Medicare Open Enrollment (Oct 15 to Dec 7, 2026): What to Review
What you can change in Medicare open enrollment for 2027, how to read your Annual Notice of Change, the $2,400 drug cap and the Part B figures known so far.
Medicare open enrollment runs from October 15 to December 7, 2026, and the changes you make during it set your health and drug coverage for 2027. You can move between Original Medicare and a Medicare Advantage plan, switch Medicare Advantage plans, or join, drop or change a drug plan, and the new coverage starts on January 1, 2027.
Doing nothing is also a choice. If you keep your current plan, its 2027 costs and benefits take effect on January 1 whether or not you have read about them. Plans can change premiums, deductibles, drug lists and networks each year, so the weeks before December 7 are the time to check that yours still fits.
Key takeaways
- Open enrollment runs October 15 to December 7, 2026. Your new plan must receive your request by December 7 for coverage to start January 1, 2027.
- A second window, January 1 to March 31, 2027, is only for people already in a Medicare Advantage plan, and it allows one change.
- Your plan's Annual Notice of Change lists what changes on January 1, 2027. Plans must send it so that it reaches you by September 30.
- In 2027, what you pay for covered Part D drugs is capped at $2,400, up from $2,100 in 2026. A plan's drug deductible can be no more than $700 in 2027, up from $615.
- The standard Part B premium is $202.90 a month in 2026. The 2027 amount had not been announced as of October 13, 2026.
What you can change between October 15 and December 7
Original Medicare is the federal program: Part A covers hospital care and Part B covers doctors and outpatient care. Medicare Advantage, or Part C, is a Medicare-approved plan run by a private company. It has to cover every medically necessary service that Original Medicare covers, and most of these plans include drug coverage. Part D is drug coverage, sold as a stand-alone plan alongside Original Medicare or built into a Medicare Advantage plan.
During open enrollment you can:
- Switch from Original Medicare to a Medicare Advantage plan, or from Medicare Advantage back to Original Medicare.
- Join, drop or switch a Medicare Advantage plan, with or without drug coverage.
- Join, drop or switch a stand-alone drug plan if you have Original Medicare.
The plan you are joining must get your request by December 7. A move into Medicare Advantage made now is not final: the January to March window below allows one more change.
What open enrollment does not give you: Medigap
Medigap, or Medicare Supplement Insurance, is a private policy that helps pay costs Original Medicare leaves to you, such as the 20% coinsurance you usually pay for Part B services after the deductible. Open enrollment lets you return to Original Medicare, but it does not give you a right to buy Medigap. That right is strongest in the six-month Medigap Open Enrollment Period, which opens in the first month you are both 65 or older and enrolled in Part B. Afterwards a policy may cost more or be unavailable, unless a guaranteed-issue right applies, such as the 12-month trial right for people who dropped Medigap to join Medicare Advantage for the first time. If you plan to leave Medicare Advantage for Medigap, ask an insurer before December 7 whether it will sell you a policy.
The second window: January 1 to March 31, 2027
| Feature | Open enrollment | Medicare Advantage open enrollment |
|---|---|---|
| Dates | October 15 to December 7, 2026 | January 1 to March 31, 2027 |
| Who can use it | Anyone with Medicare | Only people already in a Medicare Advantage plan |
| What you can do | Move between Original Medicare, Medicare Advantage and drug plans | Switch Medicare Advantage plans, or return to Original Medicare and join a stand-alone drug plan |
| Deadline or limit | The plan must get your request by December 7 | One change |
| New coverage starts | January 1, 2027 | First of the month after the plan gets your request |
In the January to March window you cannot move from Original Medicare to Medicare Advantage, join a stand-alone drug plan if you have Original Medicare, or switch between stand-alone drug plans. So with Original Medicare and a separate drug plan, December 7 is your last routine chance to change that plan for 2027. Outside these windows you need a Special Enrollment Period, for example after a move or after losing other coverage. One of these is the five-star Special Enrollment Period. It runs from December 8 to November 30 of the following year and allows one switch to a Medicare Advantage plan, drug plan or Medicare Cost Plan with a five-star quality rating, if one is offered where you live.
How to read your Annual Notice of Change
The Annual Notice of Change lists what your Medicare Advantage or drug plan will change on January 1. Federal rules require plans to send it so that it reaches you by September 30. By October 15 they must also send the Evidence of Coverage, the full description of next year's benefits, or a notice telling you how to get it. If either document has not arrived, contact your plan. Then compare each item with how you used care this year.
Premiums and deductibles
Note the 2027 plan premium and any medical or drug deductible. Joining a Medicare Advantage plan does not end the Part B premium. You keep paying it, plus any plan premium, though some plans help pay all or part of the Part B premium.
The yearly out-of-pocket limit
Each Medicare Advantage plan sets a yearly limit on what you pay for covered Medicare services, and a plan may have different limits for in-network and out-of-network care. Original Medicare has no yearly limit unless you have Medigap or other coverage, such as from an employer. Check whether your plan's limit rose for 2027.
Network, service area and extra benefits
Confirm your doctors, hospital and pharmacy are in network for 2027, and that you still live in the plan's service area. A plan can also decide to leave Medicare for the coming year. It then sends you a letter, your coverage under it ends after December 31, and you can choose another plan during open enrollment. Dental, vision and hearing extras vary by plan and can change each year, so check the 2027 amounts.
Drug list and tiers
A formulary is the plan's list of covered drugs, sorted into tiers that set your share. Check that each drug is still covered, its tier, and whether it now needs prior approval. The guide to formularies, drug tiers and coverage exceptions explains these rules.
