Reviewed by Anthony Howe, Licensed Insurance Agent, NPN #20649362. Updated October 23, 2026, with the confirmed 2027 drug-cost figures and Medicare rule changes.
The Medicare Annual Enrollment Period (AEP) runs from October 15 to December 7 every year. This year’s window, October 15 to December 7, 2026, sets your Medicare coverage for 2027. Any change you make takes effect on January 1, 2027.
What you can change during AEP
- Switch from Original Medicare to a Medicare Advantage plan, or from Medicare Advantage back to Original Medicare.
- Switch from one Medicare Advantage plan to another.
- Join, switch or drop a Medicare Part D prescription drug plan.
If you make more than one change during AEP, the last one you make before December 7 is the one that takes effect.
What AEP doesn’t cover
- Signing up for Medicare the first time. Most people enroll during their Initial Enrollment Period, the seven months around their 65th birthday.
- Medicare Supplement (Medigap) plans. Medigap has no annual enrollment window. Outside your Medigap open enrollment period, insurers can usually ask health questions. California adds a yearly window of its own, the birthday rule, explained in our San Diego County guide.
That second point matters most if you’re thinking about leaving a Medicare Advantage plan. AEP lets you return to Original Medicare, but it doesn’t guarantee you a Medigap policy to go with it. Your federal Medigap open enrollment period is the six months that start when you’re both 65 or older and enrolled in Part B; after that, an insurer can usually review your health. Some situations give you a guaranteed right to buy, such as leaving a Medicare Advantage plan within the first 12 months after you first joined one. It’s worth confirming whether a Medigap plan will accept you before you switch, not after.
Start with your Annual Notice of Change
If you have a Medicare Advantage or Part D plan, your plan mails you an Annual Notice of Change (ANOC) by September 30. It lists what changes for 2027: premiums, copays, the drug list (formulary), and the doctors, hospitals and pharmacies in the network. Plans can change all of these from one year to the next, so the notice is worth reading even if you’re happy with your plan. Some plans are also discontinued for 2027; if yours is, the notice will say so and explain your options.
What we’re hearing from clients this year
Every Annual Enrollment Period, a few themes come up again and again in our conversations with clients. For 2027, three stand out:
- Doctors and medical groups are moving. Doctors are changing medical groups, and groups are changing which plans they work with. When that happens, staying in a plan can mean finding a new doctor, which is a real chore, especially in the middle of treatment with a specialist. In San Diego County, Sharp Health Plan’s Medicare Advantage plans also aren’t returning for 2027.
- Long waits for appointments. Some clinics and medical groups are very busy, and waiting weeks to see a doctor is one of the most common reasons people ask about changing plans. A plan that uses a different medical group can mean a different clinic.
- Drugs that were covered and aren’t anymore. A prescription can leave a plan’s drug list or move to a higher tier from one year to the next, and people often find out at the pharmacy in January.
None of this means you have to change plans. A quick review each year, even when you’re happy with your plan, is how you find out whether it still fits your doctors, your prescriptions and your budget.
What to check for 2027
- Doctors and hospitals: confirm each one is still in the plan’s network for 2027. A doctor who “accepts Medicare” isn’t necessarily in a particular Medicare Advantage plan’s network, so check the plan’s directory or ask the office about that exact plan.
- Prescriptions: check that each drug is still on the formulary, which tier it’s in, and whether it needs prior authorization, step therapy or a quantity limit.
- Pharmacy: check whether your pharmacy is preferred, standard or out of network.
- Total cost: look at the premium, deductible, copays and the plan’s maximum out-of-pocket amount, not just the monthly premium. A $0-premium plan still has copays and coinsurance, and you keep paying your Part B premium.
- Extra benefits: dental, vision and hearing benefits vary widely between plans and can change each year. Grocery, utility and similar allowances are often limited to members with qualifying chronic conditions, and for 2027 plans must publish who qualifies.
- Travel: if you spend time outside California, check how the plan covers care away from home.
Drug costs in 2027: a $2,400 cap and a $700 maximum deductible
Since 2025, Medicare drug coverage (Part D, and the drug coverage in Medicare Advantage plans) has a yearly cap on what you pay out of pocket for covered drugs. The cap was $2,000 in 2025 and $2,100 in 2026. For 2027 it rises to $2,400. Once your spending on covered drugs reaches that amount, you pay nothing more for covered Part D drugs for the rest of the year.
