Last year was the first year my husband could apply for Medicare. We applied early, right at the start of the window, which opens three months before your 65th birthday month. Now we’re getting ready for our first renewal, for 2027 coverage. And just like last year, there’s more to review than we expected.
Medicare Open Enrollment runs from October 15 to December 7. Any changes you make take effect January 1. If you do nothing, your current plan usually renews automatically, along with any changes your insurer has made to it. Here’s what we’re reviewing before we let that happen.
First, Check Your Bank Account: The $90 Medicare Payment
Before you dig into plan paperwork, look at your bank statement. Medicare is sending a one-time $90 payment to about 20.8 million people to help with Part B premiums. Most direct deposits went out around October 8. If you don’t have direct deposit, a paper check from the U.S. Treasury should arrive later in October.
Not everyone qualifies. You’re eligible only if you have Original Medicare Part B. You’re not eligible if:
- You’re in a Medicare Advantage plan, even though you still pay the Part B premium
- You pay an IRMAA surcharge because of higher income
- Medicaid or another state program pays your Part B premium
The payment is automatic, with nothing to sign up for. If you are unsure of your eligibility, you can call 1-800-MEDICARE (1-800-633-4227). And be careful: no one legitimate will ask you to pay a fee or share your bank login to “release” this payment. More on scams below.
Key Medicare Numbers: 2026 vs. 2027
| Key Medicare Numbers | 2026 | 2027 |
| Part B standard premium | $202.90/month | ~$209.50/month (projected) |
| Part B deductible | $283/year | Announced in November (292.00 projected) |
| Part D maximum deductible | $615 | $700 |
| Part D out-of-pocket cap | $2,100 | $2,400 |
| Average Medicare Advantage premium | $14.37/month | ~$12.00/month (projected) |
| Average standalone Part D premium | $35.09/month | ~$36/month (projected) |
| IRMAA starts at (single / joint) | $109,000 / $218,000 (2024 income) | ~$112,000 / ~$224,000 (2025 income, projected) |
Projected figures. Official 2027 Part B amounts are expected in mid-November. Medicare Advantage and Part D figures are CMS averages, and your own plan may differ.
1. Your 2025 Income
Your 2027 Medicare premiums are based on your 2025 tax return. If your income that year was above the IRMAA threshold, you’ll pay a surcharge on both Part B and Part D. That’s true whether you have Original Medicare or a Medicare Advantage plan. Switching plans during Open Enrollment won’t change it.
Social Security usually mails IRMAA determination letters in late fall, so watch your mailbox. Pull out your 2025 return and look at your Modified Adjusted Gross Income (MAGI). If 2025 was a high-income year because of a final paycheck, a bonus, a business sale, or a big IRA withdrawal, you may owe a surcharge. If your income has dropped since then because you stopped working, you may qualify to appeal using Form SSA-44. And if your income dropped back in 2025 itself, your IRMAA may go down or disappear on its own in 2027.
Hidden Medicare Costs in Retirement: What to Expect at 65
A Word About Roth Conversions
If you converted money from a traditional IRA to a Roth in 2025, that converted amount counts as income. It could push you over an IRMAA threshold for 2027. IRMAA brackets work like cliffs. Go just $1 over a threshold, and you pay the full surcharge for that tier. And a Roth conversion isn’t a “life-changing event,” so you can’t appeal it with Form SSA-44.
But don’t let IRMAA scare you away from a smart conversion strategy. IRMAA lasts one year and is recalculated every year. Taxes saved through a conversion can benefit you for decades. It’s a math equation, and I’ll walk through the numbers in an upcoming post.
Roth Conversions vs. IRMAA; The Math (coming soon)
2. Your Annual Notice of Change (ANOC)
If you have a Medicare Advantage or Part D plan, your insurer sends an Annual Notice of Change each fall. It’s easy to toss with the junk mail, so don’t. The notice spells out what’s changing next year, including premiums, deductibles, copays, covered drugs, and network doctors. Read it line by line. Your plan can change significantly even if you change nothing.
Can’t find yours? The ANOC comes from your plan, not from Medicare, so it won’t be in your Medicare.gov account. Check your plan’s member website, usually under “Plan Documents,” or call the number on the back of your member card. You can also log in to Medicare.gov and use Plan Finder to see your current plan’s 2027 premium and drug costs.
There’s some good news in the averages this year. CMS projects the average Medicare Advantage premium will drop from $14.37 a month to about $12 in 2027. The drug coverage portion of those plans is projected to fall from $11.32 to about $7. But averages aren’t your plan. Some premiums will go down, some will go up, and a lower premium can come with higher copays or a smaller network. Your ANOC is the only place to see what’s actually happening to yours.
If you have a Medigap plan, you won’t get an ANOC for it. Medigap rate increases come in a separate letter and can arrive any time of year. You’ll still get an ANOC from your separate Part D drug plan.
3. Your Prescriptions
Prescription drug costs are changing in 2027. The standard Part D deductible rises to $700, and the annual out-of-pocket cap rises to $2,400. A federal program that helped hold down standalone Part D premiums is also ending. CMS projects the average standalone Part D premium will inch up from $35.09 to about $36 a month, but individual plans may change much more. Make a list of every medication you take, with dosages. Then enter it into the Medicare Plan Finder at Medicare.gov and compare your total yearly cost across plans. Look at the total, not just the premium. Also check whether your preferred pharmacy is still in-network.
