Medicare Advantage Changes in 2027: Costs, Benefits, Plan Changes and What to Know

Medicare Advantage changes in 2027 include updates to plan quality ratings, supplemental-benefit administration, prescription drug rules, and enrollment processes. However, not every change is a nationwide increase or decrease in what beneficiaries pay. Your 2027 Medicare Advantage premium, provider network, drug formulary, copays, out-of-pocket limit, and extra benefits can vary by plan and location.

That distinction is important when preparing for 2027. CMS has finalized the federal rules, but your individual plan’s 2027 costs and benefits are determined by the plan’s approved benefit package. CMS has said the 2027 Medicare Advantage and Part D plan landscape, including final average premiums, will be released in September after offerings are finalized.

The best way to prepare is to compare your current plan with its 2027 information, beginning with your Annual Notice of Change (ANOC) and Evidence of Coverage (EOC), then checking your doctors, medications, costs, and supplemental benefits before enrollment deadlines.

Important: This article explains general Medicare Advantage rules and 2027 changes. It does not replace your plan documents or individualized insurance advice. Medicare Advantage rules, plan benefits, premiums, provider networks, and formularies can vary and may change. Use Medicare.gov and your plan’s official documents for decisions specific to your coverage.

What Is Changing With Medicare Advantage in 2027?

The 2027 changes are easier to understand when divided into two categories:

CMS finalized the 2027 Medicare Advantage and Part D rule on April 2, 2026. The final rule includes changes to Star Ratings, supplemental benefits, debit-card administration, Part D and enrollment processes.

Medicare Advantage 2027: What Is Confirmed vs. What Is Plan-Specific?

One of the easiest mistakes to make when researching Medicare Advantage changes in 2027 is treating every reported number as if it applies to everyone.

It does not.

Changes confirmed at the federal level

CMS has finalized several program-wide rules for 2027, including:

• Changes to the Medicare Advantage and Part D Star Ratings methodology
• New transparency requirements for certain Special Supplemental Benefits for the Chronically Ill
• New rules for supplemental-benefit debit cards
• Codification of major Part D benefit changes created by the Inflation Reduction Act
• Changes to certain enrollment and administrative requirements

Information that depends on your plan

Other details are determined at the individual plan level. These may include:

• Monthly Medicare Advantage premium
• Copayments and coinsurance
• Annual medical out-of-pocket maximum
• Prescription drug formulary
• Drug tiers and pharmacy networks
• Doctors, specialists and hospitals in the network
• Dental, vision and hearing benefits
• OTC or healthy-food benefits
• Transportation benefits
• Other supplemental benefits
• Whether a specific plan remains available in your county

Medicare.gov confirms that Medicare Advantage costs vary by plan and can change each year.

That is why a headline such as “Medicare Advantage premiums will increase in 2027” can be misleading unless it identifies which plans, locations or premium measure it is referring to.

Will Medicare Advantage Premiums Increase in 2027?

There is no single 2027 Medicare Advantage premium that everyone will pay.

CMS’s 2027 rate announcement projects a 2.48% average increase in payments to Medicare Advantage plans, or more than $13 billion, compared with 2026. That figure describes payments from Medicare to plans; it does not mean your Medicare Advantage premium will automatically increase by 2.48%.

Your own premium depends on the plan available where you live and the benefit package the insurer offers for 2027.

When comparing Medicare Advantage premiums in 2027, do not look at the premium alone. Also check:

1. Your Part B premium obligation
2. The plan’s monthly premium, if any
3. Deductibles
4. Specialist and primary-care copays
5. Hospital cost sharing
6. Prescription drug costs if Part D is included
7. The annual medical out-of-pocket maximum
8. Network restrictions
9. Supplemental benefits you actually use

Medicare notes that some Medicare Advantage plans charge no additional plan premium, but you generally must continue paying your Medicare Part B premium while enrolled.

Medicare Advantage Costs in 2027: Look Beyond the Premium

A low monthly premium does not necessarily mean a plan will cost less over the entire year.

