Medicare in 2027: What CMS Has Published, and What It Has Not

Most coverage of a new Medicare year is written in the fortnight after CMS publishes its projections, which means it leans heavily on averages and skips what has not been announced yet. The averages are real and worth knowing. They are also, for an individual, close to useless on their own.

This sets out what CMS has actually published for 2027, what each figure covers, and where the gaps still are.

This applies to the United States. Figures come from CMS and Medicare.gov at the date of review.

The dates

Eight weeks sounds generous and is not, because the work is comparison rather than enrolment. Plan details for 2027 are posted on Medicare.gov ahead of the window; comparing on 6 December is how a decision ends up being made on premium alone.

If the question you are really asking is which of the two routes to be on rather than which plan to pick, that decision is worked through in Original Medicare or Medicare Advantage. If your situation is Medigap rather than Medicare Advantage, the enrolment rules are different and far less forgiving: the six-month Medigap open enrolment window is a one-time right, not an annual one.

Part D: the number that moved most

This is the change with the largest effect on anyone with significant drug costs.

Medicare states that once you reach the cap in out-of-pocket spending on covered Part D drugs, you automatically get catastrophic coverage and pay nothing out of pocket for covered drugs for the rest of that calendar year.

Two things follow that are worth being precise about.

The cap is on covered drugs. A drug that is not on your plan's formulary does not count toward it, and you pay for that drug in full regardless of how much you have already spent. What does and does not count toward the cap sets out the full list, premiums and manufacturer discounts included. Checking the formulary against your actual prescriptions is the single most valuable half hour of Open Enrollment.

The deductible figure is a ceiling, not a standard. No plan may charge more than $700, and many charge less. Some charge nothing.

Medicare also offers the Medicare Prescription Payment Plan, which spreads out-of-pocket drug costs across the calendar year in monthly payments. Medicare is explicit that it "doesn't save you money or lower your drug costs" — it changes the timing, which helps if a large cost would otherwise land in January, and does nothing at all if your costs are spread evenly already. It also renews itself if you keep the same plan and stops the moment you move to another, which is the rule most likely to catch people this autumn: how the Medicare Prescription Payment Plan works for 2027 sets out the arithmetic and the trap.

Medicare Advantage premiums, and what an average hides

Take the headline first. CMS's projection covers every MA plan, those with drug coverage and Special Needs Plans included, and puts the weighted average monthly premium at $12.00 for 2027 against $14.37 the year before. In percentage terms that is a drop of 16.5%; in money it is $2.37 a month.

For Part D specifically:

CMS also projects that 88% of non-low-income beneficiaries will have access to a basic Part D plan at $10.30 or less, and 93% of them to an enhanced Part D plan at less than $6.

Now the caveat that matters more than any of those figures. These are weighted averages across roughly 5,500 plans. CMS expects the national count to move only slightly, from 5,553 plans in 2026 to about 5,532 in 2027, with projected enrolment of 34 million people, around 47.4% of everyone on Medicare.

An average that falls 16.5% is entirely compatible with your own plan's premium rising. The average describes the market. Your Annual Notice of Change describes you.

What CMS has not published

Worth stating plainly, because the gap gets filled with guesses.

The standard Part B premium and deductible for 2027 had not been announced at the date this article was reviewed. Those figures are released separately, usually later in the autumn. The 2026 standard premium is $202.90, set out with the rest of the year's figures in the 2026 Medicare costs guide.

If you see a confident 2027 Part B figure quoted somewhere, check whether it is sourced to a CMS announcement or to someone's projection. The distinction matters, because Part B is the premium almost everyone pays and the one that drives the most planning.

The 2027 IRMAA brackets are not out either

The same applies to 2027 IRMAA brackets, the income-related monthly adjustment amounts that sit on top of Part B and Part D for higher earners. They are published in the same CMS announcement as the Part B premium, so they are not out yet and will not be until that lands.

Two things are already determined, though, and both are worth knowing in October rather than January.

The income that will set your 2027 surcharge is already filed. IRMAA runs on a two-year lookback: 2026 is charged on the 2024 return, so 2027 will be charged on the 2025 return. That return went in months ago. Whatever it says is what SSA will use, and no amount of planning between now and January changes it. What is still open is 2028, which will be charged on the 2026 return — the year that closes in about ten weeks. If you are near a threshold and weighing a Roth conversion, a property sale or a large distribution before 31 December, that decision is a Medicare decision as well as a tax one.