4. Your Doctors and Coverage Type
If you have Medicare Advantage, confirm that your doctors, specialists, and hospitals will still be in-network in 2027. Networks change every year. If you split time between two states, check whether your plan covers care outside your home area.
If you have a Medigap plan, know this: Open Enrollment doesn’t apply to Medigap. In most states, switching Medigap plans after your initial enrollment period means answering health questions, and the insurer can turn you down. So think carefully before you drop a Medigap plan for a Medicare Advantage plan. Getting back in may not be possible.
5. Your Total Cost, Including the Extras
Finally, add up your whole picture. Include your Part B premium, any IRMAA surcharge, your drug plan, your supplemental or Advantage plan, and what you expect to pay out of pocket. Then add dental and vision, which Original Medicare doesn’t cover. Some Advantage plans include these extras, but check the limits. A $1,000 annual dental maximum doesn’t go far if you need a crown. The cheapest premium isn’t always the cheapest plan.
Get Free, Unbiased Help: Your State’s SHIP Program
Here’s a resource I wish we’d known about sooner. Every state has a State Health Insurance Assistance Program, or SHIP. It offers free, one-on-one Medicare counseling from trained volunteers. They don’t sell insurance and they don’t earn commissions, so they have no reason to steer you toward one plan over another. They can help you compare Medicare Advantage, Part D, and Medigap plans, and explain your options in plain English.
In Florida, the program is called SHINE (Serving Health Insurance Needs of Elders). You can reach it at 1-800-963-5337 or floridashine.org. In other states, you can find your local program at shiphelp.org.
Before your appointment, make a list of your doctors and medications. Include the dosage for each one and how often you take it.
This year, knowing about SHIP matters more than ever. Under new marketing rules that took effect October 1, agents no longer have to mention SHIP when they explain that they don’t sell every plan in your area. So you may never hear about this free help from the person trying to sell you a plan.
How to Spot This Season’s Medicare Scams
Open Enrollment is prime time for scammers, and this year has a few new twists. Medicare’s marketing rules loosened on October 1, just two weeks before enrollment opened. Here’s what changed:
- Agents can now delay their disclaimer that they don’t sell every plan. It no longer has to come in the first minute of the call.
- The 48-hour waiting period between agreeing to a sales appointment and the appointment itself is gone. An agent can now explain your options and enroll you in the same conversation.
- Ads can use words like “best” and “highest-rated” more freely.
None of this makes a legitimate agent a scammer. But it does mean you have to protect yourself. Here are the red flags to watch for:
- A call, text, or voicemail you didn’t ask for. Medicare Advantage plans aren’t allowed to cold-call you.
- Someone claiming to be “from Medicare.” Medicare doesn’t sell plans or call to sell them. Private insurers sell plans through licensed agents.
- Pressure to decide right now, like “this rate is only good today.”
- Requests for your Medicare number, Social Security number, or bank information to “hold your spot” or “release” a payment like the $90 Medicare payment. DO NOT give anyone that information!
- Texts offering a “senior card,” “flex card,” or cash benefit, especially with a link. Medicare doesn’t text you about money or cards.
- A caller who claims your plan is ending, when you never got an Annual Notice of Change saying so.
- An agent who won’t give you their National Producer Number (NPN), their license ID.
Frequently Asked Questions
When is Medicare Open Enrollment for 2027 coverage?
Open Enrollment runs from October 15 to December 7, 2026. Any changes you make take effect January 1, 2027.
Who gets the $90 Medicare payment?
About 20.8 million people with Original Medicare Part B. You’re not eligible if you’re in a Medicare Advantage plan, pay an IRMAA surcharge, or have Medicaid or another state program paying your Part B premium. Most payments arrived by direct deposit around October 8, and paper checks are going out later in October.
Are Medicare Advantage premiums going down in 2027?
On average, yes. CMS projects the average Medicare Advantage premium will fall from $14.37 to about $12 a month. Your own plan’s premium could still go up, so check your Annual Notice of Change.
How can I tell if a Medicare call is a scam?
Be wary of any call or text you didn’t request, anyone claiming to be “from Medicare,” pressure to decide immediately, or requests for your Medicare number, Social Security number, or bank information. When in doubt, hang up and call 1-800-MEDICARE.
What happens if I don’t make any changes?
Most plans renew automatically. Your plan’s premiums, copays, and covered drugs may still change, so review your Annual Notice of Change before you let it renew.
Where can I find my Annual Notice of Change?
Your ANOC comes from your Medicare Advantage or Part D plan, not from Medicare. Look on your plan’s member website or call the number on your member card.
Can I switch Medigap plans during Open Enrollment?
Open Enrollment doesn’t apply to Medigap. In most states, switching Medigap plans later means answering health questions, and you can be denied coverage.
Will changing plans lower my IRMAA surcharge?
No. IRMAA is based on your income from two years earlier, so switching plans won’t change it. If your income has dropped because of retirement, you may be able to appeal with Form SSA-44.
Should I avoid Roth conversions to stay under IRMAA?
Not necessarily. A conversion may raise your premiums for one year, but it can lower your taxes and future required minimum distributions for decades. Compare the full tax picture before deciding.
What is the Part D out-of-pocket cap for 2027?
The Part D out-of-pocket cap is $2,400 in 2027, up from $2,100 in 2026. Once you reach it, you pay nothing more for covered drugs for the rest of the year.
What if I miss the December 7 deadline?
If you’re in a Medicare Advantage plan, you get one more chance from January 1 to March 31. During that window you can switch to a different Advantage plan or return to Original Medicare. Otherwise, you’ll generally wait until next fall.