The most a plan can charge as a drug deductible also rises, from $615 in 2026 to $700 in 2027. Many plans charge less, or no deductible at all. The deductible counts toward the $2,400 cap, so the two don’t stack. Your premiums don’t count toward the cap, and neither do drugs your plan doesn’t cover. Covered insulin still costs no more than $35 for a month’s supply.
You can also sign up for the Medicare Prescription Payment Plan, which spreads your drug costs into monthly payments across the year instead of paying at the pharmacy counter. Our drug coverage guide covers the rest of the 2027 drug changes, including the 15 drugs with new negotiated prices.
Other Medicare changes for 2027
- Negotiated prices for 15 more drugs. Starting January 1, 2027, Medicare’s negotiated prices apply to 15 more brand-name drugs, including Ozempic, Rybelsus and Wegovy, Trelegy Ellipta, Xtandi, Ibrance and Otezla. What you pay still depends on your plan’s tier and copay for the drug.
- Telehealth from home through 2027. Eligible Medicare telehealth services can be received anywhere in the U.S., including at home, through December 31, 2027. Not every service qualifies, and not every provider offers visits remotely.
- Electronic prior authorization. Starting in 2027, Medicare Advantage plans can handle prior authorization requests electronically, and you may be able to see decisions in your plan’s online portal. Plans can still require prior authorization; the process is what changes.
- Chronic-condition support in Original Medicare. A Medicare care model called ACCESS pays participating organizations to provide technology-supported care, such as virtual visits and remote monitoring, for people with qualifying chronic conditions, where a participating organization is available.
- Immigration status and eligibility. Under a 2025 federal law, Medicare eligibility is limited to U.S. citizens and nationals, lawful permanent residents, certain Cuban and Haitian entrants, and certain Compact of Free Association migrants. Some people who already have Medicare in other immigration categories are being notified that their coverage will end in early 2027. If you received a notice from Social Security, read it closely, since it explains how to appeal.
The 2027 Part B premium
The standard Part B premium is $202.90 a month in 2026. Medicare usually announces the 2027 premium and the Part A and Part B deductibles in the fall, and we’ll add them here once they’re official. People with higher incomes pay an added amount on top of the standard premium.
After December 7
- Medicare Advantage Open Enrollment Period, January 1 to March 31: if you’re in a Medicare Advantage plan, you can make one change, either to another Medicare Advantage plan or back to Original Medicare (adding a Part D plan).
- Special Enrollment Periods: events such as moving, losing other coverage or qualifying for Extra Help can let you change plans at other times of the year.
Where to get help
- The Medicare Plan Finder on Medicare.gov, which compares plans using your own drug list and pharmacy.
- 1-800-MEDICARE (1-800-633-4227), available 24 hours a day.
- HICAP, California’s free Medicare counseling program: 1-800-434-0222.
- A licensed agent. Rock Meadow compares plans from the insurers we represent, at no charge to you. Call (760) 654-6760.
For how Medicare works in California, including the state’s own rules, see Medicare in California.
Sources
- CMS, CY2027 Medicare Advantage and Part D landscape file (October 2026): 2027 Part D out-of-pocket threshold ($2,400) and standard deductible ($700).
- CMS, Selected Drugs and Negotiated Prices: the 15 drugs with negotiated prices starting January 1, 2027.
- HHS, Telehealth policy updates: Medicare telehealth flexibilities through December 31, 2027.
- CMS, Interoperability and Prior Authorization Final Rule fact sheet: electronic prior authorization requirements beginning in 2027.
- CMS Innovation Center, ACCESS Model: technology-supported chronic care in Original Medicare.
- CMS, Contract Year 2027 Medicare Advantage and Part D Final Rule fact sheet: published eligibility criteria for chronic-condition benefits and benefit-card rules.
- CMS, 2026 Medicare Parts A and B Premiums and Deductibles: the $202.90 standard Part B premium.
- Medicare.gov, Costs for Medicare drug coverage: how the cap, deductible and insulin limit work.
- Public Law 119-21 (2025): Medicare eligibility limits for noncitizens.
