Start With Your Annual Notice of Change

Before we get to the five numbers, find one important document:

Your Annual Notice of Change, or ANOC.

Medicare says Medicare health and drug plans send this notice each fall. It explains changes in coverage, costs and other plan details that will take effect in January. Medicare recommends reviewing those changes to determine whether your existing plan will continue to meet your needs.

If you have not read yours yet, this is a good time.

We created a separate guide explaining exactly what to look for:

Read our Medicare ANOC guide

Don’t toss that envelope on the kitchen counter and forget about it.

It may contain some of the most important financial information you receive this fall.

1. What Is Your 2027 Monthly Premium?

This is where most people start.

That’s reasonable.

Your premium matters.

But it should never be where your comparison ends.

CMS announced on September 28, 2026, that the weighted average Medicare Advantage monthly premium nationally is projected to decrease from $14.37 in 2026 to $12 in 2027. The average stand-alone Part D premium is projected to rise by less than $1, from $35.09 to approximately $36.

Those numbers sound encouraging.

But there is a very important word in those statements:

Average.

You don’t live in an average.

You live in a particular ZIP code and enroll in a particular plan.

Your plan could increase its premium.

It could decrease it.

It could remain the same.

Or the plan might not be offered to you next year.

So take your 2026 premium and put it beside your 2027 premium.

But don’t stop there.

A $0 Premium Does Not Mean $0 Healthcare

This is one of the most important concepts in Medicare Advantage.

Premium does not equal cost.

You can have a $0 monthly Medicare Advantage plan and still incur significant expenses during the year through:

Specialist copayments
Hospital copayments
Outpatient procedures
Diagnostic testing
Physical therapy
Emergency room visits
Ambulance services
Prescription drugs
Coinsurance

A low premium can be attractive.

But your real question should be:

What could this plan cost me if I actually need healthcare?

For a broader discussion of what is changing, read:

Medicare 2027: What Seniors Need to Know Before Choosing a Plan

2. What Is Your Maximum Out-of-Pocket Limit?

If you are enrolled in Medicare Advantage, this may be one of the most important numbers on your plan.

Unfortunately, it is also one many people overlook.

Your Medicare Advantage plan has an annual maximum out-of-pocket limit for covered Part A and Part B services.

Think of it as the number you hope never becomes important.

During a healthy year, you may never get close to it.

But insurance isn’t really tested during the easy years.

It is tested during the year when you have:

Major surgery
Cancer treatment
A stroke
A serious accident
Repeated specialist visits
Rehabilitation
Expensive outpatient treatment
Multiple hospital stays

That’s when the numbers buried deeper in your plan become important.

Compare 2026 With 2027

Write down:

2026 Maximum Out-of-Pocket: $______

2027 Maximum Out-of-Pocket: $______

Did it increase?

Did it decrease?

Did the plan change how in-network and out-of-network expenses are handled?

If you are comparing PPO plans, pay particular attention to the distinction between in-network and combined in-network/out-of-network limits.

This is where looking only at premium can lead you in the wrong direction.

Imagine two plans.

One costs $0 per month.

Another costs $50 per month.

The $0 plan immediately looks better.

But what if it exposes you to considerably more expense during a serious medical year?

Now the decision becomes more complicated.

That’s why Medicare is both a healthcare decision and a financial decision.

3. What Could a Hospital Stay Cost You?

Next, find the hospital section of your plan.

Do not assume it is the same as last year.

Look at what you could pay for inpatient hospitalization.

Some Medicare Advantage plans may charge a daily copayment for a specified number of days. Others may structure their cost-sharing differently.

Then go a little further.

Check:

Outpatient surgery
Ambulatory surgery centers
Specialist visits
Emergency room care
Ambulance transportation
Diagnostic imaging
MRIs and CT scans
Physical therapy
Skilled nursing care

People often spend considerable time examining extra benefits but very little time looking at the cost of actually being sick.

That priorities list may need to be reversed.

Dental, vision, hearing, fitness programs and other supplemental benefits can certainly be useful.

But first understand your medical coverage.

