Medicare Changes for 2027: Every Update You Need to Know Before AEP

Every fall, Medicare updates its numbers. Premiums, deductibles, IRMAA brackets, drug rules. Some of the 2027 numbers are already known. Others get released by CMS in November. Here is the full picture for 2027 in one place.

The short answer

2027 keeps most of the good changes from 2025 and 2026. The $2,000 Part D out-of-pocket cap continues. The $35 insulin cap continues. ACIP vaccines are still $0. Part B premiums and deductibles will rise (final numbers announced by CMS in November 2026). IRMAA thresholds get an inflation bump. Medicare Advantage plans keep tightening benefits.

Part B premium for 2027

The standard Part B premium in 2026 is around the mid-$180 range. The 2027 rate will be announced by CMS in November 2026 as part of the annual premium release.

Historically, Part B premiums have gone up 4 to 8 percent per year, though 2026 was smaller. Check CMS.gov for the official 2027 Part B premium as soon as it publishes.

Higher earners pay more through IRMAA (see below). Lower income seniors may get help through a Medicare Savings Program that pays the premium.

Part B deductible for 2027

The Part B deductible in 2026 is $257. The 2027 amount will also be announced in November 2026. It usually rises by about $10 to $30 per year.

You pay this deductible once per year before Medicare starts paying its 80% share of your Part B services. If you have Medigap Plan G, your plan pays everything after the deductible. If you have Plan F (still available if you enrolled before 2020), the deductible is covered too.

Part A hospital deductible for 2027

The Part A inpatient hospital deductible in 2026 is $1,676 per benefit period. The 2027 amount comes out in November. It usually goes up by $30 to $80 per year.

Reminder: the Part A deductible is per benefit period, not per year. A benefit period starts when you go into the hospital and ends 60 days after you leave. So in a bad year you could pay this deductible more than once.

Medigap Plans G, N, and even A cover the full Part A deductible. Medicare Advantage plans have their own hospital copay structure, usually a per-day charge for the first 5 to 7 days.

Part D $2,000 out-of-pocket cap continues

The biggest change to Medicare in a generation started in 2025. Every Part D and Medicare Advantage drug plan caps your out-of-pocket drug spending at $2,000 for the year. Once you hit that cap, you pay $0 for the rest of the year.

The cap grows a little each year based on drug price inflation. The 2027 cap should be slightly higher than $2,000. CMS will publish the exact 2027 number in the fall.

This cap is one of the most important protections for people on expensive drugs like cancer treatments, GLP-1s for diabetes, and specialty medications. See what happened to the donut hole in 2026 for the full story.

Insulin still capped at $35 per month

The Inflation Reduction Act capped insulin at $35 per month per prescription for every Medicare member. That cap continues in 2027 and has no expiration in current law.

The cap applies to all forms: vial, pen, pump. It applies whether you get insulin through Part B (for insulin pumps) or Part D (most other insulin).

See our full guide to the insulin cap.

ACIP vaccines still $0

Adult vaccines recommended by the CDC's ACIP committee are free under Medicare. That includes:

• Shingles (Shingrix)
• RSV
• Tdap
• Hepatitis A and B
• MMR

These are covered through Part D or Medicare Advantage drug coverage at $0.

Flu, COVID, and pneumonia vaccines are covered under Part B at $0. Nothing changed for 2027.

IRMAA in 2027

If your income is above certain thresholds, you pay more for Part B and Part D. That surcharge is called IRMAA (Income-Related Monthly Adjustment Amount).

Two things to know for 2027:

• Your 2027 IRMAA is based on your 2025 tax return. IRS looks back two years.
• The IRMAA thresholds and dollar amounts for 2027 will be announced by CMS in November 2026.

Historically, thresholds get an inflation adjustment of a few thousand dollars each year. The top bracket (which pays the highest surcharge) starts around $500,000 in modified adjusted gross income for singles.

If your income dropped due to retirement, divorce, work stoppage, or loss of a spouse, you can appeal IRMAA using form SSA-44. See what IRMAA is and how to appeal it.

2026 vs 2027 at a glance

Here is a summary table of the numbers that are already known and the ones we are waiting on. This will get updated in November 2026 when CMS releases the final 2027 rates.

Medicare Advantage in 2027

Medicare Advantage plans keep changing. Watch for these trends in 2027:

Fewer $0 premium plans

Some markets will see plans add a small monthly premium ($10 to $30) where they used to be free. Others hold the line.

Smaller extra benefits

Flex cards, dental allowances, and OTC card amounts have been shrinking. CMS pushed back on how insurers advertise these benefits, so the numbers you see should be more accurate now.

Tighter provider networks

Some large hospital systems have exited certain Advantage plan networks over the past two years. Check whether your doctors and hospital are still in network for 2027 before you enroll or renew. Your Annual Notice of Change is the first place to look. See how to read your ANOC.

