2027 Medicare Planning Checklist

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If you are on Medicare and have not yet reviewed your coverage for 2027, the clock is running out. Open Enrollment closes on December 7, 2026, and missing that window means you are locked into your current plan for another full year, even if your drugs cost more, your doctors leave your network, or better options exist. The changes coming in 2027 are significant enough that every Medicare beneficiary, not just those with high drug costs, deserves a careful second look.

What Is Actually Changing With Medicare in 2027

The most consequential change in 2027 is the continued rollout of the Inflation Reduction Act’s Part D reforms, which cap out-of-pocket drug spending at $2,000 per year for Medicare beneficiaries. This cap was introduced in 2025 and remains in effect for 2027, but what many seniors do not realize is that the specific drugs covered under their plan, and the tier those drugs sit on, can change every single year. A medication that cost you $40 per month in 2026 could move to a higher formulary tier in 2027, pushing your costs significantly higher before you even reach that cap.

Beyond Part D, Medicare Part B premiums are expected to increase modestly in 2027, as they have in most recent years. The official premium is announced by the Centers for Medicare and Medicaid Services in the fall of 2026, so watch for that announcement when reviewing your overall budget. Additionally, the Part D deductible, which was set at $590 in 2025, may be adjusted again, and the specific amount for 2027 will appear in your Annual Notice of Change letter.

For those enrolled in Medicare Advantage plans, network changes are common at the start of each plan year. Hospitals, specialists, and primary care physicians can be added or dropped without direct notification beyond your Annual Notice of Change. Do not assume your current providers are still in-network simply because they were last year.

Understanding Your Annual Notice of Change

Every fall, your Medicare plan is required by law to mail you an Annual Notice of Change, often called an ANOC. This document arrives in late September and details every modification your plan is making for the coming year, including premium changes, deductible adjustments, formulary updates, and network alterations. Most people set this letter aside without reading it, and that is exactly how unexpected costs catch them off guard in January.

When your ANOC arrives, go directly to three key sections. First, look at Part D changes, specifically whether your current prescriptions are still covered and at which tier. Second, review any premium or cost-sharing changes to understand what you will owe at the point of care. Third, if you are in a Medicare Advantage plan, check the provider directory changes to confirm your doctors and preferred hospitals remain in-network for 2027.

If you cannot locate your ANOC or if it has not arrived by early October, call your plan directly using the number on the back of your membership card, or visit medicare.gov to review your plan’s documentation. The Medicare helpline at 1-800-MEDICARE is also available around the clock to help you understand what your notice means and whether your current plan still fits your needs.

The $2,000 Part D Cap and Why It Still Requires Planning

The $2,000 annual out-of-pocket cap on Part D drug costs is genuinely good news for seniors who take expensive brand-name medications. Once you have spent $2,000 out of pocket on covered drugs in a calendar year, Medicare pays 100 percent of your remaining drug costs for the rest of that year. For beneficiaries who previously faced catastrophic drug bills, this is a transformative protection.

However, the cap only applies to drugs that are actually on your plan’s formulary. If your plan drops a medication from its formulary for 2027, you may need to pay the full cost out of pocket or seek a formulary exception, and those costs may or may not count toward your cap depending on the circumstances. This is why comparing formularies before Open Enrollment closes is not optional for anyone taking specialty or brand-name drugs.

Also note the new Medicare Prescription Payment Plan, which allows beneficiaries to spread their out-of-pocket drug costs across monthly installments throughout the year rather than paying large sums upfront at the pharmacy. If cash flow is a concern, this option is worth discussing with your plan or a licensed Medicare counselor. You can learn more and compare plan options at medicare.gov, which provides a free Plan Finder tool updated annually with 2027 plan data.

IRMAA and Income-Related Premium Adjustments for 2027

If your income exceeds certain thresholds, you pay higher Medicare Part B and Part D premiums through a surcharge called the Income-Related Monthly Adjustment Amount, or IRMAA. The Social Security Administration uses your tax return from two years prior to determine your IRMAA bracket, which means your 2027 premiums are based on your 2025 income. If your income has dropped significantly since then due to retirement, a job loss, divorce, or the death of a spouse, you have the right to appeal and request that SSA use more recent income data.

For 2026, IRMAA surcharges begin for individuals with income above $106,000 and for married couples filing jointly above $212,000. These thresholds are adjusted for inflation each year, so the exact 2027 figures will be published by SSA in late 2026. The key point is that if you experienced a life-changing event that reduced your income, do not simply accept a higher premium. File Form SSA-44 with Social Security or call 1-800-772-1213 to request a review.

