If you have a Medicare Advantage plan, you may be tempted to do exactly what millions of people do every year:

Nothing.

Your Medicare card still works.

Your insurance company sent you another thick booklet.

Your monthly premium may even look pretty good.

So why bother changing anything?

Because the Medicare plan you have today may not be the same plan you will have on January 1, 2027.

Doctors can change.

Hospitals can change.

Prescription coverage can change.

Copays can change.

Dental benefits can change.

Over-the-counter allowances can change.

And in some areas, entire Medicare Advantage plans are disappearing.

That is why one of the most important questions this Medicare season is:

SHOULD YOU KEEP THE PLAN YOU HAVE?

Maybe.

But don’t decide until you open the hood.

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MEDICARE 2027 IS HERE

Medicare’s Annual Enrollment Period begins October 15, 2026 and runs through December 7, 2026.

Changes made during this period generally take effect January 1, 2027.

During this period, people with Medicare can compare Medicare Advantage and prescription drug plans available for the coming year.

CMS projects that the average monthly Medicare Advantage premium will decline nationally from $14.37 in 2026 to approximately $12 in 2027.

That sounds like good news.

And it is.

But averages can be misleading.

You don’t belong to the “average Medicare plan.”

You belong to your plan, in your county, using your doctors, taking your medications.

That is what matters.

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A LOWER PREMIUM DOESN’T ALWAYS MEAN A BETTER PLAN

This may be one of the most important Medicare lessons for 2027:

PREMIUM DOES NOT EQUAL COST.

A plan can have a $0 monthly premium and still cost you more during the year than a plan charging a monthly premium.

Why?

Because the monthly premium is only one piece of the puzzle.

You also have to consider:

• Primary care copays
• Specialist copays
• Hospital copays
• Outpatient surgery costs
• Diagnostic testing
• Prescription drug costs
• Maximum out-of-pocket limits
• Dental costs
• Out-of-network costs

You may save $30 a month on a premium and pay hundreds or thousands more if you become ill.

That doesn’t automatically make the higher-premium plan better either.

The point is simple:

Don’t shop for Medicare by premium alone.

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NUMBER ONE: ARE YOUR DOCTORS STILL IN THE NETWORK?

For many people, this should be the first question.

Not:

“What does the plan cost?”

Not:

“How much dental does it give me?”

Not even:

“How much is the over-the-counter allowance?”

Ask:

DOES MY DOCTOR TAKE THIS PLAN IN 2027?

Medicare Advantage plans operate with provider networks.

Those networks can change from year to year.

A doctor who accepted your plan in 2026 may not necessarily participate in that plan in 2027.

The same applies to:

• Specialists
• Medical groups
• Hospitals
• Laboratories
• Imaging centers
• Rehabilitation facilities

This becomes particularly important if you have an established relationship with a cardiologist, oncologist, neurologist, orthopedist or other specialist.

Changing insurance may be relatively easy.

Changing doctors may not be.

Before enrolling, verify the actual provider.

And when possible, verify the provider through more than one source.

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DON’T JUST ASK, “DO YOU TAKE MEDICARE?”

This causes a tremendous amount of confusion.

Nearly every senior has heard:

“Yes, we take Medicare.”

That does not necessarily mean the doctor participates in your specific Medicare Advantage plan.

These are very different questions:

Do you take Medicare?

and

Do you participate in this specific Medicare Advantage plan and network for 2027?

You need the answer to the second question.

When checking, have the exact insurance company, plan name, and preferably the plan’s contract information available.

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NUMBER TWO: WHAT HAPPENED TO YOUR PRESCRIPTIONS?

Drug coverage deserves its own review every year.

A medication that cost you very little in 2026 could be treated differently in 2027.

Your plan can change:

• Its formulary
• Drug tiers
• Preferred pharmacies
• Prior authorization requirements
• Step therapy requirements
• Quantity limits

And your own medications may have changed during the year.

That is why last year’s drug comparison may no longer mean very much.

Before selecting a plan for 2027, enter your current medications into Medicare’s Plan Finder or another approved Medicare comparison system.

Use the exact:

• Drug name
• Dosage
• Quantity
• Frequency

Also enter the pharmacy you normally use.

Two plans with similar premiums can produce very different annual prescription costs.

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SOMETHING ELSE CHANGES IN PART D FOR 2027

The annual Part D out-of-pocket threshold rises from $2,100 in 2026 to $2,400 in 2027.

