On Monday the Centers for Medicare & Medicaid Services published the numbers it wants people to see before Medicare's open enrollment begins on October 15.
They are good-looking numbers. The weighted average Medicare Advantage premium, CMS projects, falls from $14.37 a month this year to $12.00 in 2027. The average premium for the drug coverage inside those plans is projected to fall 38 percent, to $7. And about eight in ten Medicare Advantage enrollees, CMS says, "will be able to remain in their current plan with the same or a lower premium in 2027."
Every one of those figures is an average or a share, and none of them is a bill. CMS estimates, from plans' own projections, that 34 million people will be in Medicare Advantage next year. Each will pay one plan's premium, take one list of prescriptions to one pharmacy, and see doctors who are or are not in one network. An average cannot say which of those things changed for any one of them. A letter can.
The letter already came
A Medicare Advantage plan that changes its rules for January 1 must tell its members "at least 15 days before the beginning of the Annual Coordinated Election Period", which is the regulation's name for open enrollment. With enrollment opening October 15, that letter, the Annual Notice of Change, was due in September. Medicare.gov describes it in one line: it "includes any changes in coverage, costs, and more that will be effective in January." And: "If you don't get this important document, contact your plan."
The letter is where a year actually changes. A drug moves to a higher tier or off the list. A doctor's group leaves the network. The out-of-pocket maximum moves. A premium can stay exactly where it was on top of every one of those changes, which is why "the same or a lower premium" is a narrower promise than it sounds.
Medicare's default is to keep you where you are. CMS's own open-enrollment pamphlet says: "If you've reviewed your options and you're happy with your current coverage, you don't need to do anything (your coverage will continue automatically)." The sentence assumes the review happened.
Two limits that moved for everyone
Some numbers are not averages. In its April 6 announcement of 2027 payment policies, CMS set the standard Part D drug benefit's deductible at $700, up from $615, and its annual out-of-pocket threshold at $2,400, up from $2,100. Medicare.gov puts both in plain terms. "No Medicare drug plan may have a deductible more than $615 in 2026 ($700 in 2027)." After the deductible you pay 25 percent coinsurance until your out-of-pocket spending on covered Part D drugs reaches the threshold, counting "certain payments made on your behalf," like those made through Extra Help. Then: "You won't have to pay out-of-pocket for covered Part D drugs for the rest of the calendar year." Some plans have no deductible at all. The change letter says what yours is.
For anyone with expensive prescriptions, the $2,400 is the number to plan around. Premiums aside, it is the most a year of covered Part D drugs can cost you out of pocket, and it went up from $2,100.
The two blanks in an agent's script
October also brings the mail and the calls. CMS's pamphlet warns about it plainly: "Around Open Enrollment, you might get a lot of mail from companies offering Medicare products."
Licensed agents and brokers can go through your drug list and your doctors and compare plans with you. They are also paid by the companies whose plans they sell: federal rules define their "compensation" as commissions, bonuses and other pay "relating to the sale, renewal, or services related to a plan or product" a Medicare Advantage company offers. And an agent who sells for more than one company, but not for all of them, has to say so.
The rule is 42 CFR 422.2267(e)(41). An agent or marketing company that sells for more than one Medicare Advantage company, but not for every one in your area, must say, on a sales call "prior to the discussion of any benefits":
"We do not offer every plan available in your area. Currently we represent [insert number of organizations] organizations which offer [insert number of plans] products in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options."
The bracketed blanks are the useful part. Ask for them out loud: how many companies do you represent here, and how many plans? It is a question with a number for an answer, and you can check the size of the whole shelf yourself. CMS says 97 percent of people with Medicare will have ten or more Medicare Advantage options next year, and Medicare's Plan Finder lists the plans in your area. An agent who represents three companies may still find you the right plan. You will just know how much of the shelf you were shown.
Help that is not selling anything
Three sources owe you no sale. 1-800-MEDICARE (1-800-633-4227) answers around the clock, and the Plan Finder at Medicare.gov will price your own drug list at your own pharmacies. And every state runs a State Health Insurance Assistance Program. The programs' national site, shiphelp.org, describes the work as "one-on-one counseling from a trusted, unbiased source" and lists the local number.
Two dates and one warning, all from CMS. Open enrollment ends December 7: "A health or drug plan must get your enrollment form by December 7." People in Medicare Advantage get a second window from January 1 to March 31 to switch plans or return to Original Medicare. And anyone who has a Medigap policy and is thinking of moving to Medicare Advantage should read this line twice: "You may not be able to get the same Medigap policy back later depending on your state's Medigap enrollment rules and your situation."
The averages will be right on average. The letter, the two blanks and the price of your own prescriptions are the numbers that are yours.
Disclosure: Hugin's publisher builds software for a Medicare insurance agency, which appears in a labeled promotion below this entry. It had no part in this entry.
Source links
- CMS, "Medicare Advantage and Medicare Prescription Drug Programs Expected to Remain Stable in 2027" (September 28, 2026)
- CMS, Announcement of CY 2027 Medicare Advantage Capitation Rates and Part C and Part D Payment Policies (April 6, 2026), Table V-2
- 42 CFR 422.111, disclosure requirements, including notice of changes (eCFR)
- 42 CFR 422.2267, required materials and content, including the third-party marketing organization disclaimer (eCFR)
- 42 CFR 422.2274, agent, broker and other third-party requirements (eCFR)
- Medicare.gov, Plan Annual Notice of Change (ANOC)
- CMS Product No. 11220, "Your Yearly Medicare Review" (September 2026)
- Medicare.gov, Catastrophic coverage and the costs of Medicare drug coverage
- State Health Insurance Assistance Programs (shiphelp.org)