2027 Medicare Changes: What I'm Seeing This Annual Enrollment
Explore 2027 Medicare Advantage changes with Shawn Ray, including plan availability, dental and vision benefits, copays, and Annual Enrollment tips.
If you've been paying attention to the news lately, you've probably seen quite a few articles about Medicare Advantage plans being canceled, insurance companies leaving certain areas, and benefits being reduced for 2027.
I've had several conversations with people who are worried about what these changes mean for their Medicare coverage and I completely understand those concerns but here's something I think is important to remember.
Medicare Advantage plans change every single year.
Insurance companies leave certain markets. New plans become available. Doctors change networks. Prescription coverage changes. Benefits go up, benefits go down, and sometimes our own healthcare needs change. That's not unique to 2027.
It's actually one of the main reasons Medicare has an Annual Enrollment Period every year. It gives you an opportunity to look at what's happening with your coverage and make adjustments to find something that works for your needs as closely as possible.
I've been helping people with Medicare since 2012, and over the past few weeks, I've spent countless hours reviewing 2027 Medicare Advantage plans with individuals across the country and I'll tell you, there are definitely some things that have stood out to me this year.
I wanted to share what I'm personally seeing, what concerns me, what's staying relatively the same, and what I think people should pay attention to when reviewing their Medicare coverage.
Are Medicare Advantage Plans Going Away in 2027?
Let's start with one of the biggest concerns I've heard. No, Medicare Advantage plans are not going away. But some insurance companies are discontinuing certain plans or leaving specific areas. This is important because there's a big difference between an insurance company canceling a particular plan and Medicare Advantage disappearing altogether.
In some of the areas I've been reviewing, someone who previously had 40 or 50 different Medicare Advantage plans available might now have 25 or 30. That's definitely a reduction in choices, but it also means there are still options to consider and in other parts of the country, plan availability hasn't changed nearly as much.
According to the Centers for Medicare & Medicaid Services, Medicare Advantage options remain widely available nationally for 2027 but here's what I always remind people.
Having more plans available doesn't necessarily mean having better choices.
You could have 50 plans in your ZIP code, but if only a handful cover your doctors and medications, those are probably the ones we need to focus on. It's not about having the largest number of plans to choose from. It's about finding one that fits your situation.
What Medicare Advantage Benefits Are Changing for 2027?
After reviewing a tremendous number of plans this month, I've noticed several trends. Now, I want to be clear. These are my personal observations from reviewing actual 2026 and 2027 Medicare Advantage plans with clients. These changes aren't happening with every insurance company or in every ZIP code but they're happening often enough that I think they're worth pointing them out. These are in no particular order of importance.
1. Vision Benefits Seem to Be Going Down
One of the first things I've noticed is that vision benefits have decreased on quite a few plans. Some plans that previously offered larger allowances for glasses or contact lenses are offering less for 2027. Depending on the plan, that could mean paying more when you need new glasses. Is that going to affect everyone? Probably not. If you only replace your glasses every few years, it might not make much difference, but for someone who uses their vision allowance regularly, it's definitely worth comparing.
2. Dental Benefits Are Similar, but Denture Coverage Is More Limited
Dental coverage has been interesting this year. For many of the plans I've reviewed, overall dental benefits have remained fairly similar to what was offered in 2026. However, one thing that has really stood out is that I'm finding fewer options with coverage for dentures, or more limitations on those benefits and that's a big deal for some people.
I've spoken with individuals who really need dentures or other major dental work and are relying on their Medicare Advantage dental benefits to help cover those expenses. Unfortunately, having a generous dental allowance doesn't automatically mean everything is covered.
For example, a plan might advertise $2,000 in dental benefits, but that doesn't necessarily mean dentures, and comprehensive benefits seem to have a coinsurance for 2027. That's why I think it's so important to look beyond the advertised dental allowance. You need to know exactly what procedures are covered and what limitations might apply.
I get asked about implants every day, and I still haven't seen a plan that includes coverage for them for 2027.
