Medicare open enrollment starts October 15. The drug cap is rising, some prices are falling, and your plan may have changed

Medicare’s annual open enrollment period begins on Thursday, October 15, and runs through Monday, December 7, 2026. During those eight weeks, people with Medicare can switch between Original Medicare and Medicare Advantage, change Medicare Advantage plans, or join, switch or drop a Part D prescription drug plan. Whatever they choose takes effect January 1, 2027.

Most people do nothing, and their coverage rolls over. That is the right outcome only if the plan still fits. Each year insurers change premiums, deductibles, the list of covered drugs and the doctors and pharmacies in their networks, and for 2027 there are federal changes on top of those.

What changes in Part D for 2027

A higher out-of-pocket cap. Since 2025, Part D has had an annual cap on what an enrollee pays out of pocket for covered drugs. For 2027 that cap rises to $2,400, up from $2,100 in 2026, according to the figures CMS finalized this spring and reported widely in enrollment guides. Once you reach the cap, you pay nothing more for covered Part D drugs for the rest of the year.

A higher maximum deductible. The maximum standard deductible a Part D plan can charge rises to $700 from $615. Many plans charge less than the maximum, and some have no deductible for certain drug tiers, which is one reason comparing plans matters.

For people who take few medications, these changes may not matter much. For people with expensive prescriptions, a $300 increase in the cap is a real cost, but the cap still limits total exposure in a way that did not exist before 2025.

Negotiated prices for more drugs

Under the Medicare drug price negotiation program created by the 2022 Inflation Reduction Act, Medicare negotiates prices directly with manufacturers for selected high-cost drugs. Negotiated prices for the first group of ten drugs took effect in 2026.

Prices for a second group of Part D drugs are scheduled to take effect January 1, 2027. The group includes the semaglutide products Ozempic, Rybelsus and Wegovy, which are widely used for type 2 diabetes and, in Wegovy’s case, weight management and cardiovascular risk reduction. Other drugs reported on the list include Trelegy Ellipta, Breo Ellipta, Ibrance, Calquence, Ofev, Otezla, Linzess, Austedo, Pomalyst, Janumet and Tradjenta. Some enrollment guides note that the final list effective in 2027 differs slightly from the original selection, so the authoritative list is the one CMS publishes on its drug price negotiation page.

A lower negotiated price does not automatically mean a lower price for every enrollee. What you pay still depends on your plan’s design, including which tier the drug is on and whether you have met your deductible. It does mean the plan’s cost for the drug is lower, which can feed into what you pay over the year.

Read the notice your plan sent

If you are already enrolled in a Medicare Advantage or Part D plan, your plan was required to send an Annual Notice of Change, usually called the ANOC, by September 30. It lists what is changing for 2027: premiums, deductibles, copayments, the drug formulary and the provider network. If you have not read it, it is the single most useful document for deciding whether to stay or switch.

Look in particular for:

• Whether each drug you take is still covered, and on which tier.
• Whether your doctors, specialists and preferred pharmacy remain in network.
• Changes to the monthly premium and the maximum out-of-pocket amount for medical services in Medicare Advantage.
• Whether the plan is continuing at all. Some insurers are leaving certain Medicare Advantage markets for 2027, according to reporting this summer, and members of plans that end must choose new coverage.

How to compare plans

Plan information for 2027 became available on Medicare.gov on October 1. The Medicare Plan Finder tool lets you enter your drugs and pharmacies and compare estimated total annual costs across plans in your area, not just premiums. A low-premium plan can cost more over the year if it covers your drugs on a higher tier or excludes your pharmacy.

A few habits help:

• Enter every prescription, with dose. Estimates are only as good as the list.
• Compare at least three plans. Include your current one so you can see the difference.
• Check networks directly. Call your doctors’ offices to confirm they will accept the plan in 2027.
• Be wary of pressure. Medicare does not call people to sell plans. Free, unbiased counseling is available from your state’s State Health Insurance Assistance Program.

What open enrollment does not cover

Open enrollment is about Medicare Advantage and Part D. It is not the main window for Medicare Supplement, or Medigap, policies, which follow separate rules that vary by state, and switching Medigap policies outside certain protected periods can involve medical underwriting. The standard Part B premium and deductible for 2027 are set by CMS and announced separately, usually in the fall, and apply whichever plan you choose.

If you miss the window

After December 7, changes are much more limited. Medicare Advantage enrollees have a separate period from January 1 to March 31 to switch plans or return to Original Medicare, and certain life events, such as moving out of a plan’s service area, create special enrollment periods. Otherwise, the choice made, or not made, by December 7 generally stands for the year.

For family members who help older relatives with these decisions, the most useful thing may simply be to sit down with the ANOC and the Plan Finder together before December. The changes for 2027 are not dramatic, but for someone on several expensive medications, the difference between plans can run to hundreds of dollars a year.