Think of it this way:

Nobody wants to discover after a hospital stay that they spent more time studying their dental allowance than their hospital copayment.

For more on preparing before you compare plans, see:

Before You Compare Medicare Plans for 2027, Plan for Your Healthcare

4. What Will Your Prescriptions Cost in 2027?

Prescription coverage deserves its own review every year.

For 2027, Medicare Part D continues to operate under the redesigned benefit structure, but some of the numbers have changed.

CMS has established a $2,400 annual out-of-pocket threshold for covered Part D drugs in 2027, compared with $2,100 for 2026.

The 2027 standard Part D deductible is $700, although individual plans can structure their benefits differently within Medicare rules.

But those national numbers still don’t answer the most important question:

What will YOUR prescriptions cost?

Take every prescription you currently use and check it against the 2027 plan.

For each medication, ask:

Is the drug still covered?

A formulary can change.

Did the drug change tiers?

A medication may remain covered but move to another tier with different cost-sharing.

Is there prior authorization?

Your plan may require approval before covering a medication.

Is step therapy required?

The plan may require trying another medication first in certain circumstances.

Is there quantity limiting?

Plans can establish limits on how much of certain medications they cover during a particular period.

Are you using a preferred pharmacy?

The pharmacy you have used for years may not necessarily provide the lowest cost under your 2027 plan.

This is why two Medicare plans with similar premiums can produce very different annual expenses for the same person.

One senior may take four inexpensive generic medications.

Another may take an expensive brand-name drug.

Those people should not assume the same plan will work equally well for both.

Compare Medicare based on your life—not somebody else’s.

For additional Medicare drug information, CMS maintains its official prescription drug coverage resources.

5. How Many of Your Doctors Are Still in the Network?

Technically, this isn’t one dollar figure.

But it’s too important to leave off the list.

Write down every doctor you consider important.

For example:

Primary care physician
Cardiologist
Oncologist
Orthopedist
Neurologist
Eye doctor
Preferred hospital or health system

Then verify them against the specific 2027 plan you are considering.

Do not assume that because a doctor participated in the plan during 2026, the situation will necessarily remain the same in 2027.

Provider networks can change.

Ask the Right Question

Don’t simply call a doctor’s office and ask:

“Do you accept Medicare?”

That can mean something very different from:

“Are you participating in this specific Medicare Advantage plan and network for 2027?”

Be specific.

If possible, verify the information directly through the insurance carrier’s provider directory as well.

And when something is particularly important—such as a specialist you absolutely want to continue seeing—consider documenting your verification.

Networks matter.

A wonderful Medicare Advantage plan on paper isn’t quite so wonderful if the doctors you need aren’t participating.

Don’t Let Extra Benefits Distract You From the Foundation

Now we can talk about the extras.

Depending upon the Medicare Advantage plan, you may see benefits involving:

Dental
Vision
Hearing
Fitness
Over-the-counter allowances
Transportation
Meal benefits
Other supplemental services

These benefits can have genuine value.

But they belong after your core healthcare comparison.

First check:

Doctors.

Hospitals.

Prescription drugs.

Premiums.

Medical cost-sharing.

Maximum out-of-pocket exposure.

Then examine the extras.

Choosing health insurance because of an attractive extra benefit while ignoring your hospital costs is a little like buying a house because you love the mailbox.

The mailbox is nice.

But let’s inspect the foundation.

The Simple 2027 Medicare Comparison

You don’t need to begin with a spreadsheet containing 75 columns.

Start with one piece of paper.

Create two columns:

What to Check	2026	2027
Monthly Premium	$_____	$_____
Maximum Out-of-Pocket	$_____	$_____
Hospital Costs	$_____	$_____
Prescription Costs	$_____	$_____
Doctors in Network	_____	_____

Then ask:

What changed?

That’s the purpose of the exercise.

Something changing doesn’t automatically mean you should switch plans.

It means you should understand the change.

Your Plan Is Renewing. Should You Keep It?

Possibly.

There is nothing wrong with keeping your existing Medicare plan if, after reviewing it, you determine that it still meets your needs.