Planning ahead for IRMAA also matters if you are approaching Medicare eligibility or if you are considering a Roth conversion or other strategy that could spike your taxable income. Decisions made today about income and withdrawals directly affect what you pay for Medicare two years from now. Speaking with a financial advisor and reviewing your situation at ssa.gov can help you avoid an unexpected premium increase.

How to Compare Plans Before Open Enrollment Closes

Medicare Open Enrollment runs from October 15 through December 7, 2026. During this window you can switch from Original Medicare to a Medicare Advantage plan, return to Original Medicare from Medicare Advantage, change Medicare Advantage plans, or switch Part D drug plans. Any changes you make take effect on January 1, 2027. After December 7, you generally cannot make changes again until the following year.

The best starting point for comparison shopping is the Medicare Plan Finder at medicare.gov. Enter your zip code, your current medications, and your preferred pharmacy to see a side-by-side cost estimate for available plans in your area. The tool calculates your estimated total annual cost including premiums, deductibles, and drug copays so you can see the true financial picture, not just the monthly premium.

For personalized, unbiased help, contact your State Health Insurance Assistance Program, known as SHIP. SHIP counselors are trained volunteers who provide free one-on-one Medicare counseling with no commission or agenda. You can find your local SHIP through eldercare.acl.gov or by calling 1-800-MEDICARE and asking for a referral. If you prefer to work with a licensed insurance agent, make sure they are authorized to sell plans in your state and that they compare multiple carriers, not just one.

Protecting Yourself From Medicare Fraud During Enrollment Season

Open Enrollment season is also peak season for Medicare fraud. Scammers call, text, and email seniors posing as Medicare representatives, plan agents, or government officials. They may offer a free card, a new benefit, or an account verification request. Medicare will never call you unsolicited to sell you a plan, ask for your Medicare number over the phone, or request payment in gift cards or wire transfers.

Guard your red-white-and-blue Medicare card the same way you guard your Social Security card. If someone calls and claims to be from Medicare, hang up and call 1-800-MEDICARE yourself to verify any information. If you believe you have been targeted by a Medicare scam, report it to the FTC at ftc.gov or by calling 877-382-4357. You can also report healthcare fraud to the Office of Inspector General at the Department of Health and Human Services.

Review your Medicare Summary Notice, which is mailed quarterly to Original Medicare beneficiaries, for any charges you do not recognize. Medicare Advantage and Part D members can check their Explanation of Benefits statements online through their plan’s member portal. Catching a fraudulent claim early protects both your benefits and the integrity of the Medicare program. You worked a lifetime for these benefits and they deserve active protection.

Your Printable Checklist

Work through each step below before December 7, 2026, to make sure your Medicare coverage is optimized, affordable, and ready for 2027

1. Locate and read your Annual Notice of Change

Your ANOC arrives by mail in late September. Retrieve it from your mailbox and read the sections on premiums, deductibles, formulary changes, and network updates. If you did not receive it by October 10, call the number on the back of your plan card or visit medicare.gov to access the document online.

2. List every prescription drug you currently take

Write down the exact name, dosage, and quantity of each medication you take, including generics. You will use this list to verify formulary coverage and to enter your drugs into the Medicare Plan Finder. Ask your pharmacist to print a current medication list if you are unsure of any details.

3. Check each drug against your 2027 formulary

Using your ANOC or your plan’s online formulary tool, confirm that every medication on your list is still covered for 2027 and note which tier it falls on. A tier change from Tier 2 to Tier 3 can increase your copay substantially. If a drug has been removed, contact your plan about a formulary exception or use medicare.gov to find a plan that covers it.

4. Run the Medicare Plan Finder comparison at medicare.gov

Go to medicare.gov and click on Find health and drug plans. Enter your zip code, your medications, and your preferred pharmacy. Review the estimated annual cost column, not just the monthly premium, for each plan. Compare at least three plans before making a decision.

5. Confirm your 2027 Part D out-of-pocket cap applies

The $2,000 annual Part D out-of-pocket cap applies to covered drugs on your formulary. Verify that your highest-cost medications are on your chosen plan’s formulary so you can benefit from the cap. If a drug is not on formulary, you may not receive cap protection for that medication.

6. Verify the 2027 Part D deductible for each plan you consider

The Part D deductible varies by plan and is set annually. Some plans offer a $0 deductible, while others charge the maximum allowed by Medicare for 2027. Find this figure in each plan’s ANOC or summary of benefits, and factor it into your total cost comparison alongside monthly premiums.

