Medicare AEP 2027: What to Expect and Why You Should Compare Your Plan

If you have Medicare, one of the most important times of the year is approaching. 

The Medicare Annual Enrollment Period, commonly called AEP, runs from October 15 through December 7, 2026. During this period, Medicare beneficiaries can review their coverage and make certain changes for the 2027 plan year. Any coverage changes made during AEP generally take effect on January 1, 2027. 

Even if you are satisfied with your current coverage, it is important not to assume that your plan will work exactly the same way next year. Medicare Advantage and prescription drug plans are approved one plan year at a time, and their benefits, costs, provider networks, pharmacy arrangements, and medication coverage can change. 

That is why comparing your plan should be part of your annual Medicare routine. 

What Is Changing for Medicare in 2027? 

The Centers for Medicare & Medicaid Services, also known as CMS, has finalized several updates affecting Medicare Advantage and Medicare Part D plans for 2027. 

Greater Focus on Plan Quality and Health Outcomes

CMS is updating the Medicare Advantage and Part D Star Ratings system to focus more heavily on clinical quality, health outcomes, access to care, and member experience. Eleven measures focused primarily on administrative processes or areas with little meaningful variation between plans are being removed. CMS is also adding a future Medicare Advantage measure related to depression screening and follow-up. 

Star Ratings can be a helpful comparison tool, but they should not be the only factor you consider. A highly rated plan may still be a poor fit if your doctors are not in network, your prescriptions are not covered favorably, or the plan’s costs do not match your healthcare needs. 

Continued Prescription Drug Protections

CMS is formally incorporating several Medicare Part D changes into the rules for 2027 and future years. These include eliminating the former coverage gap phase, maintaining a lower annual out-of-pocket threshold, and removing cost sharing for covered Part D drugs after an enrollee reaches the catastrophic phase. 

For 2027, internal Medicare training materials identify a $700 standard Part D deductible and a $2,400 annual out-of-pocket threshold. After reaching that threshold through qualifying costs, the member pays $0 for covered Part D drugs for the remainder of the year. These protections apply to covered Part D medications, so it remains important to verify that each prescription is on the plan’s formulary and to review any applicable restrictions. 

Additional Protection When Providers Leave a Network

CMS has also emphasized protections for Medicare Advantage members when a provider leaves a plan’s network. The final 2027 policies are intended to help beneficiaries access more reliable coverage and reduce unexpected disruptions.

However, provider participation can still vary by plan and can change from year to year. Always verify your doctors, hospitals, specialists, and other providers against the specific plan’s 2027 network, rather than relying only on last year’s information. 

What Could Change in Your Current Plan?

Your current plan may still be available in 2027, but that does not mean every part of the plan will remain the same. 

An annual plan review should examine potential changes to: 

• Monthly premiums 

• Medical deductibles 

• Doctor and specialist copays 

• Hospital and outpatient costs 

• Maximum out-of-pocket limits 

• Provider and hospital networks 

• Prescription drug formularies 

• Medication tiers and copays 

• Prior authorization requirements 

• Preferred pharmacy arrangements 

• Dental, vision and hearing benefits 

• Over-the-counter allowances 

• Transportation, fitness and other supplemental benefits 

• Plan availability in your service area 

Exact premiums, copays, networks, formularies, pharmacy arrangements, and supplemental benefits are plan-specific and must be verified using official 2027 plan information.

Why You Should Compare Your Plan Every Year

Your Prescriptions May Be Covered Differently

A medication that was covered this year could move to a different tier, have a different copay, require prior authorization, or no longer be included on your plan’s formulary. 

Your pharmacy also matters. The same covered medication may have different costs depending on whether you use a preferred, standard, mail-order, or out-of-network pharmacy. 

A proper drug comparison should include the exact medication name, dosage, strength, frequency, quantity, and preferred pharmacy. 

Your Doctors May Not Be in the Same Network

Do not rely only on someone saying a doctor “takes Medicare” or “takes the insurance company.” A provider may participate with one plan from an insurance carrier but not another plan offered by that same carrier. 

Confirm network participation for your exact 2027 plan, including your: 

• Primary care physician 

• Specialists 

• Preferred hospital 

• Outpatient facility 

• Pharmacy 

• Dental providers, when applicable 

Your Costs May Have Changed

A $0-premium Medicare Advantage plan is not necessarily a $0-cost plan. Copays, coinsurance, deductibles, prescription costs, and maximum out-of-pocket limits can significantly affect what you spend throughout the year. 

Instead of comparing only the monthly premium, consider your expected total annual healthcare cost. 

Your Personal Needs May Have Changed 

Your plan may not be the only thing that changed. Your health, prescriptions, finances, doctors, travel plans, or preferred pharmacy may also be different. 

Ask yourself: 

• Did I start or stop any medications? 

• Was I diagnosed with a new condition? 

• Did I begin seeing a new specialist? 

• Am I planning a procedure in 2027? 

• Did my preferred pharmacy change? 

• Will I spend significant time outside my plan’s service area? 

• Are dental, vision, hearing, or other benefits more important to me now? 

Review Your Annual Notice of Change

If you are currently enrolled in a Medicare Advantage or prescription drug plan, carefully read the plan’s Annual Notice of Change, often called the ANOC. 

This document explains how your current coverage will change for the upcoming plan year. Pay particular attention to changes involving premiums, copays, deductibles, medications, pharmacies, providers, benefits, and maximum out-of-pocket costs. 

Do not discard the document simply because the plan name appears unchanged. 

Compare More Than Extra Benefits

Dental allowances, over-the-counter benefits, fitness programs, and other extras can be valuable, but they should not be the starting point of your decision. 

First compare: 

1. Your doctors and hospitals 
   
   
2. Your prescriptions and pharmacies
    
3. Your expected medical costs 
   
   
4. The plan’s network rules 
   
   
5. Your maximum financial exposure 
   
   
6. Any authorization or referral requirements 

After the core medical and prescription coverage has been reviewed, compare supplemental benefits based on which ones you are actually likely to use. 

The Bottom Line 

You do not have to change plans every year. However, you should review and compare your coverage every year.

A plan that was a good fit for 2026 may still be the right choice for 2027. The purpose of an annual review is not to switch plans unnecessarily. It is to confirm that your current coverage continues to support your doctors, prescriptions, healthcare needs, and budget. 

The best Medicare decision is an informed decision based on your complete healthcare picture, not just a premium, advertisement, allowance, or individual benefit. 

Medicare AEP runs from October 15 through December 7, 2026. Do not wait until the final days to begin reviewing your options. 

Important Information 

This content is intended for educational purposes and does not represent a complete description of Medicare benefits or plan availability. Benefits, premiums, formularies, pharmacy networks, provider networks, cost sharing, and plan availability vary by plan and service area and may change each year. Contact the plan directly, consult a licensed insurance agent, or contact Medicare at 1-800-MEDICARE for additional information. Not connected with or endorsed by the United States government or the federal Medicare program. 

Schedule your AEP review today!