Imagine picking up your first prescription in January and hearing a different price than you paid in December. Or calling to schedule a follow-up and learning that your specialist is outside your Medicare Advantage plan’s network for the new year. Even when your plan name stays the same, some of the details you count on can change.
Medicare Open Enrollment runs from October 15 through December 7, 2026. If you make a change during this period, your new coverage generally starts January 1, 2027, as long as the plan receives your enrollment request by December 7. Start with the care you actually use and work through these five questions.
1. What is my current plan changing for 2027?
Find your Annual Notice of Change, sometimes called an ANOC. Medicare Advantage and Part D plans send this notice in the fall to explain changes taking effect in January. Start with the details you use most. If you see a specialist regularly, check the specialist copay. If you take several prescriptions, look for changes to drug costs or coverage. If you can’t find your notice, ask your plan for a copy.
2. Will my doctors, specialists, and hospital still be in my network?
If you have Medicare Advantage or are considering it, check the exact 2027 plan name with both the plan and the provider’s office. A doctor’s office may accept one plan from an insurance company and have a different arrangement with another. Check the office location you actually visit and the hospital or facility you would use for planned care.
3. How will my prescriptions be covered?
Make a list of your medications with the exact names, doses, and how often you fill them. Check each one against the plan’s 2027 list of covered drugs, called a formulary. Look at the cost and whether any prescriptions need prior approval. Add any medication you started this year so your comparison reflects what you take today.
4. What would I pay at the pharmacy I actually use?
Some plans charge different amounts at different pharmacies in their network. If your plan has preferred pharmacies, compare your estimated costs at your usual location with a preferred location you could realistically use. For medications you refill regularly, check whether a 90-day supply is available and compare what it would cost.
5. What might this plan cost in a typical year?
Start with 12 months of premiums, then estimate what you may pay for your regular prescriptions and, where applicable, office visits, specialist appointments, tests, and other care you expect to use. Look at how the deductible applies so you can estimate what you may pay early in the year. For Medicare Advantage, also check the annual out-of-pocket limit for covered medical services. Medicare Plan Compare can estimate monthly and yearly drug costs based on the prescriptions you enter.
Do I have to change plans during Open Enrollment?
If your current plan will still be offered to you in 2027 and the coverage fits your needs, you can generally keep it without re-enrolling. If you received a letter saying your plan is ending, read it for your next steps. And if you’re considering leaving Medicare Advantage for Original Medicare, check your options for separate drug coverage and whether you can buy a Medicare Supplement (Medigap) policy before making the switch. Your ability to buy Medigap can depend on your circumstances and state rules.
Want help reviewing your Medicare coverage for 2027?
Contact our office to schedule a Medicare coverage review. Bring your current plan name, a list of your medications, your preferred pharmacy, and the doctors you want to keep. We can help you identify what’s changing and walk through the questions that matter for your care and budget.
Official Medicare resources
Medicare Open Enrollment
https://www.medicare.gov/health-drug-plans/open-enrollment
Annual Notice of Change
https://www.medicare.gov/basics/forms-publications-mailings/mailings/costs-and-coverage/upcoming-plan-changes
Medicare Plan Compare
https://www.medicare.gov/plan-compare
Medicare pharmacy networks
https://www.medicare.gov/health-drug-plans/part-d/what-drug-plans-cover/pharmacies