Consider two hypothetical plans:

This example is illustrative, not a comparison of actual 2027 plans.

The important point is that total annual exposure is more useful than one headline number.

For a beneficiary who rarely uses medical services, the monthly premium may receive more attention. Someone receiving frequent specialist care may care more about copays and network access. Someone taking several expensive medications should pay close attention to formulary placement and drug cost sharing.

Smart Insurance Reviews has also covered the broader difference between premiums and total out-of-pocket exposure in its insurance cost research, which is useful background when evaluating the true cost of coverage.

Medicare Advantage Out-of-Pocket Maximum in 2027

Medicare Advantage plans have an annual out-of-pocket limit for covered Medicare Part A and Part B services. The specific limit varies by plan.

Once you reach your plan’s applicable limit for covered services, the plan generally pays 100% of covered health services for the rest of the calendar year. Medicare.gov specifically notes that Medicare Advantage plan out-of-pocket limits vary by plan.

This is different from the $2,400 Part D annual out-of-pocket threshold for 2027.

That distinction matters.

Medicare Advantage medical out-of-pocket limit vs. Part D threshold

Medicare Advantage medical out-of-pocket maximum:
Applies to covered Medicare Part A and Part B services under the MA plan and varies by plan.

Part D annual out-of-pocket threshold:
For the defined standard Part D benefit in 2027, the threshold is $2,400. This applies to qualifying prescription-drug out-of-pocket spending under Part D rules.

So, when you see the phrase “Medicare Advantage out-of-pocket maximum 2027,” make sure you know whether the discussion is about medical services under Part C or prescription drugs under Part D.

Medicare Advantage Part D Changes in 2027

Most Medicare Advantage plans include prescription drug coverage, although the exact structure depends on the plan.

For 2027, CMS is formally codifying major Part D changes created under the Inflation Reduction Act.

The 2027 standard benefit parameters include:

These figures describe the defined standard Part D benefit, not necessarily the exact cost structure of every Medicare Advantage plan with drug coverage.

For a deeper explanation of the prescription-drug changes, see Smart Insurance Reviews’ guide to Medicare Part D changes in 2027.

When comparing an MA-PD plan, check the actual 2027 formulary, drug tiers, pharmacy network and utilization requirements rather than relying on the national Part D figures alone.

Medicare Advantage Formulary Changes in 2027

A formulary is the list of prescription drugs covered by a plan.

Your 2027 plan may have changes involving:

• Whether a medication is covered
• Which tier a drug occupies
• Copay or coinsurance requirements
• Preferred pharmacies
• Prior authorization
• Quantity limits
• Step therapy
• Other utilization-management requirements

Medicare.gov advises beneficiaries to check their specific plan for drug coverage and pharmacy network information.

If your medications have a major effect on your household budget, make a complete list before comparing Medicare Advantage plans for 2027. Check the exact medication and dosage rather than assuming that a similarly named drug will have the same coverage.

Medicare Advantage Provider Network Changes in 2027

Your doctor can be one of the most important parts of your plan decision.

Medicare Advantage networks can include different doctors, hospitals, specialists and other providers depending on the plan. HMO plans generally require you to use in-network providers except for certain situations, while PPO plans generally allow out-of-network care at higher costs.

Before renewing or changing coverage for 2027, verify:

• Primary-care doctor
• Important specialists
• Preferred hospital
• Outpatient facilities
• Major medical groups
• Pharmacies
• Providers you use regularly

Do not assume that a doctor who accepted your 2026 Medicare Advantage plan will automatically participate in the 2027 version.

Medicare.gov specifically recommends checking whether your providers are in-network before receiving services.

What Is Changing About Medicare Advantage Benefits in 2027?

Medicare Advantage plans can offer benefits beyond what Original Medicare normally covers, including dental, vision, hearing and certain other supplemental benefits. The exact benefits vary by plan.

For 2027, CMS is changing how some supplemental benefits are administered and documented rather than announcing one universal package of extra benefits for every beneficiary.