3. Primary Care Doctor Copays Are Still Looking Pretty Good
Here's some good news! On many of the plans I've reviewed, primary care doctor visits are still $0. That's one benefit that appears to have remained relatively consistent in a lot of the areas I've been working with. For someone who regularly visits their primary care doctor, that's certainly a positive but don't forget to check whether your doctor is still in the plan's network for 2027.
A $0 copay doesn't help much if the doctor you want to see is no longer participating in the plan and remember, specialist copays may be different, so make sure you're reviewing those as well.
4. Hospital and Outpatient Procedure Copays Are Increasing
This is one of the changes that concerns me more. I've noticed higher copays on a number of plans for hospital stays, outpatient surgeries, and other medical procedures, and here's why I think people need to pay attention. When most people compare Medicare Advantage plans, they naturally look at their monthly premium, doctor copays, prescriptions, and extra benefits, but how often do we think about what happens if we end up in the hospital? Hopefully, it's something you never have to worry about. However, unexpected health issues happen.
A plan might have great dental and vision benefits, but if you're paying substantially more for a hospital stay or outpatient procedure, those extra benefits may not make up for the difference. I always encourage people to think about what their plan would cost if something unexpected happened, not only what it costs when everything is going well. On a side note a Hospital Indemnity plan is a great way to help pay for hospital, ER visits, urgent care visits, and I can help you with those plans as well.
5. Maximum Out-of-Pocket Limits Are Increasing on Many Plans
Another trend I've noticed is higher maximum out-of-pocket limits on certain Medicare Advantage plans. If you're unfamiliar with this term, let me explain it in a simple way. Your plan's maximum out-of-pocket limit is essentially a financial safety net for covered medical services. It sets a limit on how much you may have to pay for covered Medicare Part A and Part B services during the year. In-network and out-of-network limits can differ, depending on the type of plan. Once you reach the applicable limit, your plan pays the covered medical costs subject to that limit for the remainder of the plan year. Prescription drug expenses and certain other costs generally aren't included in that medical limit.
Most people aren't going to reach their maximum out-of-pocket amount but if you end up having a serious medical issue, it can become very important. When comparing plans, I think it's worth asking yourself: If something unexpected happened next year, how much could I realistically afford to pay? It's not the most exciting benefit to compare, but it can certainly be one of the most important.
6. Prescription Drug Costs Are Changing, Especially for Tier 3 and Tier 4 Medications, and Drug Deductibles
This is another area where I'm spending quite a bit of time during plan reviews. For many of the plans I've looked at, Tier 1 and Tier 2 medications, which are typically lower-cost generics, have remained relatively similar to 2026. However, I'm seeing some significant differences with Tier 3 and Tier 4 prescriptions. Deductibles for Tier 3-5 are generally higher. More of the plans I've reviewed are using coinsurance instead of a set copay for certain medications.
What's the difference? Let's say you currently pay a $40 copay for a prescription. That's a fixed amount, but if your plan changes to 25% coinsurance, your share depends on the medication's negotiated cost. If that medication costs $300, your portion would now be $75, assuming that coinsurance applies at that point in your coverage. That's a noticeable difference. Of course, prescription costs depend on several factors, including the medication, pharmacy, deductible, coverage phase, and whether you qualify for additional assistance.
There is also an important protection in 2027: the annual Medicare Part D out-of-pocket threshold is $2,400 for covered prescription drugs, compared with $2,100 in 2026 but even with that protection, individual prescriptions can cost more than they did before. This is why I think reviewing your actual medication list is one of the most important parts of comparing Medicare plans.
A plan that looks great when you're comparing extra benefits might not be the most affordable option once you calculate what you'll spend on your medications throughout the year.
Is Medicare Advantage Getting Worse in 2027?
This is a question I've been thinking about as I review plans and I really don't think there's one simple answer. Yes, some benefits are decreasing. Yes, certain medical expenses are increasing and yes, some people have fewer plan choices than they did last year, but that doesn't mean every person is going to have worse coverage in 2027. In fact, some people may find that a different plan offers a better combination of benefits for their current situation. Others may discover that their existing plan is still their best option. Here's something I tell people all the time:
Every Medicare plan is a give and take.