Star rating adjustments

CMS refined how Star ratings are calculated for 2027. Some plans that were 4 or 5 stars in past years may drop. Rating changes matter because they affect the extra benefits plans can offer. See how to compare plans and companies.

Prior authorization rules

CMS has tightened rules on how Medicare Advantage plans can use prior authorization. Plans still use it, but decisions have to be faster and more consistent with Original Medicare rules.

Part D plan changes

Stand-alone Part D plans (SDPs) are still available in every state for 2027. Fewer of them than a decade ago, but enough to shop. Expect:

• A range of premiums from about $0 to $80 per month
• Deductibles up to a maximum set by CMS (usually around $600)
• The same $2,000 out-of-pocket cap that Medicare Advantage plans use
• Formulary changes: drugs moving up or down on tiers, some drugs dropped

Always run your drug list through the Medicare.gov Plan Finder during AEP. Best plan can shift year to year.

Medigap in 2027

Medigap plans are standardized by federal law. Plan G in 2027 covers the same things as Plan G in 2026. Same for Plan N, Plan F, Plan K, and the others.

What can change is the premium. Every Medigap carrier can adjust rates each year. Common increases are 3 to 8 percent. If your rate got expensive, you can shop other carriers for the same plan. Medical underwriting may apply unless your state has a birthday rule or open enrollment protection. See the state-by-state birthday rule guide.

Plan F is only available if you were eligible for Medicare before January 1, 2020. That does not change in 2027. If you already have Plan F, you can keep it.

Enrollment periods for 2027

Same as always:

• October 15 to December 7, 2026: Annual Enrollment Period. Change your Medicare Advantage or Part D plan for 2027.
• January 1 to March 31, 2027: Medicare Advantage Open Enrollment. If you already have Advantage, you get one chance to switch or drop it.
• All year: Special Enrollment Periods if you move, lose employer coverage, qualify for Extra Help, and other life events.

Deep dive: The Annual Enrollment Period explained.

What is not changing

Not everything gets rewritten each year. These stay the same:

• Medicare eligibility age (still 65 for most)
• 7-month Initial Enrollment Period rules
• Medigap open enrollment (6 months from Part B start)
• The three ways to get Medicare (Original + Medigap + Part D, or Medicare Advantage, or Original alone)
• Late enrollment penalties for Part B, Part D, and Part A (if you have to buy Part A)

What to do this fall

Simple three-step plan:

1. Read your ANOC when it arrives in September. Note any changes to premium, deductible, drug tiers, or network.
2. Check the Medicare.gov Plan Finder during AEP. Use your real drug list and preferred pharmacy. Rank plans by total yearly cost.
3. Talk to an independent agent if the numbers do not add up. Free to you. An outside opinion can save real money.

Common mistakes

Believing early number leaks

You will see articles in September and early October guessing at the 2027 Part B premium. Some outlets always guess. Ignore them until CMS makes it official in November.

Assuming Medicare is getting worse every year

It is not. The $2,000 cap alone is one of the biggest cost protections in the program's history. Insulin is capped. Vaccines are free. Fewer people hit the old donut hole.

Waiting until December to shop

By December the Medicare.gov site slows down and agents get slammed. Start comparing in mid-October when the tools are fresh.

Only looking at premium

The cheapest premium is often not the cheapest total cost. A $0 premium plan with high drug tiers can cost you thousands more than a $30 premium plan with better drug coverage.

Not appealing IRMAA

If you retired or had a life event that dropped your income, you can file SSA-44 to reduce IRMAA. Most people who qualify never apply.

Bottom line

Medicare in 2027 is mostly a continuation of 2025 and 2026. The big cost protections stay in place. The premium and deductible numbers will step up modestly, with the final figures out in November 2026. The action item is the same as every fall: read your ANOC, compare plans during AEP, and switch if a better option exists.

Not sure which 2027 changes affect you? Book a free call and we will walk through your situation. Bring your current plan card, your drug list, and your doctors. Twenty minutes is usually enough to know if a switch makes sense.

Related reading: What is IRMAA, The Medicare donut hole in 2026, Medicare insulin cap explained, and Full AEP guide.

Frequently asked questions

What is the Medicare Part B premium for 2027?

CMS will announce it in November 2026. Historically premiums rise 4 to 8 percent per year. Check CMS.gov for the official rate.

Is the $2,000 Part D cap still in place for 2027?

Yes. The cap continues, indexed for inflation. Once you spend $2,000 on covered drugs, you pay $0 the rest of the year.

Does insulin still cost $35 per month in 2027?

Yes. The $35 cap is federal law with no expiration.

Are vaccines still free on Medicare in 2027?

Yes. All ACIP-recommended adult vaccines are $0. Flu, COVID, and pneumonia stay $0 too.

When do 2027 IRMAA amounts get announced?

November 2026, along with Part B and Part D premiums. Your 2027 IRMAA uses your 2025 tax return.

What is changing for Medicare Advantage in 2027?

Fewer $0 premium plans, smaller extra benefits, tighter networks. Read your ANOC to see exactly what your plan is doing.