Check your drugs against the 2027 Part D cap
| Standard Part D figure | 2026 | 2027 |
|---|---|---|
| Maximum drug deductible | $615 | $700 |
| Yearly out-of-pocket cap on covered drugs | $2,100 | $2,400 |
Spending that counts toward the cap includes what you pay for covered Part D drugs and certain payments made for you, such as through Extra Help. When the total reaches $2,400 in 2027, covered Part D drugs cost you $0 for the rest of the year. The cap works the same way in a stand-alone drug plan and in a Medicare Advantage plan with drug coverage. It is a limit on spending for covered drugs, so the comparison below treats the monthly premium as a separate cost.
Also new for 2027: Medicare's negotiated prices for 15 more Part D drugs take effect on January 1, 2027. CMS is also ending the Part D Premium Stabilization Demonstration at the end of 2026, so check your stand-alone plan's 2027 premium rather than assume it matches this year's. Every Part D plan offers the Medicare Prescription Payment Plan, which spreads what you owe for covered drugs across the calendar year. It changes when you pay, not how much.
Example: The premiums and copays are illustrative; the $700 deductible and $2,400 cap are the real 2027 limits. Someone on one costly drug compares two stand-alone plans in the Medicare Plan Finder. Plan A costs $20 a month with a $700 deductible, and the drug costs enough to reach the $2,400 cap. Plan B costs $60 a month with no deductible, and the drug's copays total $1,500 for the year. Plan A: $240 in premiums plus $2,400, or $2,640. Plan B: $720 plus $1,500, or $2,220. The higher-premium plan costs this person $420 less. For someone taking no drugs it runs the other way: $240 against $720.
With few drugs, the premium is most of the yearly cost. With an expensive drug, compare premiums plus expected drug spending up to the cap. The guide to comparing plans by total yearly cost shows the method in full.
Part B costs: what is known for 2026 and 2027
In 2026 the standard Part B premium is $202.90 a month, up $17.90 from $185.00 in 2025, and the Part B deductible is $283. The 2026 Part A inpatient hospital deductible is $1,736. CMS released these figures on November 14, 2025.
Higher earners also pay an Income-Related Monthly Adjustment Amount, or IRMAA, based on modified adjusted gross income from the tax return two years earlier. For 2026 it starts when 2024 income was above $109,000 on an individual return or $218,000 on a joint return. At that first level it adds $81.20 a month to Part B, for a total of $284.10, and $14.50 a month to Part D. If your income has dropped, for example because of a life-changing event, the Medicare & You 2027 handbook points to SSA.gov/medicare/lower-irmaa.
The 2027 Part A and Part B premiums and deductibles had not been announced as of October 13, 2026. The 2026 Medicare Trustees Report, dated June 9, 2026, projects a 2027 Part B premium of $209.50 a month and a Part B deductible of $292. Those are projections, not final amounts.
A review checklist before December 7
- Find your Annual Notice of Change and Evidence of Coverage.
- Confirm your doctors, hospital and pharmacy are in network for 2027.
- Enter every drug and dose in the Medicare Plan Finder at Medicare.gov/plan-compare.
- For each plan, add up premiums, deductibles and expected copays, plus the worst case if you reach the out-of-pocket limit.
- If you have employer, union or retiree coverage, ask the benefits administrator first. Medicare's booklet on other insurance notes that adding Medicare drug coverage may cost you that coverage, including health benefits for a spouse or dependents, and you may not get it back.
- Enroll by December 7 and keep your confirmation.
If you are still working at 65 and deciding whether to take Part B at all, see turning 65 while still working.
Frequently asked questions
Do you have to do anything if you are happy with your plan?
Usually not. You stay in your plan, and its 2027 costs and benefits take effect on January 1, 2027. The exception is a plan that is leaving Medicare: your coverage under it ends after December 31, 2026, so you need to choose other coverage. Read the Annual Notice of Change either way.
Can you change your drug plan after December 7?
With Original Medicare and a stand-alone drug plan, generally not for 2027 unless you qualify for a Special Enrollment Period, such as the five-star period or one triggered by a move.
Does the $2,400 cap apply to Medicare Advantage plans?
Yes, for covered Part D drugs in a Medicare Advantage plan that includes drug coverage. Those plans also have a separate yearly limit for covered medical services.
When will the 2027 Part B premium be announced?
It had not been announced as of October 13, 2026. The 2026 premium came out on November 14, 2025. The Trustees projected $209.50 a month for 2027, but the official figure can differ.
Where can you get unbiased help comparing plans?
Every state has a State Health Insurance Assistance Program, or SHIP. SHIPs are funded by the federal government, have no ties to insurance companies, and counsel people with Medicare one to one at no charge. Find yours at shiphelp.org or through 1-800-MEDICARE (1-800-633-4227).
Sources
- Joining a plan (Medicare.gov)
- Medicare & You 2027 (Centers for Medicare & Medicaid Services)
- How much does Medicare drug coverage cost? (Medicare.gov)
- Announcement of CY 2027 Medicare Advantage Capitation Rates and Part C and Part D Payment Policies, April 6, 2026 (CMS)
- Annual Release of Part D National Average Monthly Bid Amount and Other Part C & D Bid Information, July 28, 2026 (CMS)
- 2026 Medicare Parts A & B Premiums and Deductibles (CMS)
- 2026 Annual Report of the Medicare Boards of Trustees (CMS)
- How Medicare Works with Other Insurance (Medicare.gov)