Every fall, Medicare beneficiaries enrolled in a Medicare Advantage or Medicare Part D plan receive an Annual Notice of Change, or ANOC. This key document outlines exactly what is changing — premiums, benefits, provider networks and prescription drug coverage, for instance — in their coverage for the coming year. Plans are required to deliver ANOCs by September 30, but many begin sending them in late August or early September, prior to the open enrollment period (October 15 to December 7).
“The ANOC outlines exactly how your Medicare Advantage or Part D plan will change effective January 1, 2027,” says Ryan Ramsey, associate director of health coverage and benefits at the National Council on Aging in Arlington, Virginia. “Don’t assume a plan that worked well in 2026 will remain your best option. Even modest changes to costs, drug coverage or provider networks can significantly affect both access and affordability.”
Understanding your ANOC can help you weigh the pros and cons of your Medicare Advantage plan versus other Medicare Advantage plans or even original Medicare. In fact, while Medicare Advantage plans remain popular with more than half (55%) of eligible Medicare-enrolled beneficiaries in 2026, the rate of enrollment growth has continued to slow, according to KFF.
Medicare Advantage vs. Original Medicare: At a Glance
| Original Medicare | Medicare Advantage (Part C) | |
| Monthly premium | Typically just the Part B premium of $202.90 in 2026; optional Part D and Medigap adds extra cost | Premiums vary by plan; some have $0 premiums on top of the Part B premium all beneficiaries must pay |
| Deductible | $283 Part B annual deductible in 2026; Part A has a $1,736 deductible per benefit period for inpatient hospital care | Varies by plan |
| Copay or coinsurance | 20% for covered services after meeting applicable deductible | Generally pay copays or coinsurance for covered services after meeting the deductible, but plan dependent |
| Maximum out-of-pocket limit | No annual limit; separate Medigap plan helps cover out-of-pocket expenses | 2026 maximum: $9,250 for in-network services or $13,900 for combined in- and out-of-network services; individual plans may set lower limits |
| Provider choice | Broad choice: any doctor or provider who accepts Medicare nationwide | More limited: most plans use provider networks in a specific geographic area |
| Referrals | Generally not required | Typically required, but varies by plan |
| Prior authorization | Needed in limited circumstances | Commonly required for certain services |
| Prescription drug coverage | Not included; you can enroll in a separate Part D plan | Usually included in the plan |
| Dental, vision, hearing and other additional benefits | Not covered unless part of a larger covered service | Most plans have some coverage for certain services, but plan dependent |
What Stays the Same: Original Medicare and Medigap
While Medicare Advantage and Part D plans can change significantly from one year to the next, original Medicare and Medigap benefits may not.
“One of the major advantages of original Medicare and Medigap (is) their relative stability. Benefits are established by federal law and do not vary by insurer, although premiums and other costs may rise,” Ramsey says.
— Original Medicare: The same hospital coverage (Part A), outpatient benefits (Part B) and cost-sharing framework that applied in 2026 carries forward into 2027, with only incremental adjustments to specific figures like the Part A deductible or Part B premium, which CMS announces each fall.
— Medigap: Policy benefits are standardized by law, meaning a Medigap Plan G or Plan N provides the same core benefits regardless of the insurer offering it. Premiums may change, but the benefits do not change from year-to-year.
[READ: How to Manage Anxiety with Rising Medicare Costs]
What Can Change: Medicare Advantage and Part D
CMS approves Medicare Advantage and Part D plans annually, which is why you might notice the following:
— Increased out-of-pocket costs: Changes to the monthly premium, yearly deductible, copays and coinsurance and the maximum out-of-pocket limit
— Provider network adjustments: Shifts in the doctors, specialists and hospitals participating in the plan’s network
— Pharmacy network changes: Limitations to networks and updates to preferred pharmacies or locations
— Prescription drug formulary updates: Revisions to which drugs are covered and their cost-sharing tiers
— New coverage rules: Added requirements for prior authorization, referrals and other coverage rules
— Supplemental benefit modifications: Adjustments to access, limits and cost structure for extra benefits
[Read: What to Do When Your Doctor Leaves Your Health Plan.]
Details That Can Make a Difference
If you are considering switching plans or adjusting your overall coverage, don’t compare based on financials alone; consider the total package and your future needs.
Think ahead about Medigap
Medigap only pairs with original Medicare, and switching to a Medicare Advantage plan comes with several risks:
— Your Medigap policy may be cancelled if you switch to a Medicare Advantage plan.
— You may not be guaranteed the right to buy another Medigap policy if you later return to original Medicare.
— You may face medical underwriting, when insurers may deny coverage or charge higher premiums for preexisting conditions, if you try to switch back.
In certain situations, however, you have a guaranteed right to buy or switch Medigap coverage.
— Loss of coverage: If a beneficiary’s Medicare Advantage plan is no longer available, then they can enroll in original Medicare and purchase a Medigap plan without facing medical underwriting.
— Birthday rule: Beneficiaries have a guaranteed window each year when they can switch Medigap policies without facing medical underwriting. Currently, this option is available in 15 states (California, Delaware, Idaho, Illinois, Indiana, Kentucky, Louisiana, Maryland, Nevada, Oklahoma, Oregon, Utah, Virginia, West Virginia and Wyoming); New Mexico will offer this option in 2027. “New York, Connecticut and Massachusetts allow changes year-round, and in those states, available plans have dropped significantly and premiums for a 65-year-old run much higher than in states without those rules,” adds Diane Omdahl, president of Medicare consultancy 65 Incorporated and author of “Medicare For You: A Smart Person’s Guide.”
