What to Look Out for in 2027
Our lives don’t stand still—and neither do our healthcare needs.
As we get older, the doctors we see may change. A new medication may become part of our daily routine. We may care more about keeping a trusted specialist, or find ourselves paying closer attention to premiums and out-of-pocket costs. What felt like the perfect Medicare coverage a few years ago may not necessarily be the best fit today.
And just as our needs change, Medicare plans change, too.
That’s why Annual Enrollment is an important opportunity to look at where you are now—and make sure your coverage is keeping up.
Prescription Costs Are Changing
For 2027, the prescription deductible will be $700, although some plans may offer a lower deductible. Many plans will also use co-insurance for Tier 3 or name-brand medications instead of a straight co-pay.
The good news? The annual out-of-pocket maximum for all covered medications will be no more than $2,400. Once you reach that amount, your plan pays the cost of covered medications for the remainder of the year—a big improvement over the dreaded “donut hole” of years past.
If you have Medicare Advantage, your prescription deductible could actually decrease in 2027, depending on your plan. After carriers faced higher medication costs in 2026, some raised deductibles and have mediated those costs for 2027.
Your Current Plan May Be Changing, Too
Some medical out-of-pocket maximums have risen, which makes your Annual Notice of Change particularly important. It must arrive by September 30. Check your co-pays, prescription drug formulary to ensure your medications are still covered, and provider network to make sure your doctors are still in-network.
Changes for coverage beginning January 1 can be made October 15 through December 7. Medicare Advantage members also have an opportunity to make one change from January 1 through March 31.
Medicare Supplement premiums and prescription drug plan costs may be rising as well. If those expenses are becoming too much for your budget, Medicare Advantage may be worth exploring. Plans can include dental, vision and hearing benefits, over-the-counter allowances, gym memberships and Part B Medicare rebates. Many Medicare Advantage PPOs also offer out-of-network coverage and zero monthly premiums.
Match Your Coverage to What Matters to You
There isn’t one “best” Medicare choice. The question is what works best for you.
If freedom to choose providers is especially important, a Medicare Supplement paired with a prescription drug plan can provide coverage with any Medicare provider. Dental coverage can also be added. It costs more, but many people value that flexibility.
For people with diabetes, heart disease or congestive heart failure, chronic illness plans may provide additional benefits such as food cards, lower-cost insulin and coordinated care, along with other Medicare Advantage benefits.
Hospital indemnity plans can also help cover hospitalization and certain outpatient costs associated with Medicare Advantage. For a small monthly premium, they pay benefits directly to you to use toward co-pays, and daily reimbursements can be higher than the hospital co-pay itself. Many are guaranteed issue with no health questions through age 70.
Considering switching from a Medicare Supplement? The law allows you to try a Medicare Advantage plan for a year and return to a supplement and prescription drug plan without health questions during that year if it isn’t the right fit.
Medicare offers more choices than ever. The key is making sure your coverage reflects your health, your priorities and your life today.
If you need help navigating the “Medicare Maze,” call me at 828-699-1808. I’m happy to help you review your options, and there is no cost for my services.
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