Medicare's open enrollment starts Thursday. The 2027 drug-cost numbers that changed, and what happens if you do nothing

Once a year, people on Medicare get a window to change how they are covered for the next year. This year it runs from Thursday, October 15, through Monday, December 7, according to the State Health Insurance Assistance Program's national guide. Whatever is on file at the end of the window is what covers someone on January 1.

In that window a person can move between Original Medicare and a Medicare Advantage plan, switch from one Medicare Advantage plan to another, or join, change or drop a stand-alone drug plan.

The 2027 drug-plan numbers

The federal government set next year's limits for the standard Part D drug benefit in its April 6, 2026 rate announcement (Table V-2):

The deductible is a ceiling. A plan can charge less, or none. The cap counts what the person pays for drugs on the plan's list. Monthly premiums do not count toward it, and neither do drugs the plan does not cover. Covered insulin and the adult vaccines on the federal advisory committee's list carry their own lower cost-sharing rules under the 2022 Inflation Reduction Act, which the announcement's tables reflect.

A worked example

Take a retired couple in 77354, each on a stand-alone drug plan that uses the full standard deductible and the standard 25% share after it. These are round numbers for the arithmetic, not anyone's actual drugs.

• One spouse takes a drug whose full price is $800 a month, or $9,600 a year. In 2027 that person pays the first $700, then 25% of the remaining $8,900, which would be $2,225. The total, $2,925, is over the cap, so the bill for the year stops at $2,400. The same drug in 2026 stopped at $2,100. That is $300 more for the year, before premiums.
• The other spouse takes a generic whose full price is $40 a month, or $480 a year. That never clears a $700 deductible, so on a plan that uses the full deductible the person pays the whole $480. On a plan with no deductible, the same person pays only the plan's copay.
• The zero case: someone who fills nothing all year pays only the premium.

The two spouses can be on different plans. Which plan suits which drug is exactly what the government's comparison tool, below, shows side by side.

If you do nothing

If a person's plan is still offered next year and nobody changes anything, the enrollment carries into 2027 with whatever new premium, deductible and drug list the plan has set. If the plan is leaving Medicare, it sends a Plan Non-Renewal Notice in October. In that case, the SHIP guide says, the person is disenrolled on January 1, and anyone who has not picked a new plan by then can face a gap in coverage.

Things to check

• The Annual Notice of Change. Plans were due to mail it by September 30. It lists next year's premium, deductible, copays and coinsurance, drug-list changes, and pharmacy or doctor network changes.
• A Plan Non-Renewal Notice, if one arrives this month.
• Each drug, by name and dose, against next year's list. A drug that drops off the list stops counting toward the $2,400 cap.
• The pharmacy. Whether the usual pharmacy is still in the network, and whether it is a preferred one.
• The premium on the January statement, not just the deductible. The two move separately.

Staying or switching, side by side

What is not set yet

The 2027 Part B premium, which most people on Medicare pay no matter which plan they pick, has not been announced. It is $202.90 a month this year. The Medicare trustees projected $209.50 for 2027, and the official number is expected in November, MOAA reported. Higher-income households pay more than the standard amount.

Where to look, free

• The government's plan comparison tool at medicare.gov/plan-compare, which takes a list of drugs and pharmacies and prices each plan for the year.
• Texas HICAP, the state's free Medicare counseling program, at 1-800-252-9240, weekdays 8 a.m. to 5 p.m., listed in the federal directory, with more at hhs.texas.gov. Counselors do not sell plans.
• 1-800-MEDICARE (1-800-633-4227), the program's own line.

Sources: the Centers for Medicare & Medicaid Services' CY 2027 Rate Announcement, April 6, 2026, Table V-2; the State Health Insurance Assistance Program's guide to open-enrollment mail; MOAA on the trustees' Part B projection; the CMS contact directory for HICAP. The worked example is the paper's arithmetic on round numbers.