for $50 for a monthly supply. CMS has extended the program through December 31, 2027, after the planned Part D portion of the broader BALANCE Model was delayed. Eligibility is limited and depends on medical criteria, the medication prescribed, and other requirements. CMS provides current eligibility information here.
Medicare Advantage Enrollment Caps Could Affect Some Choices
Beginning in 2027, certain Medicare Advantage plans may use enrollment capacity limits set through the bidding process. If an affected plan reaches its approved limit, it may stop accepting new members even though Open Enrollment is still underway. These limits are optional and don’t apply to stand-alone Part D plans.
If you have your heart set on a particular Medicare Advantage plan, waiting until the final days of Open Enrollment carries more risk than it used to. Compare carefully first, but once you’ve decided, don’t put off submitting your request.
What Should You Review This Fall?
Don’t assume the plan that worked in 2026 will be the best choice in 2027. Before Open Enrollment ends, review:
Your plan’s Annual Notice of Change
The monthly premium and deductible
Copayments and coinsurance for each prescription
Whether every medication you take is still covered
Whether a covered drug has moved to a different pricing tier
Prior-authorization, step-therapy, or quantity-limit requirements
Preferred pharmacies and mail-order options
Provider networks, hospitals, and supplemental benefits, if you have Medicare Advantage
When comparing Part D plans, look at the total estimated annual cost, not just the monthly premium. A low-premium plan can cost far more if it covers your medications poorly.
You can compare plans at Medicare.gov, call 1-800-MEDICARE, or request free counseling through GeorgiaCares, Georgia’s State Health Insurance Assistance Program.
Be Ready for 2027 Medicare Changes
For families helping aging parents, this is also a good time to make sure the right person is authorized to help. Medicare and insurance companies generally cannot discuss a person’s private information with an adult child just because that child is a caregiver. Proper Powers of Attorney, Medicare authorization forms, and other planning documents make it much easier to step in when questions or a health crisis arise.
Kimbrough Law does not select or sell Medicare plans, but we can help families put the legal pieces in place so trusted people have the authority to advocate, obtain information, and make decisions when necessary. If you need help reviewing your estate plan, Powers of Attorney, or long-term care plan, call Kimbrough Law at 706.850.6910.
