Medicare open enrollment starts Thursday, Oct. 15, and runs through Dec. 7, 2026. During that window you can switch between Original Medicare and Medicare Advantage, change Medicare Advantage plans, or join, drop or switch a drug plan, with coverage starting Jan. 1, according to Medicare.gov. If you do nothing, you generally stay in the plan you have, even if its costs or drug list changed.

That is a real risk, because most people never look. Nearly 7 in 10 Medicare enrollees (69%) did not compare their coverage options during a recent open enrollment, KFF found. Here is what changed for 2027 and a checklist to make the review manageable.

What changed for Medicare open enrollment 2027

In late September, the Centers for Medicare & Medicaid Services released its 2027 premium outlook. The headline numbers from the CMS announcement:

• Medicare Advantage premiums: The average monthly premium is projected to fall 16.5%, from $14.37 in 2026 to $12.00 in 2027. About 34 million people are expected to be enrolled.
• Stand-alone drug plans: The average total Part D premium is projected to rise less than $1, from $35.09 to $36.
• Plan choices: CMS says 97% of people with Medicare will have access to 10 or more Medicare Advantage plans, and supplemental dental, vision and hearing benefits are expected to remain stable.

Averages are not your bill, though. A federal premium stabilization demonstration that helped hold down stand-alone drug plan premiums ended after 2026, and the Part D base beneficiary premium rises to $41.33 in 2027, according to a CMS fact sheet. Your plan’s premium could move more or less than the average.

On the drug side, the annual Part D out-of-pocket cap rises to $2,400 in 2027, up from $2,100 in 2026, and no Medicare drug plan can have a deductible above $700, up from $615, according to Medicare.gov. Kiplinger also notes that Congress extended core Medicare telehealth flexibilities through Dec. 31, 2027.

Negotiated prices for 15 more drugs take effect Jan. 1, 2027, including Ozempic, Rybelsus and Wegovy, according to AARP. What you actually pay still depends on your plan’s drug list and pricing tiers, so check your prescriptions plan by plan.

One number is not out yet: the 2027 Part B premium. Medicare’s trustees projected $209.50 a month, up from $202.90, MOAA reported, and the official figure typically comes later in the fall.

Why comparing plans matters for Black seniors

Cost pressure is not evenly shared. Black Medicare enrollees are more likely than white enrollees to report problems paying medical bills (21% vs. 9%) and delaying care because of cost (14% vs. 10%), according to Justice in Aging. The same April 2026 report found that 19% of Black older adults were dually eligible for Medicare and Medicaid in 2022, though they made up 9% of the older adult population.

Many Black seniors manage conditions such as high blood pressure and diabetes that mean several prescriptions a month. For them, the drug list and pharmacy network matter more than the monthly premium. If blood pressure is part of your story, our high blood pressure guide for Black adults is a good companion to this review.

Your step-by-step plan review

The Annual Notice of Change is the most skipped letter in the mailbox, but Kiplinger points out it is where you will find higher copays, dropped doctors or removed medications. To compare options, use the official Medicare Plan Compare tool at Medicare.gov/plan-compare or call 1-800-MEDICARE (1-800-633-4227). If you pick a Medicare Advantage plan and regret it, you get one more chance: from Jan. 1 to March 31, Medicare Advantage members can switch plans or return to Original Medicare, per the same Medicare.gov enrollment page.

Extra Help and Medicare Savings Programs

These two programs are among the most underused money savers in Medicare, and open enrollment is a good time to apply.

• Extra Help lowers Part D costs, and can bring your plan premium and deductible to $0. For 2026, the limits are $23,940 in yearly income and $18,090 in resources for an individual, or $32,460 and $36,100 for a married couple, according to Medicare.gov. You apply through Social Security. If you get full Medicaid, Supplemental Security Income or help with your Part B premium from your state, you qualify automatically.
• Medicare Savings Programs are run by states and can pay your Part B premium, and in the case of the QMB program, deductibles and copays too. 2026 monthly income limits for an individual are $1,350 for QMB, $1,616 for SLMB and $1,816 for QI, per Medicare.gov. Apply through your state Medicaid office.

Free help: your local SHIP

Every state has a State Health Insurance Assistance Program (SHIP) that offers free, one-on-one Medicare counseling from a trusted, unbiased source. Use the locator at ShipHelp.org or call the national SHIP center at 877-839-2675. Bring your drug list and your Annual Notice of Change to the appointment, and talk with your doctor or pharmacist about any medication changes a new plan might require.

Scam warnings for open enrollment season

• Medicare does not cold call. Medicare will never call you to sell you anything or visit you at your home, Medicare.gov says.
• Guard your number. Do not give your Medicare Number or Social Security number to anyone except your doctor or another trusted provider, especially not a caller offering “free” gifts, gadgets or a better plan.
• Report it. Call 1-800-MEDICARE, or reach your local Senior Medicare Patrol at 877-808-2468 for help spotting and reporting fraud.

Helping a parent who is not on Medicare yet, or a younger relative who buys coverage on their own? Their shopping season is different, and our ACA open enrollment 2027 guide covers it.