When people compare Medicare plans, one number often gets most of the attention:

The monthly premium.

That makes sense.

If one Medicare Advantage plan costs $0 a month and another costs $50 or $75 a month, the $0 plan certainly looks less expensive.

But Medicare is changing in 2027, and this may be the year to stop asking only:

“What does this plan cost per month?”

and start asking:

“What could this plan cost me for the entire year?”

Those are two very different questions.

A plan with a lower premium can potentially cost you more if your doctor is no longer in the network, your hospital is out of network, your prescription moves to a more expensive tier, your specialist copay increases, or benefits you regularly use are reduced.

That is why we believe one principle is especially important for 2027:

PREMIUM DOES NOT EQUAL COST.

You have to open the hood and look at the entire plan.

Medicare Advantage Premiums Are Expected to Decline Nationally

There is some good news.

CMS announced on September 28, 2026 that the average Medicare Advantage premium is projected to decline by more than 16% nationally for 2027.

CMS also projects that average prescription drug premiums included in Medicare Advantage plans will decline substantially.

That sounds encouraging.

And it is.

But national averages do not tell you what is happening to the particular Medicare plan available in your ZIP code.

Medicare Advantage is local.

Two people living in different counties can face completely different choices, even if they have the same insurance company.

One county may have several PPO plans.

Another may have mostly HMOs.

One plan may keep your doctors.

Another may not.

One may include a generous dental allowance.

Another may reduce it.

So when you hear that Medicare Advantage premiums are declining nationally, don’t automatically assume that your personal Medicare costs are going down.

You have to examine your individual plan.

Start With Your Annual Notice of Change

If you already have a Medicare Advantage or Part D plan, one of the most important documents you receive each year is your Annual Notice of Change, commonly called the ANOC.

Don’t throw it into the pile with the Medicare advertisements.

The ANOC tells you how your existing plan is changing for the coming year.

Look specifically for changes involving:

• Monthly premium
• Medical deductible
• Maximum out of pocket
• Primary care copay
• Specialist copay
• Hospital copays
• Outpatient surgery
• Diagnostic testing
• Prescription drug coverage
• Dental
• Vision
• Hearing
• Over the counter benefits
• Transportation
• Fitness benefits
• Provider networks

A plan may keep its familiar name while changing several important features.

That is why the question should not be:

“Do I like my current plan?”

The better question is:

“Do I like the 2027 version of my current plan?”

Those may not be the same plan financially.

Your Doctor May Be More Important Than Your Premium

For many seniors, the first thing we would check for 2027 is not the premium.

It is the doctor.

Ask:

Is my primary care physician still participating in this plan for 2027?

Then check your specialists.

Cardiologist.

Oncologist.

Orthopedist.

Neurologist.

Endocrinologist.

Anyone you see regularly.

Then check the hospitals and medical systems you normally use.

This is especially important with Medicare Advantage because provider networks can change.

A $0 premium doesn’t help much if the doctors you want to see don’t accept the plan.

And don’t rely exclusively on an old provider directory.

Provider information can change.

Whenever a doctor is particularly important to you, call the doctor’s office directly and ask whether they expect to participate in the specific Medicare plan in 2027.

Use the complete plan name, not simply the insurance company’s name.

A physician may accept one plan from an insurance company and not another.

PPO Does Not Mean Every Doctor Is Equal

Another common misunderstanding involves PPO plans.

People sometimes hear “PPO” and assume:

“I can go anywhere.”

Not exactly.

A PPO generally provides some coverage for eligible out of network services, but your cost may be considerably higher outside the network.

Some providers may also choose not to accept the plan.

So don’t simply ask whether your Medicare Advantage plan is a PPO.

Ask:

What will I actually pay if I go out of network?

That can make an enormous difference if you develop a serious condition and want treatment from a particular hospital or specialist.

Look Beyond the Doctor Copay

A $0 primary care visit is easy to understand.

But major medical expenses usually don’t come from routine primary care appointments.

Look deeper.

What would you pay for:

A specialist?

An MRI?

A CT scan?

An outpatient surgery?

An emergency room visit?

A five day hospital stay?

Physical therapy?

Radiation therapy?

Chemotherapy?

Durable medical equipment?

Skilled nursing care?

Those numbers help you understand the real financial exposure inside the plan.

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

That number deserves serious attention.

Hopefully you’ll never reach it.

But insurance isn’t designed only for the year when everything goes right.

You also need to understand what could happen financially during a bad year.

Prescription Drugs Need Their Own Review

Prescription coverage can change every year.

Don’t assume that because your medication was covered favorably in 2026 it will be covered the same way in 2027.

Check every medication you take.

Look at:

• Whether the drug remains on the formulary
• What tier it is on
• Your copayment or coinsurance
• Whether prior authorization is required
• Whether step therapy applies
• Which pharmacies are preferred
• Whether mail order changes the cost

This matters even more if you take an expensive medication.

For 2027, the standard Medicare Part D benefit has an annual out of pocket threshold of $2,400, up from $2,100 in 2026. The standard Part D deductible rises to $700 for 2027. Once the applicable out of pocket threshold is reached, beneficiaries enter catastrophic coverage with no additional cost sharing for covered Part D drugs under the standard benefit structure.