Special Supplemental Benefits for the Chronically Ill

CMS is strengthening the administration of Special Supplemental Benefits for the Chronically Ill (SSBCI).

One important 2027 change is that plans must publicly post their plan-developed SSBCI eligibility criteria. This is intended to make it easier for beneficiaries and prospective enrollees to understand who qualifies for these benefits.

This does not mean every beneficiary automatically receives every SSBCI benefit.

Eligibility depends on the specific plan’s rules and the beneficiary’s circumstances.

Are Medicare Advantage Grocery Benefits Changing in 2027?

Some Medicare Advantage plans offer healthy-food or grocery-related supplemental benefits, but these benefits are not universal.

CMS’s 2027 final rule adds requirements governing certain debit cards used to administer supplemental benefits. The cards must be electronically linked to covered items and services through a real-time identification mechanism, and cards are limited to the specific plan year.

The practical lesson is simple: do not treat a “$X grocery benefit” advertised for one plan as a Medicare-wide benefit.

For 2027, check the actual plan’s benefit document to find out:

• Whether healthy-food benefits are offered
• Who qualifies
• What products are eligible
• Where the benefit can be used
• Whether a debit card is used
• What happens to unused amounts at the end of the plan year

What About Medicare Advantage Dental Benefits in 2027?

Dental coverage is another area where plan-specific comparison matters.

Medicare Advantage plans may offer dental benefits beyond Original Medicare, but the amount and scope can vary considerably. A plan could cover preventive dental services while another offers additional comprehensive benefits, subject to its rules, limits and provider network.

Before choosing a 2027 plan, check:

• Preventive vs. comprehensive services
• Annual benefit limits
• Copayments or coinsurance
• Waiting periods, if applicable
• Covered procedures
• Dental provider network
• Whether the benefit uses a separate dental network

For related research, see Smart Insurance Reviews’ guide to Dental insurance options for seniors on Medicare.

The important point is that a plan’s dental benefit should be evaluated based on the services you actually expect to use, rather than the headline dollar amount.

Medicare Advantage Star Ratings 2027

Medicare Advantage Star Ratings help beneficiaries compare the quality of Medicare Advantage and drug plans.

For 2027, CMS is changing the Star Ratings methodology. Among other changes, CMS is removing 11 measures that it says focus on administrative processes or areas where plans perform similarly, and it is not implementing the Excellent Health Outcomes for All reward for 2027 Star Ratings. CMS is also adding a Part C Depression Screening and Follow-Up measure beginning with the 2027 measurement year; that measure is scheduled for the 2029 Star Ratings.

This creates an important distinction:

A change in the Star Ratings methodology is not the same as your plan’s benefits changing.

When comparing plans, look at the actual Star Rating shown for the relevant year rather than assuming a methodology change automatically means a plan became better or worse.

Are Medicare Advantage Plans Going Away in 2027?

Medicare Advantage as a program is not going away in 2027.

However, individual Medicare Advantage plans can change, consolidate, reduce their service area or stop being offered in a particular location.

That means the useful question is not simply, “Are Medicare Advantage plans going away?”

The more useful question is:

“Is my specific Medicare Advantage plan available for 2027, and if it is, what changed?”

Medicare Advantage is offered through private insurers that contract with Medicare, and plans can have different networks, costs and rules.

If you receive a notice that your plan will not be offered for 2027, do not assume that every plan from the same insurance company is affected. Plan availability is location-specific.

What Happens If Your Medicare Advantage Plan Is Discontinued?

If your Medicare Advantage plan’s contract with Medicare is not renewed, Medicare provides a Special Enrollment Period that allows you to choose another plan.

For a plan whose contract is not renewed, Medicare.gov says the Special Enrollment Period runs from December 8 through the last day of February of the following year. You can switch to another Medicare Advantage plan or a Medicare drug plan as applicable. If you do not join another Medicare Advantage plan before the current plan ends, you will be enrolled in Original Medicare.

