It’s that time of year again when traditional Medicare enrollees can change their Part D prescription drug plan, move from a Medicare Advantage plan back to original Medicare, and in a handful of states, switch Medigap plans. Several changes in 2027 suggest local coverage angles.
Remember: Medicare’s Fall Open Enrollment period runs October 15 through December 7, and any changes beneficiaries make take effect January 1, 2027.
What to watch for
Here are some ideas and pitfalls to keep in mind:
Report premium estimates as estimates, not final numbers. The standard Part B premium is projected to rise from $202.90 to about $209.50 a month in 2027. That’s an increase of $6.60 a month, or about $79 a year, based on the 2026 Medicare Trustees Report.
The Part B deductible is projected to climb from $283 to around $292. The Centers for Medicare and Medicaid won’t confirm the actual 2027 figures until late October or November, so be sure to note these numbers are projections and be ready to update once the official announcement is released.
Look beyond premiums when covering prescription drug costs
Explain the Part D out-of-pocket cap increase 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 climbs to $2,400 in 2027. Unlike the Part B premium, this figure is locked in and can be a hook for stories on the cost of drugs, choosing a plan wisely, and the importance of beneficiaries reviewing their drug plan annually, even if nothing else has changed.
Don’t assume readers know about the Medicare Prescription Payment Plan or how enrollment works.
The Medicare Prescription Payment Plan lets enrollees with expensive medications spread the $2,400 cap into roughly equal monthly installments instead of paying it off in the first few months of the year. It’s an easy story to localize with pharmacists or SHIP counselors, but be clear with readers that enrollment isn’t automatic; beneficiaries must request it through their plan, and anyone switching plans during open enrollment has to set it up again with the new plan, not the old one.
Look past the premium to formulary and tier changes. Formulary and tier changes are a common blind spot for beneficiaries, according to Louise Norris, a health policy analyst for medicareresources.org . A drug moving to a lower-cost tier is good news while a move to a higher tier means bigger out-of-pocket costs even though the $2,400 cap still applies. This is a good prompt for stories reminding readers to check not just whether a drug is still covered but what tier it falls into before automatically renewing.
Treat Medigap as a story of its own
Cover Medigap premium increases separately from Part B. A sampling of Medigap plans nationally showed double-digit percentage premium increases this year, with another round possible for 2027. These increases hit at each enrollee’s individual policy anniversary, not uniformly on January 1. This is an important detail to clearly explain since readers may not realize their Medigap costs could change at a different time of year than other Medicare costs.
Explain why most people can’t just shop around for a cheaper Medigap plan. The guaranteed-issue window most people get is a one-time, six-month period tied to turning 65 and enrolling in Part B. After that, in most states, switching Medigap plans, even to a different plan within the same insurer, requires medical underwriting, meaning a health change can effectively lock someone out of a switch. This is a frequent source of reader confusion worth addressing directly.
Localize the state-by-state Medigap underwriting rules. New York and Connecticut don’t medically underwrite Medigap applicants regardless of when they apply; Massachusetts, Maine, Missouri, Washington and several other states have their own limited windows or “birthday rule” provisions allowing switches without underwriting under certain conditions. This state-by-state breakdown can help journalists learn what applies in their coverage area, since the rules vary widely and most readers won’t know their state’s specific protections.
Check which Medicare Advantage plans are leaving your market
Track Medicare Advantage plans exiting your market because different rules apply. Enrollees whose Medicare Advantage plan is exiting the market for 2027 get guaranteed-issue access to most Medigap plans in their area if they choose to switch to original Medicare, a right they wouldn’t normally have. Several insurers are shrinking service areas or dropping contracts this year, so checking which plans are pulling out locally is an important angle that could impact a big chunk of your audience.
Resources
- Medicare Open Enrollment — CMS partner resources and key dates
- Medicare Prescription Payment Plan — official program details from Medicare.gov
- 2027 Medicare Advantage/Part D rate announcement — CMS fact sheet on finalized 2027 figures
- medicareresources.org state-by-state Medigap guide — underwriting rules by state
- 2026 Medicare Trustees Report analysis — projected Part B premium and deductible figures for 2027
