When Medicare open enrollment begins Oct. 15, beneficiaries will need to know the key changes coming in 2027. During fall open enrollment, which runs through Dec. 7, traditional Medicare enrollees can change their Medicare Part D prescription drug plan or, in some states, switch to a different Medigap plan or from a Medicare Advantage plan to traditional Medicare.
Part B premiums and deductibles will rise, AARP reported Oct. 5, citing a projection from the Medicare Board of Trustees. The standard monthly premium payment may go up by $6.60 to $209.50 per month in 2027, AARP added. Part B covers drugs physicians administer, diagnostic tests and preventive care. The trustees expected that the annual Part B deductible could rise from $283 this year to $292 in 2027, AARP added. Later this fall, CMS will announce the actual deductibles and premium rates for 2027, AARP noted.
In January, some beneficiaries receiving Part D drug benefits also will pay more. The Part D out-of-pocket cap, created under the Inflation Reduction Act, started at $2,000 in 2025, rose to $2,100 this year and will climb to $2,400 in 2027.
Legal immigrants may lose coverage
For journalists, one new significant angle to cover this year involves the estimated 100,000 immigrants who are here legally and enrolled in Medicare, according to a report from Justice in Aging, an advocacy group. Many Medicare members who are lawfully present immigrants and who have lived here, worked legally and paid into the program for at least a decade will lose access to Medicare early in 2027, the group reported.
H.R.1, the budget reconciliation bill that Republicans passed in July 2025, cut nearly $1 trillion from Medicaid and gave tax cuts to the wealthy and corporations. The bill also included rules ending Medicare eligibility for certain groups of legal immigrants beginning next year. Included among those at risk are humanitarian immigrants, refugees, asylees, those with temporary protected status and survivors of trafficking or domestic violence, according to U.S. Citizenship and Immigration Services.
“Many older immigrants could lose Medicare coverage without realizing it until they need care,” Natalie Kean of Justice in Aging warned in an emailed statement. “The proposed rule does not provide adequate notice, and for people with serious illnesses, like cancer, the consequences could be life-threatening.”
After Medicare proposed the rule affecting certain legal immigrants, Justice in Aging submitted comments and organized more than 100 organizations to sign a letter asking Medicare to develop a robust notification process to reduce the burden on people as much as possible.
How legal immigrants fare during every encounter with the health care system will be a story for all journalists. Will those legal immigrants face deportation, risk having their care denied, or face other risks?
Help for high-cost drugs
As in previous years, some beneficiaries will face higher costs in 2027. The out-of-pocket cap for Part D drug plans increases to $2,400 in 2027, meaning beneficiaries using higher-cost prescriptions will pay more up front at the pharmacy counter. Those taking expensive medications can enroll in the Medicare Prescription Payment Plan, which spreads that $2,400 cap into roughly equal monthly installments rather than front-loading costs early in the year. Enrollment isn’t automatic. Beneficiaries must request it through their plan, and anyone switching plans during open enrollment must set it up with the new plan, not the old one, once enrollment takes effect.
Beneficiaries need to check their plan each year. Louise Norris, a health policy analyst for medicareresources.org, also flagged formulary and tier changes as a common blind spot. A drug moving to a lower-cost tier may reduce out-of-pocket costs. But one moving to a higher tier means higher out-of-pocket costs even though the $2,400 cap still applies.
“Your formulary may be changing,” Norris warned. Therefore, before renewing, she urged enrollees to check not just whether a drug is covered but which tier it will fall into in 2027.
Medigap premiums may rise, too
Medigap premiums are also rising. Norris and several colleagues reviewed data from some national plans showing that many will charge double-digit percentage increases for 2027 and another round is possible for 2028, Norris explained. These increases fall on each enrollee’s individual policy anniversary, not on a uniform January 1 schedule.
Switching Medigap plans isn’t easy for most beneficiaries, however. Seniors seeking free, unbiased one-on-one counseling from experts who know how to enroll in Medicare Advantage, Medigap or Medicare prescription drug plans, the State Health Insurance Assistance Program (SHIP) is available in every state.
SHIP advisers can explain the enrollment period that most seniors get in a one-time, six-month period tied to turning 65 and enrolling in Medicare Part B. After that date, SHIP advisors can explain how to switch Medigap plans in most states — even to a different plan from the same insurer — and how switching might require medical underwriting, meaning a health change could prevent a senior from switching, Norris explained.
Some states, however, allow seniors to switch Medigap plans. New York and Connecticut do not allow insurers to use underwriting for Medigap applicants regardless of when they apply.
Massachusetts, Maine, Missouri, Washington state and several others have their own limited windows or “birthday rule” provisions that allow switching without underwriting under certain conditions. Medicareresources.org lists those rules for each state.
Useful reports for journalists
One story to cover this fall is that many seniors need to find new coverage because some Medicare Advantage plans will leave the market for 2027 and other insurers will shrink their service areas or drop their contracts, according to KFF.
Here are three KFF reports on these issues:
Medicare Open Enrollment and Coverage Options: Key Questions and Answers tackles what changes Medicare beneficiaries can make during open enrollment; how Medigap and other forms of supplemental coverage affect coverage decisions; how Medicare Advantage plans and Part D stand-alone prescription drug plans vary; and the tradeoffs involved when deciding whether to enroll in traditional Medicare versus Medicare Advantage
Medicare Advantage Plan Availability Varies Widely by County for 2027 examines county-level variation in the availability of Medicare Advantage plans with prescription drug coverage (MA-PDs) in 2027, including which insurers are entering or leaving markets, and other changes from 2026. This report shows that 20% of Medicare beneficiaries can choose from more than 40 MA-PDs for 2027, down from 27% this year, and 1% of beneficiaries will have no MA-PD options next year.
How Much Do People with Medicare Pay for Coverage? provides an overview (using data for 2026) of the out-of-pocket costs beneficiaries pay in traditional Medicare, Medicare Advantage, and Medicare Part D, including premiums, deductibles, copays, and coinsurance.
