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4 Medicare Changes to Know for 2027

CMS projects lower average Medicare Advantage premiums and a modest rise for standalone Part D in 2027. Learn the benefit, ratings, and enrollment changes to check.
From TheFinanceBase Team4 min to read
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Four developments will shape Medicare coverage in 2027: CMS projects slightly higher average premiums for standalone Part D drug plans but lower average Medicare Advantage premiums; the redesigned Part D benefit continues with a $2,400 annual out-of-pocket threshold; Medicare Advantage and Part D quality ratings use updated measures; and local plan choices still need to be compared during Open Enrollment. These are a mix of projections and finalized policy changes—not a CMS-published four-item list—and national averages do not predict what any one person will pay.

1. Average premiums are projected to move in different directions

CMS projects a lower average monthly premium for Medicare Advantage plans in 2027, while the national average for standalone Part D prescription drug plans is projected to rise by less than $1 a month. The figures are national averages, not quotes for a particular ZIP code or plan.

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Coverage measure 2026 2027 projection What it means
Medicare Advantage monthly premium $14.37 $12.00 CMS projects a 16.5% decrease in the weighted average premium.
Standalone Part D monthly premium $35.09 $36 CMS projects an increase of less than $1 per month.
Part D premium within Medicare Advantage plans with drug coverage, after MA rebates $11.32 $7 CMS projects a lower average monthly Part D premium component.

These figures come from CMS’s September 2026 outlook. They are projections for national averages; premiums and total costs depend on the plan available in your area and the coverage you choose. CMS’s 2027 Medicare Advantage and Part D outlook

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CMS estimates about 34 million people will be enrolled in Medicare Advantage in 2027, approximately 47.4% of Medicare enrollment. That forecast is about enrollment, not a measure of whether a particular plan is right for an individual.

2. Part D’s redesigned benefit continues, with a $2,400 threshold

The main Part D benefit redesign is not new for 2027. The 2027 final rule codifies provisions of the Inflation Reduction Act that CMS had already implemented through program instructions. Under the redesigned benefit, the coverage-gap phase is eliminated, the annual out-of-pocket threshold is reduced, cost sharing ends in the catastrophic phase, and the Manufacturer Discount Program is incorporated.

For the 2027 defined standard Part D benefit, CMS sets the annual out-of-pocket threshold at $2,400. This is the threshold for the defined standard benefit; it is not a monthly premium, and it does not mean every person will spend that amount. A person’s drug costs depend on covered prescriptions, plan terms, and their use of medication. CMS’s Contract Year 2027 final-rule fact sheet and CMS’s 2027 Rate Announcement

Two Part D figures that are not your plan’s premium

CMS separately reports a 2027 national average monthly bid amount of $296.05 and a base beneficiary premium of $41.33. The national bid amount is a statistic used to calculate subsidies, and the base beneficiary premium is a formula input for plan-specific basic premiums. Neither figure is a universal invoice for a prescription drug plan. The voluntary Part D Premium Stabilization Demonstration, which began for standalone plans in 2025, ends after 2026; CMS says sponsors can price 2027 bids under traditional market conditions. CMS’s 2027 Part D bid information

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3. Medicare Advantage and Part D quality ratings use updated measures

CMS finalized changes to Star Ratings measures and certain enrollment processes for Contract Year 2027. The ratings changes affect how plans are measured; they do not promise new benefits or better care for every member. CMS says the changes aim to “improve quality and access to care for people enrolled in these programs by finalizing updates to MA and Part D Star Ratings quality measurements and streamlining certain enrollment processes.” CMS’s final-rule fact sheet

For 2027 ratings, CMS identifies two new measures: concurrent use of opioids and benzodiazepines, and use of multiple anticholinergic medications in older adults. A respecified functional-status assessment measure returns, and the colorectal cancer screening measure is respecified. The weight for the physical- and mental-health improvement or maintenance measure rises from one to three. CMS’s 2027 Star Ratings fact sheet

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4. Plan availability and benefits remain local—compare before enrolling

CMS expects more than 99% of beneficiaries to have access to at least one Medicare Advantage plan in 2027 and 97% to have at least 10. It forecasts approximately 5,532 Medicare Advantage plans nationally, compared with 5,553 in 2026. CMS also expects hearing, dental, and vision supplemental benefits to remain stable overall, and estimates about eight in ten Medicare Advantage enrollees will be able to remain in their current plan with the same or a lower premium. Those national forecasts do not guarantee a plan’s availability, network, premium, or benefits in your location. CMS’s 2027 outlook

Use the 2027 Open Enrollment window to check the actual offer

Medicare Open Enrollment for 2027 coverage runs October 15 through December 7, 2026. Compare plans using your own medicines, pharmacies, doctors, and budget, rather than choosing based on a national average. Medicare.gov’s 2027 Plan Compare tool uses your ZIP code and lets you add prescriptions and pharmacies to compare plan costs.

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  • Monthly premium: Check the plan’s actual premium, not a national average.
  • Prescription coverage: Confirm each medication is covered and compare your expected annual drug costs.
  • Pharmacy access: Check whether your preferred pharmacy is in the plan’s network and how costs may differ by pharmacy.
  • Doctors and hospitals: For Medicare Advantage, verify that your providers and facilities are in network.
  • Out-of-pocket exposure: Review the plan’s cost-sharing terms and annual maximum, where applicable.
  • Supplemental benefits: Check the specific dental, hearing, vision, or other extra benefits offered by the plan.

CMS Administrator Dr. Mehmet Oz urged beneficiaries to use Open Enrollment to “review their coverage, compare options, and pick the plan that best suits their needs and budget.” CMS’s September 2026 statement

Get the official handbook at no cost

The official Medicare & You 2027 handbook is a useful reference for understanding coverage and enrollment. Medicare.gov says an updated printed copy is mailed to Medicare households and provides the handbook and accessible formats as public resources; it is not a required purchase. Medicare & You and Medicare.gov publications

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