Medicare.gov has an online tool to help you determine whether you qualify. State rules can provide additional protections for Medigap enrollees, but those protections vary widely. You can contact your local State Health Insurance Assistance Program to get unbiased help understanding your rights.
Consider your total healthcare costs
It’s important to look beyond the monthly premium and deductible and consider how much you’ll pay when you actually use healthcare. Think about both what you expect to spend in a typical year and what you could be responsible for if you suddenly need significant medical care. A plan with a lower premium isn’t necessarily the least expensive option overall.
Think beyond your healthy years
— If you’re healthy and take few medications: Prior authorization, specialist referrals and out-of-pocket costs may seem less important than benefits like dental and vision coverage.
— If your health changes: Access to the providers you need and the cost of care can become much more important. For example, someone living in Louisiana could see a specialist at Cleveland Clinic in Ohio under original Medicare, while Medicare Advantage plans most likely would not cover it. Medicare Advantage plans would, however, keep your expenses lower, thanks to the maximum out-of-pocket limit. When comparing plans, consider not only how they meet your needs today but also longer term.
Weighing those “extra” benefits
In 2026, Medicare Advantage plan enrollees had about the same access to dental, vision and hearing benefits as in 2025, but fewer plans offered additional benefits such as over-the-counter (OTC) allowances, gym memberships, meals and transportation, according to KFF. If these benefits factored into your original plan decision, check your ANOC closely.
“We’ve found that many beneficiaries don’t use the benefits offered by their Medicare Advantage plan. It could be that their needs may be better met by a plan that provided fewer extra benefits but better coverage for the benefits it did offer,” says Gretchen Jacobson, vice president of the Medicare program for the Commonwealth Fund in New York City.
[READ: When and How to Change Your Medicare Plan]
Key 2027 Part D Changes and the $2,400 Out-of-Pocket Cap
Two notable adjustments are coming to Part D in 2027, both related to the Inflation Reduction Act.
— Part D out-of-pocket cap: This cap on the maximum amount beneficiaries pay out-of-pocket in a year for medications (excluding premiums) is still in effect but is projected to increase to $2,400 in 2027. This applies to both stand-alone and Medicare Advantage prescription drug plans.
— Part D premium stabilization demonstration: This temporary CMS program, which capped how much stand-alone drug plans could raise their premiums after the Inflation Reduction Act’s out-of-pocket cap took effect, is ending at the close of 2026.
“When the Inflation Reduction Act’s $2,000 out-of-pocket cap took effect, the concern was that drug plans would have to absorb a much bigger share of costs — and that stand-alone Part D premiums would spike as a result,” Omdahl explains. “To prevent that, CMS put a temporary guardrail in place that capped how much any plan could raise its premium from one year to the next — first $35, then $50. Now CMS says plan bids are showing stability, and premiums shouldn’t increase more than $20, so they’ve removed that cap entirely. There is no longer any limit on how much a Part D plan can raise its premium. CMS may be right that the market has stabilized — but we won’t know until the actual plans come out.”
Your September Action Checklist for Open Enrollment
Use the next few weeks to get ahead of open enrollment before the October 15 window opens.
1. Check for your ANOC now. Plans are required to deliver the ANOC by September 30, but many arrive in late August or early September. Check both your mailbox and your plan’s online member portal.
2. Read the sections that affect you most. Focus on changes to your out-of-pocket costs (premiums, copays, deductibles), maximum out-of-pocket limit, drug formulary and prescription costs, provider and pharmacy networks, supplemental benefits and other plan rules. “The real details are found in the plan’s Evidence of Coverage,” says Omdahl. “The EOC is your plan’s detailed guide to what coverage includes and what you’ll pay. While the ANOC highlights what’s changing for the coming year, the EOC provides the details, including copays, coverage limits, prior authorization requirements, network rules and information on supplemental benefits.”
3. Use 2026 numbers as your baseline. The official standard 2027 Medicare figures, including the Part B premium, Part B deductible and IRMAA thresholds, will not be announced by CMS until the fall. Don’t substitute projections for official figures when comparing your costs.
4. Wait for the 2027 plan information before making a final comparison. Wait until early October to use online compare tools, such as the Medicare Plan Finder or U.S. News’ search tool, which allows you to see the Medicare Advantage, Part D and Medigap plans available in your area. Any search before October will return 2026 information, so set a reminder and come back once the updated data is live.
2027 Medicare Enrollment Timeline
| Period | Dates | Action |
| ANOC arrival | August to September | Review changes to costs or networks. |
| Search tool updates | Early to mid-October | Meaningful plan comparisons begin. |
| Annual enrollment period | October 15 to December 7 | Make coverage changes for January 1. |
| New plan year | January 1 | Coverage begins. |
| Medicare Advantage open enrollment | January 1 to March 31 | Switch plans or return to original Medicare. |
Frequently Asked Questions
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Medicare Advantage vs. Original Medicare: 2027 Plan Preview originally appeared on usnews.com