7. Confirm all your doctors are in-network for 2027

If you are in a Medicare Advantage plan, visit your plan’s online provider directory or call the number on the back of your card to confirm your primary care doctor, specialists, and preferred hospital are still in-network. Do not rely on last year’s directory. Out-of-network care can result in significantly higher costs or no coverage at all.

8. Check your expected 2027 Part B premium

The 2027 Part B premium will be announced by CMS in fall 2026. Watch for this announcement at medicare.gov and update your monthly budget accordingly. If you have your premium deducted from your Social Security benefit, the adjustment happens automatically, but you should still verify the new amount on your benefit statement.

9. Determine whether IRMAA applies to your 2027 premiums

Log in or create an account at ssa.gov to review your income records. If your 2025 income exceeded the IRMAA threshold, you will receive a determination letter from SSA. If your income has since dropped due to retirement, divorce, or death of a spouse, call 1-800-772-1213 to file an appeal using Form SSA-44.

10. Contact your State Health Insurance Assistance Program for free help

SHIP counselors provide free, unbiased Medicare counseling with no sales pressure. Find your local SHIP at eldercare.acl.gov or request a referral by calling 1-800-MEDICARE. Schedule an appointment before October so you have time to act on their recommendations before the December 7 deadline.

11. Explore the Medicare Prescription Payment Plan option

If paying large drug costs upfront is a financial strain, ask your plan whether you can enroll in the Medicare Prescription Payment Plan, which spreads your annual drug out-of-pocket costs into equal monthly payments. Visit medicare.gov or call 1-800-MEDICARE to learn whether your plan participates and how to enroll.

12. Check eligibility for Extra Help or Medicare Savings Programs

If your income and assets are limited, you may qualify for the Part D Low Income Subsidy, known as Extra Help, which reduces drug premiums, deductibles, and copays. Apply through SSA at ssa.gov or call 1-800-772-1213. Your State Medicaid office can also evaluate you for Medicare Savings Programs that cover Part B premiums.

13. Report any suspicious Medicare-related contacts to the FTC

During Open Enrollment, note any unsolicited calls, texts, or emails claiming to be from Medicare. Medicare will never call to sell you a plan or ask for personal information. Report scam attempts at ftc.gov or by calling 877-382-4357. Share any fraud concerns related to internet crime at ic3.gov.

14. Make your plan change or confirm your current plan by December 7

If you decide to switch plans, do so online at medicare.gov, through a licensed insurance agent, or by calling 1-800-MEDICARE before December 7, 2026. If you are satisfied with your current plan and it has not made harmful changes for 2027, no action is required. Your current coverage continues automatically on January 1, 2027.

What to Do Next

Once you have completed this checklist and made any necessary changes, keep a copy of your new plan documents in a safe place where a family member or trusted contact can find them. Set a reminder for September 2027 to review your Annual Notice of Change again, because coverage details change every single year and staying ahead of those changes is the single most effective thing you can do to control your healthcare costs in retirement. If questions come up throughout the year, 1-800-MEDICARE is available 24 hours a day, 7 days a week.

Frequently Asked Questions

When does Medicare Open Enrollment start and end for 2027 coverage?

Medicare Open Enrollment for 2027 coverage runs from October 15 through December 7, 2026. Any changes you make during this window take effect January 1, 2027. Missing this deadline means you are generally locked into your current plan until the next Open Enrollment period, with limited exceptions for qualifying Special Enrollment Periods.

What is the 2027 Part D out-of-pocket cap and how does it work?

The 2027 Part D out-of-pocket cap is $2,000. Once you have spent that amount on covered prescription drugs within the calendar year, Medicare pays 100 percent of your remaining covered drug costs through December 31. The cap applies only to drugs on your plan’s formulary, which is why verifying your medications are covered before enrolling is essential.

How do I appeal an IRMAA surcharge if my income has gone down?

If your income has decreased due to a life-changing event such as retirement, divorce, or the death of a spouse, you can appeal your IRMAA determination by filing Form SSA-44 with the Social Security Administration. Call 1-800-772-1213 to request the form or to speak with an SSA representative who can walk you through the process using your updated income information.

Medicare is one of the most valuable benefits you have earned, and taking a few hours each fall to review your options is one of the most important financial decisions you will make all year. You deserve coverage that actually fits your life in 2027, and the tools and free help to find it are available right now.