Medicare changes every year, and 2027 will bring several important updates that Medicare beneficiaries should know about. Changes to Medicare Part D prescription drug coverage, Medicare Advantage plans, prior authorization, premiums and plan benefits could affect what you pay and how you receive your healthcare.
If you live in San Diego County and have Medicare — or you’re becoming eligible for Medicare in 2027 — here’s what you need to know.
Medicare Part D Out-of-Pocket Maximum Increases to $2,400
One of the biggest changes for 2027 involves Medicare Part D prescription drug coverage.
For 2027, the annual Part D out-of-pocket threshold will be $2,400, up from $2,100 in 2026.
Once you reach the $2,400 out-of-pocket threshold for covered Part D medications, you enter the catastrophic coverage phase and generally pay $0 for covered Part D drugs for the remainder of the year.
This protection can be especially important for people who take expensive brand-name or specialty medications.
The 2027 Part D Deductible Increases to $700
The maximum standard Medicare Part D deductible increases from $615 in 2026 to $700 in 2027.
That does not mean every prescription drug plan will have a $700 deductible. Individual Part D plans can have a lower deductible, and some plans may apply the deductible only to certain tiers of medications.
This is one reason it’s important to compare Part D plans based on your actual medications rather than simply choosing the plan with the lowest monthly premium.
The Part D Coverage Gap Remains Eliminated
The old Medicare Part D coverage gap — commonly called the “donut hole” — is no longer part of the standard Part D benefit.
The redesigned Part D benefit consists of three main phases:
- Deductible phase
- Initial coverage phase
- Catastrophic coverage phase
Once a beneficiary reaches the annual Part D out-of-pocket threshold, there is no additional cost sharing for covered Part D medications during the catastrophic phase.
Medicare's Prescription Payment Plan Continues
People enrolled in Medicare Part D can continue to use the Medicare Prescription Payment Plan.
This program allows you to spread your out-of-pocket prescription drug costs over monthly payments rather than having to pay a large amount all at once at the pharmacy.
It’s important to understand that the program does not reduce the total cost of your prescriptions. It simply changes when you pay those costs.
This can be helpful for someone who has significant prescription expenses early in the year.
Many Medicare Advantage Plans will Change in 2027
Medicare Advantage plans are private Medicare plans, and their benefits can change from one year to the next. For 2027, Medicare Advantage beneficiaries should review their plan’s Annual Notice of Change carefully.
Changes could potentially include:
- Monthly premiums
- Medical copays
- Maximum out-of-pocket limits
- Prescription drug coverage
- Provider networks
- Dental benefits
- Vision benefits
- Hearing benefits
- Over-the-counter allowances
- Transportation benefits
- Fitness benefits
- Other supplemental benefits
A Medicare Advantage plan that worked well for you in 2026 may not necessarily be your best choice for 2027.
Prior Authorization Continues to Change
Prior authorization has become an increasingly important issue for people enrolled in Medicare Advantage plans. CMS has already established faster decision requirements for certain prior authorization requests, and additional electronic prior authorization requirements take effect in 2027.
Beginning in 2027, certain health plans will be required to implement electronic systems designed to make it easier for healthcare providers to submit and track prior authorization requests. These changes are intended to reduce paperwork and make the authorization process more efficient for patients and healthcare providers.
Medicare Advantage Plan Quality Ratings Are Changing
CMS is also changing the Medicare Advantage and Part D Star Ratings system. Medicare Star Ratings are designed to help consumers compare the quality and performance of Medicare Advantage and Part D plans.
CMS is removing several measures that provided little meaningful difference between plans and placing greater emphasis on measures related to clinical care, health outcomes and patient experience.
Star Ratings are useful when comparing plans, but they shouldn’t be the only factor you consider.
Your doctors, medications, hospitals, costs and healthcare needs are usually much more important when determining which plan is appropriate for you.
2027 Medicare Part B Premium and Deductible
The official 2027 Medicare Part B premium and deductible have not yet been announced.
These amounts are typically announced by the Centers for Medicare & Medicaid Services later in the year.
For comparison, in 2026 the standard Medicare Part B premium is $202.90 per month, and the annual Part B deductible is $283.
Higher-income Medicare beneficiaries may pay more for Part B and Part D because of the Income-Related Monthly Adjustment Amount, commonly called IRMAA.
We will update this page when the official 2027 Medicare Part A and Part B amounts are released.
Medicare Supplement Plans in 2027
Medicare Supplement plans, also called Medigap plans, work differently from Medicare Advantage plans.
The standardized benefits of plans such as Plan G and Plan N do not reset or change every year in the same way Medicare Advantage benefits can. However, insurance companies can change their Medicare Supplement premiums. For people with Original Medicare and a Medicare Supplement plan, it can make sense to periodically review rates to see whether another company offers the same standardized benefits at a better price.
California residents also have special Medicare Supplement rules, including the California Birthday Rule, that may provide an opportunity to change Medicare Supplement companies without medical underwriting.
Medicare Open Enrollment for 2027 Coverage
Medicare’s Annual Enrollment Period runs from:
October 15 through December 7, 2026
Changes made during this period generally take effect January 1, 2027.
During the Annual Enrollment Period, Medicare beneficiaries can review their Medicare Advantage and Part D coverage and determine whether another plan may be a better fit for the coming year.
Why Reviewing Your Medicare Coverage Matters
Don’t assume that because your Medicare plan worked well in 2026 it will work exactly the same way in 2027.
Plans can change premiums, copays, drug formularies, pharmacy networks, provider networks and supplemental benefits.
Before deciding whether to keep or change your coverage, consider:
- Are your doctors still in the plan’s network?
- Are your prescriptions still covered?
- Have your medication copays changed?
- Is your preferred pharmacy still a preferred pharmacy?
- Have your medical copays changed?
- Have any dental, vision or other supplemental benefits changed?
- Has your monthly premium changed?
For many people, reviewing these items once a year can prevent unpleasant surprises after January 1.
Need Help Reviewing Your 2027 Medicare Options in San Diego?
Medicare doesn’t have to be complicated!!
As an independent Medicare broker serving San Diego County, I help people compare Medicare Supplement, Medicare Advantage and Medicare Part D options from multiple insurance companies.
There is no additional cost to you for using my services.
If you’re becoming eligible for Medicare in 2027 or would like help reviewing your current coverage for the upcoming year, contact San Diego Medicare Broker to schedule a Medicare consultation. You can also book onto my calendar for a review HERE
This information is educational and is not a complete description of Medicare benefits. Plan benefits, premiums, formularies, pharmacy networks and provider networks can change. Contact Medicare, the individual plan, or a ME! for additional information.