A high 2025 income does not settle it if your circumstances have changed. If you stopped work, lost a pension, divorced or were widowed after that return, SSA can use a more recent year instead. That is the purpose of form SSA-44, and it is not automatic — nobody applies it for you.

The mechanism, the current brackets and the appeal are set out in the 2026 IRMAA brackets guide, which is the right reference until the 2027 figures are published. Both surcharges are also billed separately from each other: Part D's is collected alongside your drug plan premium, not with Part B.

Supplemental benefits: a market statement, not a promise

CMS says supplemental benefit offerings, including hearing, dental and vision, are expected to remain stable.

Read that carefully. It is a projection about what the market will offer in aggregate. It is not a statement that your plan's dental allowance is unchanged, and it cannot be, because those allowances are set by individual plans rather than nationally. Thousands of plans can collectively "remain stable" while a great many individual allowances move in both directions.

This distinction is the single most common misreading of a CMS announcement, and what CMS did and did not say about 2027 Medicare Advantage dental benefits works through it in detail, including where your own number is actually written down.

Two further changes to supplemental benefits take effect for 2027 and were barely reported. CMS has written the rules for plan debit cards into federal regulation, including that a card must be limited to the specific plan year, and in the same rule it rescinded the mid-year notice that would have listed the benefits an enrollee had not used. What both mean for a flex card covers them.

ACCESS: a genuinely new option in Original Medicare

Largely unreported, and relevant if you have a chronic condition and are not in Medicare Advantage.

ACCESS, which stands for Advancing Chronic Care with Effective, Scalable Solutions, is a voluntary CMS model in Original Medicare that began on 5 July 2026 and runs for ten years. It pays participating organisations for achieving health outcomes rather than for individual services, and can cover virtual visits, health coaching, remote monitoring and connected devices between ordinary appointments. CMS launched it with more than 160 participating organisations and expects to add more over the model's life. Patients sign up directly with a participating organisation, keep the freedom to see any Medicare provider, and CMS states that taking part "does not change Medicare benefits, coverage, or rights".

The tracks at launch cover early cardio-kidney-metabolic conditions including hypertension, cardio-kidney-metabolic conditions including diabetes and chronic kidney disease, chronic musculoskeletal pain, and behavioural health including depression and anxiety. New tracks start on 1 April 2027 for heart failure, chronic obstructive pulmonary disease, substance use disorder and tobacco cessation.

If you have one of those conditions and have stayed in Original Medicare, this is worth asking your primary care clinician about directly, because it is the kind of option that reaches people through their doctor rather than through a plan brochure.

Six things to do before 7 December

1. Read your Annual Notice of Change. It is the only document that describes your plan rather than the market.
2. Check the formulary against your actual prescriptions, by name and dose. The $2,400 cap only applies to covered drugs.
3. Check your own doctors and pharmacy are still in network for 2027. Networks change annually.
4. Compare on Medicare Plan Finder, not on the premium alone.
5. If you have a chronic condition and are in Original Medicare, ask whether an ACCESS organisation is available to you.
6. Diary 7 December. Missing it generally means living with the plan you have for the year. The wider checklist is in what to check during Medicare Open Enrollment.

This article reports figures published by CMS and Medicare at the date of review. This is background for readers in the United States rather than insurance, medical, tax or financial advice. An average describes a market; it does not describe your plan. Confirm everything that affects you against your Annual Notice of Change, Medicare Plan Finder or 1-800-MEDICARE before changing coverage.

Sources

• CMS: Medicare Advantage and Medicare Prescription Drug Programs Expected to Remain Stable in 2027 (opens in a new tab)
• Medicare.gov: How much does Medicare drug coverage cost? (opens in a new tab)
• Medicare.gov: Your Medicare in 2027, what's new and changing (opens in a new tab)
• CMS Innovation Center: ACCESS Model (opens in a new tab)
• CMS: Contract Year 2027 Medicare Advantage and Part D Final Rule (opens in a new tab)
• Medicare.gov: Medicare costs (opens in a new tab)

This article is general information for a United States audience and reflects figures published by CMS and Medicare at the date of review. It is not insurance, medical, tax or financial advice, and it does not recommend any plan or insurer. Premiums, caps, formularies and supplemental benefits are set by individual plans and change annually, and some 2027 figures including the standard Part B premium had not been announced when this was written. Confirm your own position against your plan documents, Medicare Plan Finder or 1-800-MEDICARE before acting. Last reviewed 19 October 2026.