There are different Special Enrollment Period rules for other situations, such as a contract ending during the year, so the reason your coverage is ending matters.

If your plan is ending, check these items immediately

1. Confirm the notice.
   Make sure the document actually says the plan is ending or is not being renewed. An ANOC is not the same as a nonrenewal notice.
2. Check replacement options.
   Review the plans available in your area rather than assuming another plan from the same insurer is identical.
3. Review your medications.
   Check the new plan’s formulary and pharmacy network.
4. Verify your doctors.
   Confirm your primary doctor, specialists and preferred hospital.
5. Compare your total cost.
   Look at the premium, deductible, copays, coinsurance and out-of-pocket limit.
6. Check supplemental benefits.
   Review dental, vision, hearing, OTC, food and transportation benefits if they are important to you.

Medicare Advantage Annual Notice of Change 2027: How to Read It

The Annual Notice of Change, or ANOC, is one of the most important documents to review before the new plan year.

Medicare.gov says plans send the ANOC each fall and that it explains changes to coverage, costs and other plan details that will take effect in January.

When your 2027 ANOC arrives, compare these areas first:

ANOC vs. Evidence of Coverage

These two documents serve different purposes.

ANOC: Focuses on what will change next year.

Evidence of Coverage: Provides detailed information about what your plan covers, what you pay, and the rules that apply to your coverage. Medicare lists the EOC among the important September plan documents.

A good approach is to use the ANOC to identify changes and then use the EOC to investigate the details.

Medicare Advantage Enrollment 2027 Dates

For coverage beginning in 2027, the key dates include:

Medicare.gov confirms that the regular Open Enrollment period is October 15 through December 7 and that changes generally become effective January 1.

Special Enrollment Periods can have different dates depending on why you qualify, so do not apply the nonrenewal timeline to every situation.

Medicare Advantage vs. Original Medicare in 2027

A Medicare Advantage change may also be the point at which you reconsider how you receive Medicare coverage.

Medicare Advantage and Original Medicare work differently.

Medicare.gov emphasizes that Original Medicare generally allows beneficiaries to use any doctor or hospital that accepts Medicare, while Medicare Advantage plans may have network and referral rules.

Neither structure should be evaluated solely on the monthly premium. Provider access, prescription needs, expected healthcare use, supplemental benefits and financial exposure can all matter.

A Practical Medicare Advantage 2027 Checklist

Before deciding whether to keep or change your plan, work through this checklist:

Medical care

• Are my primary doctor and specialists still in-network?
• Is my preferred hospital included?
• Did specialists, hospitals or other companies change?
• Did my annual out-of-pocket limit change?

Prescription drugs

• Are all my medications still covered?
• Did any medication move to a different tier?
• Is my pharmacy still preferred or in-network?
• Are prior authorization or other restrictions different?

Supplemental benefits

• Did dental coverage change?
• What vision and hearing benefits are available?
• Did OTC, food or transportation benefits change?
• Do I still meet any eligibility requirements for supplemental benefits?

Overall cost

• What is the monthly premium?
• What deductible applies?
• What will I pay for the services I actually use?
• What is the annual medical out-of-pocket maximum?

Coverage and timing

• Is my exact plan continuing in my county?
• Did I receive an ANOC?
• Do I have an EOC?
• Do I need to act during Open Enrollment?
• Do I qualify for a Special Enrollment Period?

This process is more useful than choosing a plan based on one advertised benefit or premium.

What Should Medicare Beneficiaries Do Before 2027?

Start by reviewing your current coverage rather than waiting until the enrollment deadline.

A useful sequence is:

Review your ANOC → compare the 2027 premium and cost sharing → verify doctors and hospitals → check every prescription → review supplemental benefits → compare available plans → make your enrollment decision before the applicable deadline.

For people already taking several prescriptions, the drug comparison deserves particular attention. A plan with a different premium can produce a very different annual cost depending on the medications you take, their formulary tiers and the pharmacies you use.

