Starting Oct. 15, millions of older adults will evaluate their traditional Medicare, Medicare Advantage and Part D drug plans. Many may move to new plans during Medicare’s annual open enrollment period, which runs through Dec. 7, as we reported in part one.
Making those decisions may be harder this year because of changes in plan costs and coverage, an expected Part B premium increase, and some Medicare Advantage plans leaving the market, as Modern Healthcare reported Sept. 30.
By now, Medicare Advantage and Part D enrollees should have received an Annual Notice of Change by mail that explains how their plan’s coverage and costs will change in 2027. But many seniors may find these publications unclear and unable to address their concerns.
As a result, beneficiaries may use AI chatbots such as ChatGPT, Claude, or Gemini to answer these questions. But the answers could be incomplete, so consumers should verify plan-specific information using official Medicare resources or qualified advisers.”
Health journalists covering the annual scramble should know why using AI as a shortcut could backfire — and what is actually changing in 2027.
Why this matters
By explaining the pitfalls of open enrollment, journalists can help audiences understand Medicare’s nuances and avoid expensive mistakes.
AI can explain concepts, for example, but it cannot calculate personal costs. It can distinguish between Medicare Advantage and traditional Medicare. Still, it cannot pull actual premium and drug-cost data like Medicare’s Plan Finder tool can, because that data isn’t available on open websites the way AI training data are.
State rules can also confuse AI tools. Medigap enrollment rights and financial assistance eligibility vary by state, and general-purpose AI models cannot consistently track which rule applies where.
And AI chatbots may not know a senior’s doctor network, prescription or formulary information, Jessica Hall reported for MarketWatch in August. Hall quoted Cobi Blumenfeld-Gantz, CEO and co-founder of Chapter, a company that helps subscribers choose Medicare and Medicare Advantage plans. “If they give the right answer, it will be pure happenstance,” Blumenfeld-Gantz told her.
Questioning AI’s apparent certainty
Louise Norris, a health policy analyst for medicareresources.org, warned that AI and chatbots may seem certain, so a wrong answer could look identical to a right one. Norris recommended that consumers using AI verify all plan information against Medicare.gov’s Plan Finder, a State Health Insurance Assistance Program (SHIP) counselor, 1-800-MEDICARE, or consult a State Health Insurance Assistance Program (SHIP) counselor. This advice is especially true for any information related to a decision the consumer needs to make.
When testing several AI tools, Norris found they were confident in their answers, even when they provided incorrect information about basic coverage questions. This past summer, she asked multiple AI tools a set of common questions, using details a typical shopper might enter, such as state of residence, general health situation and age.
While the answers were detailed and seemed authoritative, Norris caught numerous errors because her job involves evaluating health coverage.
In a recent analysis, Norris found AI tools using outdated federal poverty guidelines to calculate subsidies, incorrectly telling her she’d qualify for Affordable Care Act marketplace subsidies in Colorado when her income actually made her eligible for Medicaid instead. Another tool missed Minnesota’s Basic Health Program altogether.
AI chatbots can potentially help distill or summarize information, said Jeffrey Marr, Ph.D., a health economist and assistant professor of health services, policy and practice at Brown University’s School of Public Health. But like Norris, he cautions that consumers and journalists should be aware the tools can produce misleading or incorrect information.
Shop around for drug plans
One of the most complex decisions any senior will make involves drug-plan coverage. That’s why AARP’s Prescription Drug Policy Expert Leigh Purvis tells seniors, “You better shop around.”
Even if you intend to keep your current prescription-drug plan, Purvis warned seniors to compare every aspect of their current plan with what’s available under plans effective Jan. 1, 2027.
It’s important for people to know that the next 15 drugs with negotiated prices will become available on Jan. 1. That means that 25 high-priced drugs now have Medicare-negotiated prices, meaning we expect to see significant savings from those 25 drugs.
Leigh Purvis, AARP
Diligent shoppers will find that insurers are changing everything they can about their prescription-drug plans to keep their own costs low, Purvis said in an interview. She explained that health insurers are not only raising prescription drug prices, but could also change their pharmacy networks and raise the copayments they charge consumers.
Medicare Advantage members who have Medicare Part D prescription drug plans may find that health insurers are asking seniors to pay what’s called “co-insurance.”
“That’s where you’re paying a percentage of that drug’s price,” Purvis said. “And so those price increases have a meaningful impact on the people taking those drugs. Drug prices are already high, and they tend to rise every year.”
Purvis added that all seniors should know exactly what they will pay out of pocket. Out-of-pocket costs are also called “cost sharing,” or the copayment consumers pay when filling prescriptions.
“You have to check whether your drug will be covered at all, and whether prior authorization will be required,” she advised.
Insurers use prior authorization to decide whether to fill a prescription, even overriding a physician’s prescription.
Beware of rising costs
A May 2026 AARP Public Policy Institute report showed that what consumers pay for the 25 top-selling brand-name drugs rose an average of 81% after entering the U.S. market. That rate of increase is much higher than what consumers paid for the same drugs in 19 comparable high-income nations, AARP said. In those 19 countries, the average price fell by 13%, the association reported.
Health insurers don’t just change their Medicare drug plans; CMS does too, Purvis commented.
For example, under Medicare Part D, members will see an increase in what they pay for a deductible from $615 to $700 in 2027.
Leigh Purvis, AARP
Another Inflation Reduction Act provision will help make prescriptions more affordable by raising the out-of-pocket spending limit from $2,100 this year to $2,400 in 2027, Purvis noted.
“Also there’s an increase in how much seniors will pay as their maximum out-of-pocket in Medicare Advantage plans,” she said. “That limit has increased to $9,850 for 2027.”
KFF reported in June that this year, the out-of-pocket limit for Medicare Advantage plans could not exceed $9,250 for in-network care or $13,900 for in-network and out-of-network services combined, though plans could offer lower limits.
One of the most significant changes under the Inflation Reduction Act is CMS’s ability to negotiate drug prices with companies, as KFF detailed in a March 2026 report.
“It’s important for people to know that the next 15 drugs with negotiated prices will become available on Jan. 1,” Purvis said. “That means that 25 high-priced drugs now have Medicare-negotiated prices, meaning we expect to see significant savings from those 25 drugs.”
Resources
- AI wants to help you pick a Medicare plan. Should you let it? – Morningstar
- Medicare shopping in the age of AI: Can AI help you navigate enrollment? – eHealth Insurance
- How AI helps you pick the right Medicare plan for your meds and your doctors – AI for Your Day blog
- Can AI help you shop for health insurance? healthinsurance.org
- Medicare Advantage in 2026: Premiums, Out-of-Pocket Limits, Supplemental Benefits, and Prior Authorization, KFF, June 5, 2026
- Key Facts About Medicare Drug Price Negotiation, KFF, March 11, 2026