The standard Part D deductible increases from $615 to $700.

That does not mean every prescription drug plan will charge a $700 deductible for every medication.

Plans have different benefit designs.

But it is another reminder that prescription coverage needs to be reviewed rather than assumed.

CMS currently projects the average stand-alone Part D premium to increase by less than $1 per month nationally for 2027.

Again, however:

National averages do not tell you what your drugs will cost.

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NUMBER THREE: WHAT WILL HAPPEN IF YOU GET SICK?

Nobody likes shopping for health insurance this way.

We naturally look at what we expect to use.

Maybe:

“I only see my doctor twice a year.”

That’s understandable.

But insurance isn’t really designed for the year when nothing happens.

It’s designed for the year when something does.

So when comparing Medicare Advantage plans, look at some of the expensive categories.

Ask:

What happens if I am hospitalized?

What happens if I need outpatient surgery?

What does an MRI cost?

What does chemotherapy cost?

What does rehabilitation cost?

How much could I potentially spend during a bad medical year?

That brings us to a number many people overlook.

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LOOK AT THE MAXIMUM OUT-OF-POCKET LIMIT

Medicare Advantage plans have an annual maximum out-of-pocket limit for covered Part A and Part B medical services.

That number deserves your attention.

Think of it as your financial guardrail for covered medical expenses within the plan’s rules.

Suppose one plan has attractive extras but a substantially higher maximum out-of-pocket limit.

Another plan may offer fewer bells and whistles but better protection against large medical expenses.

Which is better?

There isn’t one answer for everyone.

But you should know the number before you enroll.

Remember also that Part D prescription drug expenses operate separately from the Medicare Advantage medical maximum out-of-pocket limit.

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NUMBER FOUR: WHAT BENEFITS DISAPPEARED?

This is the part that gets people’s attention.

Dental.

Vision.

Hearing.

Over-the-counter allowances.

Transportation.

Gym memberships.

Meal programs.

Part B premium reductions.

These benefits can be valuable.

But supplemental benefits can change.

That $100 quarterly allowance you enjoyed last year may be smaller.

Dental coverage may have a different maximum.

The plan may change which services count toward that dental benefit.

A Part B giveback may disappear or shrink.

Your copay structure can change at the same time.

This is why you should read your plan’s Annual Notice of Change.

Yes, I know.

Reading an insurance document ranks somewhere between cleaning the garage and watching paint dry.

But there is important information inside it.

Don’t read every word.

Look for the sections showing what is changing for 2027.

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NUMBER FIVE: IS YOUR PLAN EVEN COMING BACK?

This is a much bigger issue for some Medicare beneficiaries this year.

Insurance companies continually evaluate where they will offer Medicare Advantage plans.

Sometimes a company changes benefits.

Sometimes it changes networks.

Sometimes it replaces one plan with another.

And sometimes a plan leaves a county or is discontinued completely.

If your plan is ending, don’t panic.

YOU ARE NOT LOSING MEDICARE.

Your Medicare entitlement does not disappear because an insurance company discontinues a Medicare Advantage plan.

But you do need to make another coverage decision.

Depending upon the circumstances, people whose Medicare Advantage plans terminate may also receive special enrollment rights.

Those rights can be extremely important, particularly if someone is considering returning to Original Medicare and purchasing a Medicare Supplement policy.

Don’t throw away a plan termination notice.

Keep it.

It may be important documentation.

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PPO DOESN’T ALWAYS MEAN WHAT PEOPLE THINK IT MEANS

Another mistake I see is assuming:

“It’s a PPO, so I can go anywhere.”

Not necessarily.

A PPO generally provides some ability to receive covered services outside the network.

But that does not mean every doctor has to treat you.

And it does not mean your cost will be the same.

An out-of-network specialist might involve coinsurance rather than a simple copay.

For example, instead of paying a fixed $40 or $50 specialist copay, you might be responsible for a percentage of the bill.

That can become expensive quickly.

When comparing PPO plans, don’t just ask whether they have out-of-network coverage.

Ask:

HOW MUCH DOES OUT-OF-NETWORK CARE COST?

That is particularly important for people who travel, spend part of the year in another state, or regularly receive care outside their local area.

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HMO OR PPO?

This is another question without a universal answer.

An HMO may have:

• Lower premiums
• Lower copays
• Richer supplemental benefits

But you generally need to remain within its provider network for routine covered care, except for certain situations such as emergencies.

