As Medicare beneficiaries prepare for another Annual Enrollment Period, it’s important to remember that Medicare coverage is not necessarily “set it and forget it.” Each year, Medicare Advantage and Part D plans can change their premiums, deductibles, provider networks, prescription drug formularies, and out-of-pocket costs.
Medicare’s Annual Enrollment Period (AEP) runs from October 15 through December 7 each year. During this time, Medicare beneficiaries can review their current coverage and make changes for the upcoming year. Any changes made during AEP generally take effect January 1.
What Should You Review?
Even if you are satisfied with your current coverage, reviewing your Annual Notice of Change is a critical step in understanding any changes to your benefits and costs for the upcoming year.
Prescription Drugs:
Your medications are one of the most important things to review. Drug formularies, tiers, copays, and preferred pharmacies can change from year to year. A medication that was covered under your current plan may have different costs or coverage requirements in 2027, while another plan may offer more favorable coverage for the prescriptions you take.
Doctors and Hospitals:
If you have a Medicare Advantage plan, verify that your preferred doctors, specialists, and hospitals will remain in-network for the following year. A change in network status could have a significant impact on your healthcare costs.
Premiums and Out-of-Pocket Costs:
When evaluating your coverage, it is important to consider more than just the monthly premium. Deductibles, copayments, coinsurance and maximum out-of-pocket costs can all play a significant role in understanding the changes you may incur the following year.
Important Part D Changes for 2027
Prescription drug coverage continues to be an area of significant Medicare change. For 2027, the standard Part D deductible is projected to increase to $700, compared with $615 in 2026. The annual Part D out-of-pocket threshold is also projected to increase to $2,400, compared with $2,100 in 2026.
The major redesign of the Part D benefit that began with the Inflation Reduction Act will also continue. For 2027 and beyond, CMS is codifying provisions that eliminate the coverage gap phase and maintain protections for beneficiaries once they reach the annual out-of-pocket threshold.
These changes make it even more important to look beyond a plan’s monthly premium and understand how your specific medications will be covered.
Make Medicare Open Enrollment Part of Your Annual Routine
Medicare Open Enrollment is an opportunity to make sure your coverage continues to fit your healthcare needs and budget—not just an enrollment deadline.
Before December 7, review your plan’s changes for 2027, check your medications and providers, and compare your available options. A yearly review can provide valuable peace of mind and help ensure you start the new year with coverage that works for you.
Whether you’re preparing for Medicare, selecting a new health insurance plan, or managing coverage for your business, Jazmin is ready to help make a confident, stress-free choice. To talk about your options, call her at 949.243.5390 or email jplemon@plemonins.com.
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