For people who value dental coverage, also examine the actual covered services and limitations rather than relying on a large advertised benefit amount.

And if your current plan is being discontinued, treat the notice as a reason to review your options promptly rather than assuming the replacement will have the same doctors, medications, benefits or costs.

The Bottom Line

The major Medicare Advantage changes in 2027 are not one single benefit cut or universal premium increase.

CMS has finalized changes to the Star Ratings system, supplemental-benefit administration, SSBCI transparency, supplemental-benefit debit cards, Part D and certain enrollment processes.

At the individual level, the most important 2027 changes may be the ones specific to your plan: premium, out-of-pocket limit, copays, provider network, drug formulary, pharmacy network and supplemental benefits.

For people with Medicare Advantage plans that include Part D, the 2027 standard Part D deductible rises to $700, while the annual Part D out-of-pocket threshold becomes $2,400.

The safest way to prepare is therefore not to ask only, “What is changing in Medicare Advantage in 2027?”

Ask:

“What is changing in my Medicare Advantage plan for 2027, and how will those changes affect the care, prescriptions and benefits I actually use?”

That answer is found in your plan’s 2027 documents and the official Medicare plan information—not in a national headline alone.

Frequently Asked Questions

Are Medicare Advantage plans going away in 2027?

No. Medicare Advantage continues in 2027. However, individual plans can change, consolidate, reduce their service area or stop being offered. Check your specific plan and county for 2027 availability.

Will Medicare Advantage premiums increase in 2027?

Not necessarily for every beneficiary. Medicare Advantage premiums are plan-specific. CMS’s projected 2.48% increase for 2027 refers to average payments to Medicare Advantage plans, not an automatic 2.48% increase in beneficiary premiums.

What is the Medicare Advantage out-of-pocket maximum for 2027?

Your Medicare Advantage medical out-of-pocket maximum is specific to the plan. Medicare.gov says these limits vary by plan. Do not confuse the medical MA out-of-pocket maximum with the separate $2,400 Part D annual out-of-pocket threshold for 2027.

What is the Medicare Part D deductible for Medicare Advantage plans in 2027?

For the defined standard Part D benefit, the 2027 deductible is $700, up from $615 in 2026. Individual Medicare Advantage plans with drug coverage can have different benefit designs within Medicare rules.

What is an Annual Notice of Change for Medicare Advantage?

The ANOC is a notice your Medicare plan sends each fall describing changes to coverage, costs and other plan details that will take effect in January. It is an important document to review before deciding whether your plan still meets your needs.

What happens if my Medicare Advantage plan is discontinued?

If your plan’s contract with Medicare is not renewed, you generally receive a Special Enrollment Period from December 8 through the last day of February of the following year. You can use the applicable SEP to choose another plan; if you do not join another Medicare Advantage plan before the current plan ends, Medicare says you will be enrolled in Original Medicare.

Will Medicare Advantage dental and grocery benefits change in 2027?

They can, but there is no single dental or grocery benefit that applies to every Medicare Advantage plan. These benefits are plan-specific. CMS is changing certain rules governing the administration and eligibility transparency of supplemental benefits, so review your specific 2027 benefit materials.

When is Medicare Advantage Open Enrollment for 2027 coverage?

The annual Open Enrollment period for 2027 coverage is October 15 through December 7, 2026. Changes made during this period generally take effect January 1, 2027.

Should I compare Medicare Advantage plans again if my current plan is continuing?

Yes. A continuing plan can still change its premium, cost sharing, provider network, formulary or supplemental benefits. Medicare specifically advises beneficiaries to review changes in their plan documents before deciding whether to remain enrolled.

Is Medicare Advantage or Original Medicare better in 2027?

There is no single option that is appropriate for everyone. Medicare Advantage may involve networks and plan-specific cost sharing but can bundle benefits and usually prescription coverage, while Original Medicare generally provides broader provider access but does not have an annual out-of-pocket limit by itself. The appropriate choice depends on your healthcare needs, providers, prescriptions, budget and coverage priorities.