Your Medicare coverage could look very different next year, and now is the time to review your options.
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Medicare open enrollment is underway, and some beneficiaries are facing a trifecta of changes: higher costs, fewer benefits and more restrictions on where they can get care.
Matt Coben is reviewing his Medicare plan for next year.
“I have used an advantage plan because I’m a relatively low user of medical services,” said Coben, a retiree.
Medicare Advantage plans are offered by private insurers as an alternative to traditional Medicare. The same plan he’s relied on will come with changes in 2027.
And Yoni Bick, owner of Medicare Advisors of South Florida, says he’s in good company.
“A lot of the plan premiums are increasing, a lot of the deductibles and out-of-pocket costs are going up, and a lot of the plan benefits are being reduced,” Bick told NBC6 anchor Sheli Muniz.
The insurance advisor points to rising healthcare costs and other financial pressures on insurers. And the changes extend to prescription drug coverage.
“The average deductible on a prescription drug plan is going up about 14% to $700 per year, and the maximum out-of-pocket for those prescription drug plans is increasing from 2100 to 2400 next year,” Bick said.
For seniors on a fixed income, those costs can add up.
But it’s not just about what they pay. Some Medicare plans are cutting extra benefits or changing their networks of doctors and hospitals.
For Coben, that means losing in-network access to University of Miami Health System providers under his plan. He’s also facing higher costs if he’s hospitalized.
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“I could go to the emergency room, and in 2026 it would cost me $0 for the first four days. They’ve raised that to $95 per day for the first four days,” Coben said.
And with so many plans and benefits to compare, the decision can be overwhelming. That’s where Medicare counselors and licensed advisors can help weigh their options.
“It’s more important now than ever to make sure that all your doctors are covered, your prescriptions are covered, and that you find a plan that meets your budget,” Bick said.
Medicare open enrollment runs through Dec. 7, with changes taking effect Jan. 1.
Beneficiaries can compare plans through Medicare.gov or get free, unbiased counseling through Florida’s SHINE program as well.
SHINE Liaison on specific changes for 2027:
There are several changes Medicare beneficiaries should be aware of for 2027, particularly with Medicare prescription drug coverage. For 2027, the standard Medicare Part D deductible will be $700, up from $615 in 2026. Individual plan designs may vary, so beneficiaries should review the specific deductible and costs for their plan.
The annual out-of-pocket threshold for covered Part D prescription drugs will also increase from $2,100 in 2026 to $2,400 in 2027. Once a beneficiary reaches that threshold through qualifying out-of-pocket spending, they will not pay additional out-of-pocket costs for covered Part D drugs for the remainder of the calendar year.
Individual Medicare Advantage and Part D plans may also make changes for 2027, including changes to premiums, covered medications, pharmacy networks, provider networks and other plan benefits and costs.
That is why Medicare Open Enrollment is an important opportunity to review your current coverage and compare your options for the coming year. The 2027 Medicare Part A and Part B premiums and deductibles have not yet been officially announced by CMS. When those amounts are released, beneficiaries should rely on official Medicare information.
If you have questions about how these changes may affect you, SHINE provides free, unbiased and confidential Medicare counseling. A SHINE counselor can help you review your current coverage and understand your options for 2027.
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