Medicare's 2027 enrollment window opens as private plan premiums are projected to fall

Medicare's annual Open Enrollment period opened Thursday, giving roughly 68 million beneficiaries until Dec. 7 to review or switch their Medicare Advantage and prescription drug coverage for 2027. The window opens against an unusual backdrop: the federal government is projecting lower average premiums for private Medicare plans even as it winds down a subsidy program that had been propping up stand-alone drug plan pricing.

The Centers for Medicare & Medicaid Services said in a Sept. 28 announcement that the weighted average Medicare Advantage premium is projected to fall from $14.37 a month in 2026 to $12 in 2027, a decline of roughly 16.5 percent. Average Part D premiums for drug coverage bundled into Medicare Advantage plans are expected to drop even more sharply, from $11.32 to $7 a month after rebates, a 38 percent decrease.

The numbers

Stand-alone Part D plans, used mainly by beneficiaries in traditional Medicare, tell a more mixed story. CMS projects the average premium for those plans will rise by less than $1, from $35.09 to $36 a month. But that national average obscures a narrower marketplace: analysis by KFF found the number of stand-alone Part D plans available nationwide is set to fall by about 13 percent, from 360 to 312, as insurers including CVS Health's Aetna and companies offering HealthSpring Extra and SilverScript Choice withdraw plans from multiple regions.

CMS says more than 99 percent of beneficiaries will have access to at least one Medicare Advantage plan in 2027, and 97 percent will be able to choose among 10 or more. The total number of available Medicare Advantage plans nationally is projected to edge down slightly, from 5,553 to about 5,532. The agency also estimates enrollment in Medicare Advantage will reach 34 million people next year, or about 47.4 percent of everyone on Medicare, though it cautions that actual enrollment has historically outpaced its own projections.

On the drug-plan side, CMS says 88 percent of beneficiaries who don't qualify for low-income subsidies will have access to a basic Part D plan priced at $10.30 a month or less, and 93 percent can get an enhanced plan under $6. The full state-by-state breakdown is published in a landscape fact sheet the agency released alongside the announcement.

How we got here

The relatively favorable Part D averages come as CMS phases out the Part D Premium Stabilization Demonstration, a program that paid insurers roughly $9.8 billion over 2025 and 2026 to hold down stand-alone plan premiums while the industry adjusted to redesigned Medicare drug benefits under the Inflation Reduction Act, including a new $2,000 annual out-of-pocket cap. CMS narrowed the program for 2026 and is ending it after this year. Administrator Dr. Mehmet Oz has described the subsidy as an insurance-industry bailout the market no longer needs.

"By slashing handouts to big insurance companies, CMS is keeping premiums stable," Oz said in the agency's announcement, adding that the approach is "ensuring that 97% of Medicare beneficiaries have access to 10 or more MA plans."

Not every analyst reads the numbers the same way. Juliette Cubanski, a Medicare policy expert at KFF, has noted that beneficiaries who had a $0-premium stand-alone drug plan in 2026 and don't qualify for the low-income subsidy known as Extra Help will see a premium for the first time in 2027, since insurers are allowed to end zero-premium offerings as the stabilization program lapses. She has also pointed out that CMS's topline averages don't capture cost-sharing or formulary changes within individual plans.

Who is affected

The open enrollment window, formally the Annual Election Period, applies to anyone enrolled in Medicare who wants to join, drop or switch a Medicare Advantage plan or a stand-alone Part D drug plan, or move between Medicare Advantage and original Medicare, for coverage that takes effect Jan. 1, 2027. It does not involve initial enrollment for people newly turning 65, which follows separate rules explained on Medicare.gov.

Beneficiaries whose current plan is leaving their market, cutting benefits or dropping specific drugs from its formulary are most exposed if they don't act. CMS and consumer advocates both recommend checking the Annual Notice of Change mailed by each plan this fall, since a plan that was inexpensive in 2026 is not guaranteed to remain so, and a monthly premium on its own does not capture deductibles, copays or which pharmacies and specialists are in network.

What people are saying

CMS has framed the falling averages as evidence that scaling back federal subsidies to insurers has not destabilized the market, and the agency is using the figures to encourage shopping around during the enrollment window rather than auto-renewing. Consumer-facing analysts broadly agree with the shopping advice even where they diverge on the underlying policy. A guide published by Kiplinger notes that CMS typically releases the separate, and closely watched, standard Part B premium and deductible figures later in the fall — likely in November — meaning beneficiaries will be choosing 2027 plans before knowing what their baseline Medicare costs will be.

Reporting by AARP on the Part D landscape quotes Cubanski urging beneficiaries not to assume stability: "The bottom line is that it will pay to shop around," she said, pointing to wide premium variation among the remaining stand-alone plans, with some insurers' offerings falling and others rising depending on the carrier and region.

What happens next

Open Enrollment runs through Dec. 7, and any changes beneficiaries make take effect Jan. 1, 2027. Beneficiaries who do nothing are automatically kept in their current plan, which CMS and advocacy groups both warn can mean paying more than necessary if a plan's premium, formulary or network has changed for the new year. The separate Medicare Advantage Open Enrollment Period, a narrower window from Jan. 1 to March 31 that allows one additional plan switch for people already in Medicare Advantage, follows afterward.

CMS has not yet announced the 2027 standard Part B premium or deductible, the costs that apply regardless of which supplemental plan a beneficiary chooses; that announcement, along with the 2027 Medicare Trustees-adjacent figures, is expected later this fall. Beneficiaries can compare plans using the Medicare Plan Finder tool or by calling 1-800-MEDICARE, which operates extended hours during the enrollment period.