Medicare Open Enrollment: What to check before December 7 to avoid unexpected expenses in 2027

The clock has started ticking for millions of Medicare beneficiaries. Since October 15, the Open Enrollment period has officially begun, a crucial window that will run until December 7. During these weeks, members can review, modify, and optimize their health coverage for the year 2027.

Starting October 15, millions of older adults in the United States have until December 7 to review and modify their health coverage through the annual Medicare Open Enrollment period, the only window of the year in which beneficiaries can change plans effective January 1, 2027, according to Medicare and the official Medicare Open Enrollment website.

The period is critical because health and drug plans can change their costs, benefits, provider networks, and drug formularies from one year to the next, even when the plan name remains the same.

Ignoring this period can be costly. Each year, Medicare health and prescription drug plans (Part D) can change their premiums, deductibles, copays, and even the networks of doctors and pharmacies that accept them. What was an affordable and convenient plan in 2026 might not be in 2027.

What changes can you make during Open Enrollment?

During this period, beneficiaries have the freedom to:

• Join a new Medicare health or drug plan.
• Leave their current plan and return to Original Medicare.
• Switch from one Medicare Advantage plan to another, or change prescription drug plans.

The key to getting it right: The “Plan Compare” tool

To facilitate this process, Medicare makes its official Plan Compare tool available to users. This online platform is essential for making informed decisions.

By entering your zip code, the tool allows you to compare all available options in your area. Additionally, you can enter the names of your current prescription drugs and search for your primary care physicians or specialists. The system will calculate estimated costs for 2027, ensuring your medicines remain covered and that you do not have to change doctors unexpectedly.

Drug spending caps increase in 2027

One of the most relevant changes for next year affects Medicare Part D, the prescription drug coverage component.

The annual out-of-pocket spending limit for covered drugs rises to $2,400 in 2027, up from $2,100 in 2026. Once that cap is reached, the beneficiary pays no additional costs for drugs covered by their plan for the rest of the year.

The maximum Part D deductible also increases: it goes from $615 in 2026 to $700 in 2027, although each plan may set a lower deductible or eliminate it. However, the $35 monthly cap for covered insulin and the $0 copay for recommended adult vaccines included in Part D remain in place.

Confirm doctors, specialists, and pharmacies before choosing a plan

Medicare Advantage plans operate with provider networks, which means beneficiaries may be limited to specific doctors, hospitals, and pharmacies for non-urgent care. Before enrolling in a new plan or confirming your current one, it is recommended to make a list of your primary care physician, specialists for chronic conditions, and any provider whose replacement would be difficult.

Provider directories are updated year to year, so it is advisable to verify each doctor's participation both with the plan under evaluation and directly with the office. The same applies to pharmacies: some plans have preferred pharmacy agreements that can reduce the cost of the same prescription depending on the establishment where it is purchased.

Final recommendations

Health experts recommend not waiting until the last minute. Take the time to open the correspondence from your current plan (especially the “Annual Notice of Change” document) and compare it with other options on the market.

Remember: any change you make before the December 7 deadline will take effect on January 1, 2027. Review your options today and protect your health and your wallet for the coming year.