A PPO may provide more flexibility.

But that flexibility may come with higher premiums, higher copays, or higher out-of-network costs.

The letters on the insurance card don’t determine which plan is best.

Your medical situation does.

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DON’T CHOOSE MEDICARE BASED ON THE DENTAL BENEFIT

Dental benefits get people’s attention.

Insurance companies know that.

A plan may advertise thousands of dollars in dental benefits.

Sounds terrific.

But ask a few questions.

Which dentists participate?

Is there an annual maximum?

Are implants covered?

Are dentures covered?

Are crowns covered?

Is there coinsurance?

Is prior authorization required?

A $2,000 dental benefit isn’t worth $2,000 to you if the dentist you use doesn’t participate or the procedure you need isn’t covered the way you expected.

Dental matters.

But medical coverage should come first.

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YOUR DOCTOR MAY BE MORE IMPORTANT THAN YOUR DENTIST

Suppose Plan A offers $3,000 in dental coverage.

Plan B offers only $1,500.

Plan A looks better.

But then you discover your cardiologist and hospital are in Plan B and not Plan A.

Now which plan is better?

That’s exactly why Medicare shopping requires looking at the entire picture.

The best benefit brochure doesn’t necessarily mean the best healthcare plan.

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DON’T AUTOMATICALLY KEEP YOUR OLD PLAN

But don’t automatically change it either.

There is nothing wrong with staying where you are.

In fact, after comparing your options, you may discover that your existing plan remains your best choice.

Excellent.

Then you have made an informed decision instead of an accidental one.

That’s the goal.

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THE FIVE THINGS TO CHECK FOR MEDICARE 2027

Before keeping or changing your Medicare Advantage plan, review these five areas:

1. Doctors

Are your physicians, specialists and medical groups participating?

2. Hospitals

Are the hospitals and facilities you would actually use included?

3. Prescriptions

Are your medications covered, at what tier, and through which pharmacy?

4. Costs

Look beyond the premium. Check copays, coinsurance, deductibles and maximum out-of-pocket exposure.

5. Benefits

What changed in dental, vision, hearing, OTC, transportation and other supplemental benefits?

Only after checking those should you ask:

SHOULD I STAY OR SHOULD I GO?

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MEDICARE IS BECOMING A SHOPPING DECISION

Medicare has changed.

Years ago, many people enrolled in coverage and kept it year after year without thinking about it.

Today the Medicare Advantage marketplace changes continuously.

Plans enter markets.

Plans leave markets.

Provider networks change.

Benefits change.

Drug formularies change.

Costs change.

That makes annual comparison increasingly important.

The Centers for Medicare & Medicaid Services itself encourages beneficiaries to use Open Enrollment to review their coverage and compare 2027 options.

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MEDICARE IS CHANGING. THE WAY YOU SHOP FOR MEDICARE SHOULD CHANGE ALSO.

That is why we created MedicareSelfEnroll.com.

The old Medicare sales model often began with a telephone call.

Then came the salesperson.

Then came the sales pitch.

We think the order should be different.

LEARN.

ASK.

COMPARE.

DECIDE.

ENROLL.

Education first.

Enrollment second.

You should have the opportunity to understand your choices before anyone asks you to make a decision.

At MedicareSelfEnroll.com, you can explore Medicare information, ask questions, compare available options and enroll when you are comfortable.

No pressure.

No need to make a decision during a sales call.

And you remain in control.

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BEFORE YOU ENROLL, EDUCATE YOURSELF

Medicare is not simply a medical decision.

It is also a financial decision.

The plan you choose determines which doctors you can conveniently use, what you pay when you become sick, how your prescriptions are covered, and potentially how much financial exposure you face during the year.

Spend a little time looking beneath the premium.

Check the network.

Check the drugs.

Check the hospital.

Check the maximum out-of-pocket limit.

Check what changed.

Then make your decision.

Because the Medicare plan you had in 2026 may still be an excellent choice for 2027.

But don’t assume it.

Know it.

MEDICARE 2027

Educate Yourself First.

Then compare.

Then decide.

And when you’re ready:

Enroll with confidence at MedicareSelfEnroll.com.

MedicareSelfEnroll.com is not affiliated with or endorsed by the U.S. government or the federal Medicare program. Plan availability, benefits, provider networks, formularies and costs vary by location and can change. Always verify current plan information before enrolling.