Changing plans merely for the sake of changing is not the goal.

Neither is staying with a plan merely because changing feels complicated.

We’ve written more about this exact decision here:

Should I Keep My Medicare Plan for 2027? 7 Things to Check Before You Decide

And if you’ve already learned that your plan is changing:

Your Medicare Plan Is Changing. Now What?

The objective is not to convince yourself to stay or switch.

The objective is to make an informed decision.

One Question Can Change How You Look at Your Medicare Plan

Here’s a question worth asking yourself:

If I were choosing Medicare coverage today for the first time, knowing what I know now, would I select this same plan?

That’s different from asking:

“Do I really want to go through the trouble of changing?”

Human beings are creatures of habit.

If something isn’t obviously broken, we tend to leave it alone.

But Medicare plans change annually.

Your health changes.

Your medications can change.

Your doctors can change.

Your financial situation can change.

Doing nothing is still a decision.

Make sure it’s an informed one.

Medicare Open Enrollment for 2027

Medicare Open Enrollment—also commonly called the Annual Enrollment Period—runs from October 15 through December 7, 2026, for coverage beginning January 1, 2027. During this period, people with Medicare can review and change Medicare Advantage and Part D coverage subject to Medicare’s enrollment rules.

Medicare’s official website also provides plan comparison tools and Medicare information.

Visit Medicare.gov

There is no prize for making your Medicare decision on the first day.

But there isn’t much benefit in waiting until the final hours of December 7 either.

Give yourself time.

Educate Yourself First

We believe Medicare decisions should begin with education—not pressure.

That’s why MedicareSelfEnroll.com is built around a simple sequence:

Educate Yourself

Understand Medicare and what your current coverage actually provides.

Compare

Look at the plans available in your area based on your needs.

Decide

Consider your doctors, prescriptions, costs and financial exposure.

Enroll

When you’re comfortable with your decision, enroll.

Education first. Enrollment second.

You can start with our Medicare education resources here:

Visit MedicareSelfEnroll.com

Our site also includes tools to learn about Medicare, ask questions, practice comparing plans and compare actual plan choices when you’re ready.

Prefer to Watch Instead of Read?

We’re building a complete Medicare 2027 video series explaining the changes seniors should be watching.

Videos include topics such as:

Medicare 2027: What Every Senior Needs to Know Before Making a Decision

Your Medicare Plan Is Ending. Now What?

Your Medicare Plan Is Changing. Now What?

Your Medicare Premium Went Up. Should You Switch?

Your Doctor Isn’t in the 2027 Network. Now What?

Your Prescription Changed Tiers. What Does That Mean?

And our newest video:

5 Numbers to Check Before You Keep Your Medicare Plan for 2027

Watch the videos and subscribe for continuing Medicare 2027 updates:

MedicareSelfEnroll.com YouTube Channel

The Bottom Line

Your existing Medicare plan may still be exactly what you need for 2027.

Or it may not be.

Don’t let an advertisement decide.

Don’t let fear decide.

Don’t let inertia decide.

And don’t make the entire decision based on one attractive premium.

Check the numbers.

Check your doctors.

Check your prescriptions.

Read your Annual Notice of Change.

Then compare.

Educate Yourself. Compare. Decide. Enroll.

Because an informed senior is in a much better position to make a confident Medicare decision.

MedicareSelfEnroll.com

Learn first. Compare when you’re ready. Enroll with confidence.

MedicareSelfEnroll.com is not affiliated with or endorsed by Medicare or any government agency. Medicare has neither reviewed nor endorsed this information. Plan availability, premiums, benefits, provider networks and drug coverage vary by location and can change from year to year. Verify plan-specific information with the insurance carrier, official plan documents or Medicare.gov before enrolling.

William Vargas

William Vargas brings over 50 years of financial and insurance expertise to every Medicare conversation. He operates MedicareSelfEnroll.com, helping seniors in Florida, New York, and North Carolina — with no pressure, no phone calls required.

5 Numbers to Check Before You Keep Your Medicare Plan for 2027

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