Medicare Open Enrollment Opens Oct. 15 With a Higher Part D Cap, an Expiring Subsidy and Plan Exits in 28 States

Open enrollment for Medicare began today, Thursday, Oct. 15, and ends Dec. 7. Anything you change takes effect Jan. 1, 2027.

During the window, people can switch between traditional Medicare and privately run Medicare Advantage plans, or pick a new standalone Part D drug plan. The Medicare Plan Finder at Medicare.gov is the official comparison tool.

The timing is political. Midterm elections are weeks away, and voters have consistently named cost of living as a top concern. The Social Security Administration announced Wednesday that the 2027 cost-of-living adjustment will be 3.6%. That works out to about $75 more per month for nearly 72 million Social Security recipients and about 7.3 million people on Supplemental Security Income.

Part D: higher caps, subsidy ends

The annual cap on out-of-pocket Part D drug spending rises to $2,400 in 2027, up from $2,100 in 2026. The standard deductible goes from $615 to $700.

A temporary Part D premium subsidy also ends at year's end. The Biden administration launched it in 2024 in response to the effects of the 2022 Inflation Reduction Act. The Trump administration is concluding it.

The Centers for Medicare & Medicaid Services has projected only modest premium increases for most people. CMS did not respond to an Associated Press request for comment on the subsidy.

Negotiated prices reach 15 more drugs

Medicare-negotiated prices, a product of the Biden-era law, take effect Jan. 1 for 15 drugs. They include Ozempic, Rybelsus and Wegovy, along with Trelegy Ellipta, Xtandi, Pomalyst, Ibrance, Ofev, Linzess, Calquence, Austedo, Breo Ellipta, Tradjenta, Xifaxan, Vraylar, Janumet and Otezla.

CMS expects the negotiated prices to lower drug costs for people in Medicare by $685 million in 2027.

Medicare Advantage: cheaper on average, fewer choices in many states

In a Sept. 28 statement, CMS said average monthly Medicare Advantage premiums will fall to $12 in 2027, from more than $14 in 2026. That is a decline of more than 16%. CMS also projects a 38% drop in premiums for Medicare Advantage prescription drug coverage. It says supplemental benefits such as dental, vision and hearing are expected to remain stable.

The national average hides a lot of variation. CMS says the number of plans nationwide is nearly unchanged. But options shrink in 28 states and the District of Columbia.

Wyoming leads the decline, dropping from 14 plans to eight. More than a quarter of plans exited Montana (28%), Washington, D.C. (25%) and Maryland (25%).

Premiums rise in 19 states. Wyoming's jumps from nearly $46 a month to more than $69. Idaho's climbs about $10 to roughly $38, Connecticut's rises $8 to $25, and Vermont's goes from $0 to $7.80.

CMS Administrator Dr. Mehmet Oz urged beneficiaries "to use Open Enrollment as an opportunity to review their coverage, compare options, and pick the plan that best suits their needs and budget."

David Lipschutz, co-director of the Center for Medicare Advocacy, sees more turbulence than the averages suggest. Some Medicare Advantage plans are pulling out of specific areas and scaling back benefits such as dental, he said, while potentially raising cost-sharing. "It looks like this time there's more disruption than usual," Lipschutz said.

The stakes are large. According to KFF, 35.2 million people, or 55% of Medicare beneficiaries, were in Medicare Advantage in 2026. A February study in the Journal of the American Medical Association found that about 10% of Medicare Advantage enrollees, roughly 2.9 million, had to find new coverage in 2026 after plans were discontinued and insurers left the market.

What to check before switching

Juliette Cubanski, director of KFF's program on Medicare policy, said open enrollment gives people a chance to see if there are better options for accessing care "at possibly a lower cost."

The Medicare Rights Center tells enrollees to read the Annual Notice of Change or Evidence of Coverage that plans sent in late September. Those documents spell out changes to costs, drug lists, coverage restrictions and provider networks. Anyone who wants to keep a particular doctor or pharmacy should confirm it is still in network.

The group also warns that people on Original Medicare with a Medigap policy who move to Medicare Advantage may find it difficult or impossible to get Medigap back. State Health Insurance Assistance Programs can explain local rules. In Washington state, Insurance Commissioner Patty Kuderer's office offers free counseling through its SHIBA program and a Medicare Jumpstart Toolkit. Callers anywhere can reach 1-800-MEDICARE (1-800-633-4227).

What comes next

Medicare is expected to release the 2027 Part B premium and the Part A and Part B deductibles in late October or early November, according to Kiplinger's enrollment calendar. For most beneficiaries the Part B premium is deducted from Social Security checks. That figure will determine how much of the $75 monthly raise reaches their bank accounts.

The deadline to make a change is Dec. 7.