That $2,400 protection is important.

But it does not mean every prescription automatically costs little.

The way drugs are covered before reaching that threshold still matters.

And remember:

PART D DRUG COSTS ARE SEPARATE FROM THE MEDICARE ADVANTAGE MEDICAL MAXIMUM OUT OF POCKET.

That distinction can surprise people.

Extra Benefits Are Nice. Medical Coverage Comes First.

Dental.

Vision.

Hearing aids.

Over the counter allowances.

Transportation.

Fitness memberships.

Healthy food benefits for people who qualify.

These benefits can be valuable.

But they should not become the tail wagging the Medicare dog.

Suppose Plan A gives you a larger dental allowance but your cardiologist isn’t in network.

Plan B has a smaller dental benefit but includes all your doctors and hospitals.

Which benefit matters more?

That’s a personal decision.

But it illustrates why comparing Medicare plans by their extras alone can be misleading.

A Medicare plan is health insurance first.

The extras come second.

A Zero Premium Plan Is Not a Free Plan

This is worth repeating every year.

A $0 Medicare Advantage premium does not mean you pay nothing for healthcare.

You still generally continue paying your Medicare Part B premium.

You may also have copayments, coinsurance, deductibles and prescription expenses depending on the plan and the services you use.

The $0 simply refers to the additional monthly premium charged by that particular Medicare Advantage plan.

That can still be an excellent value.

But understand what the zero means.

Original Medicare Plus a Supplement Works Differently

Some beneficiaries will also compare Medicare Advantage with Original Medicare plus Medicare Supplement Insurance, commonly called Medigap.

The financial structure is very different.

With Medicare Advantage, the monthly premium may be relatively low, but you generally pay copays and coinsurance as services are used, up to the plan’s applicable maximum out of pocket.

With a Medigap policy, you generally pay a higher monthly premium in exchange for more predictable medical expenses, depending on the particular supplement.

You may also need separate Part D prescription drug coverage.

Neither approach is automatically right for everyone.

Your health.

Your finances.

Your doctors.

Your travel.

Your prescriptions.

And your tolerance for unpredictable medical bills all matter.

There is also another important issue.

Depending on where you live and your circumstances, you may not always be able to switch from Medicare Advantage to a Medigap plan later without medical underwriting.

That makes this more than a one year decision.

Medicare Open Enrollment Begins October 15

The Medicare Annual Open Enrollment Period runs from October 15 through December 7, 2026 for coverage beginning January 1, 2027.

During this period, Medicare beneficiaries generally can change Medicare Advantage plans, switch between Original Medicare and Medicare Advantage, and make changes to Medicare prescription drug coverage.

You do not have to change your plan simply because Open Enrollment arrives.

But you should review it.

If your plan still works for you, keeping it may be the right decision.

The objective is not to change plans.

The objective is to make an informed decision.

Five Questions to Ask Before Keeping Your Plan

Before allowing your Medicare plan to automatically roll into 2027, answer these five questions:

1. Are my doctors and hospitals still in the network?

2. Are all my prescriptions still covered affordably?

3. What is my maximum financial exposure if I become seriously ill?

4. Which benefits have increased, decreased, or disappeared?

5. Is there another plan available in my area that better fits the way I actually use healthcare?

If you can answer those five questions confidently, you are already making a more informed Medicare decision than simply comparing premiums.

Don’t Choose Medicare From an Advertisement

During Medicare Open Enrollment, seniors are surrounded by advertising.

Television commercials.

Mail.

Telephone calls.

Internet advertisements.

Celebrity endorsements.

Promises about benefits.

There is nothing wrong with learning about available benefits.

The mistake is making a healthcare decision from an advertisement.

An advertisement doesn’t know who your cardiologist is.

It doesn’t know what prescriptions you take.

It doesn’t know which hospital you prefer.

It doesn’t know your financial situation.

And it doesn’t know what matters most to you.

Your Medicare decision should begin with your needs, not somebody else’s sales message.

A Better Way to Shop for Medicare

At MedicareSelfEnroll.com, we believe the Medicare shopping process should be different.

Learn first.

Ask questions.

Compare your choices.

Make your decision.

Then enroll.

That is what self service Medicare is about.

You don’t have to make a decision because somebody called you.

You don’t have to rush.

And you don’t have to choose a plan because one number on the advertisement looked attractive.

Medicare is changing.

The way you shop for Medicare should change also.

The Bottom Line for Medicare 2027

Lower premiums are good news.

But premiums are only one part of the Medicare equation.

Your doctors matter.

Your hospitals matter.

Your prescriptions matter.

Your copays matter.

Your maximum out of pocket matters.

And your freedom to receive care where you want it matters.

So when you’re comparing Medicare plans for 2027, don’t simply ask:

“Which plan has the lowest premium?”

Ask the more important question:

“Which plan gives me the best overall value for the healthcare I actually use?”

Because the cheapest Medicare plan on January 1 may not be the least expensive plan by December 31.

Educate yourself first.

Compare carefully.

Then enroll with confidence.

For official Medicare plan information, you can also review available plans using the Medicare Plan Finder at Medicare.gov.