One plan might offer better dental benefits but higher hospital copays. Another might have better prescription coverage but a smaller vision allowance. Another might have a lower maximum out-of-pocket limit but not offer some of the extra benefits you were hoping for. That's simply the reality of comparing Medicare plans and it's why there isn't one perfect plan for everyone.
The Best Medicare Advantage Plan Is the One That Works for You
When I sit down with someone to review their coverage, I don't automatically start looking for the plan with the most benefits. I want to understand what's most important to them. For example, if you're planning to get dentures next year, dental coverage is probably going to be a priority. If you take several expensive prescriptions, your medication costs may matter much more than an extra allowance for glasses. If you're seeing multiple specialists or expecting surgery, your medical copays and out-of-pocket limits may be especially important and if you're happy with your doctors, keeping those doctors might be the most important consideration of all.
Here are the questions I think everyone should ask when reviewing Medicare Advantage plans for 2027:
Are my doctors and preferred hospitals still in network?
Are all my prescriptions covered, and what will they cost?
Am I expecting any surgeries, procedures, or treatments next year?
Which extra benefits do I actually use?
What are my hospital and specialist copays?
What is my maximum out-of-pocket limit?
Would changing plans really improve my coverage?
I think answering these questions does much more good than choosing a plan simply because it advertises a large dental allowance or a bunch of extra benefits. The goal should always be to find the best combination of benefits for your personal needs.
Sometimes the Best Decision Is to Keep Your Current Medicare Plan
There's something else I want to mention because I think it's important, not everyone needs to change their Medicare plan every year. I have plenty of conversations with people where we review what's changing, look at other available options, and ultimately decide that keeping their current plan makes the most sense and I'm perfectly happy with that! My job isn't to convince you to switch insurance companies. It's to help you understand your options.
If your plan is continuing in 2027, your doctors are still covered, your prescriptions are affordable, and your benefits meet your needs, you may have no reason to make a change but I still recommend reviewing everything, because the last thing I want is for someone to get into January and discover that a benefit you depend on has changed.
When Can You Change Your Medicare Plan for 2027?
The Medicare Annual Enrollment Period runs from October 15 through December 7, 2026. During this period, eligible people with Medicare can review their coverage and switch Medicare Advantage or Medicare prescription drug plans. Changes generally take effect January 1, 2027. If you haven't already, I encourage you to review your Annual Notice of Change, which explains what's changing with your current plan.
You can also use this Medicare Plan Finder to compare available options in your area, if you want to do it on your own. Even if you're planning to stay with your current plan, taking some time to review your coverage is worthwhile.
My Advice After Reviewing Countless Medicare Advantage Plans This Month
I'm sure there are other changes I haven't mentioned. These are simply the things that have stood out to me as I've worked with individuals across the country during the first part of this Annual Enrollment Period and if I could leave you with one piece of advice, it would be this.
Don't let the headlines scare you into making a decision.
Yes, Medicare Advantage plans are changing. Some costs are going up. Some benefits are going down. Some plans are leaving certain areas but there are still coverage options available for most people. The important thing is understanding what's available where you live and how those plans fit your own healthcare needs. Don't focus on finding a plan that offers everything. Focus on finding a plan that offers the things you're most likely to need and use in 2027. You can't predict every medical expense or health issue that might come up next year but you can make an informed decision based on what you know today, and that's really what Medicare Annual Enrollment is all about.
Need Help Reviewing Your Medicare Advantage Coverage for 2027?
If you're wondering what's changing with your current Medicare plan, I'd be happy to help. My name is Shawn Ray, and I've been helping people with Medicare since 2012. I'm an independent Medicare insurance broker, and I work with individuals across the country to review their coverage, compare available options, and understand what those options mean for them. When you work with me, you're working directly with me. You're not dealing with a call center or being passed from person to person, and my help doesn't end when you enroll. I'm here throughout the year whenever questions or concerns come up. Whether you're considering changing plans or simply want someone to review your current coverage, I'm happy to help.
My goal is simple: Help you understand your Medicare options and feel confident in the coverage you choose.