Medicare open enrollment 2027 started October 15, 2026, and runs through December 7. Any change you make takes effect January 1, 2027 (Medicare.gov). This year matters more than usual: the Part D out-of-pocket cap rises to $2,400, the standard drug deductible climbs to $700, a premium subsidy for standalone drug plans ends, and new negotiated prices take effect for drugs that include Ozempic and Wegovy (AP via PBS NewsHour). Here’s what’s changing, how to compare plans, and the tax rules that affect what you pay.
Medicare Open Enrollment 2027 Dates and Deadlines
| Date | What happens |
| October 15 – December 7, 2026 | Open enrollment: join, switch, or drop Medicare Advantage or Part D plans |
| Late November 2026 | 2027 Part B premium posted in your my Social Security Message Center |
| January 1, 2027 | New coverage and 2027 costs take effect |
| January 1 – March 31, 2027 | Medicare Advantage Open Enrollment: one change for people already in a Medicare Advantage plan |
Sources: Medicare.gov, SSA, Medicare enrollment periods guide.
Your plan must receive your request by December 7. Don’t wait until the last week, when plan finders and phone lines are busiest.
What’s Changing in 2027
Some 2027 numbers are final and some are still projections. Part B figures become official when CMS announces them, usually in November.
| Item | 2026 | 2027 | Status |
| Part D out-of-pocket cap | $2,100 | $2,400 | Final |
| Part D standard deductible | $615 | $700 | Final |
| Part B standard premium | $202.90/mo | $209.50/mo | Projected |
| Part B deductible | $283 | About $292 | Projected |
Sources: Part D figures from AP via PBS NewsHour; Part B figures from the Medicare Trustees projection reported by Kiplinger.
Other changes to know about:
- Drug plan premium subsidy ends. A temporary federal program that held down premiums for standalone Part D plans ends this year. It lowered those premiums by $16 a month in 2026 (Yahoo Finance). Some people may see higher premiums even if their plan doesn’t otherwise change.
- More negotiated drug prices. Starting January 1, 2027, Medicare-negotiated prices apply to a new group of drugs, including Ozempic, Rybelsus, Wegovy, Trelegy Ellipta, Xtandi, Ibrance, and Linzess (AP via PBS NewsHour). What you actually pay still depends on your plan’s copays and coverage tiers.
- One-time $90 Part B payment. The administration announced a one-time $90 payment this month to help more than 20 million enrollees with Part B premiums. Medicare Advantage enrollees aren’t eligible, nor are millions of people with disabilities or low incomes (AP via PBS NewsHour).
- Plan changes. Medicare Advantage plans can change networks, benefits, and costs each year, and some leave markets. Your plan’s Annual Notice of Change spells out what’s different for you. Our post on Medicare Advantage changes in 2026 covers the changes that took effect this year.
What You Can (and Can’t) Change
During open enrollment, you can (Medicare.gov):
- Switch from Original Medicare to a Medicare Advantage plan, or the reverse.
- Join, drop, or switch Medicare Advantage plans, with or without drug coverage.
- Join, drop, or switch a standalone Part D drug plan if you have Original Medicare.
After December 7, your options narrow. From January 1 to March 31, people already in a Medicare Advantage plan get one change: switch to another Medicare Advantage plan or return to Original Medicare and add a drug plan. You can’t use that window to move from Original Medicare into Medicare Advantage (Medicare.gov).
A caution on Medigap: If you leave Medicare Advantage for Original Medicare, you may want a Medigap supplement policy, but Medicare.gov notes there are limits on when you can add one. Depending on your state and circumstances, an insurer may be able to charge more or deny coverage, so check your Medigap options before you switch.
How to Compare Plans in Five Steps
- Read your Annual Notice of Change. It lists your plan’s 2027 premium, deductible, copays, and drug list changes.
- Enter every prescription in the Medicare Plan Finder. Drug lists and tiers change each year, and the cheapest premium doesn’t always mean the lowest total cost.
- Compare total yearly cost. Add premiums, deductibles, and expected copays. With the $2,400 Part D cap, heavy drug users may care more about premiums than cost sharing.
- Check networks. Confirm your doctors, hospitals, and pharmacies are in network for 2027.
- Get free help. Every state has a State Health Insurance Assistance Program (SHIP) that offers free, unbiased counseling (Yahoo Finance).
The Tax Side of Medicare Open Enrollment 2027: IRMAA
Plan choice isn’t the only thing that sets your Medicare costs. If your income is higher, you pay an income-related monthly adjustment amount (IRMAA) on top of the standard Part B and Part D premiums. It’s based on your tax return from two years earlier, so 2027 premiums will generally be based on your 2025 return (SSA).
| 2026 IRMAA tier (MAGI) | Single | Married filing jointly | Part B surcharge per month |
| Tier 1 | $109,001 – $137,000 | $218,001 – $274,000 | $81.20 |
| Tier 2 | $137,001 – $171,000 | $274,001 – $342,000 | $202.90 |
| Tier 3 | $171,001 – $205,000 | $342,001 – $410,000 | $324.60 |
| Tier 4 | $205,001 – $499,999 | $410,001 – $749,999 | $446.30 |
| Tier 5 | $500,000+ | $750,000+ | $487.00 |
Source: SSA. Part D surcharges also apply. The 2027 tiers will be released with the official 2027 premiums.
What you can do about it:
- Appeal after a life-changing event. If your income dropped because you retired, cut back on work, married, divorced, or lost a spouse, you can ask SSA to use a more recent year with Form SSA-44 (SSA).
- Plan 2026 income now. Your 2026 return will set your 2028 premiums. Large IRA withdrawals, Roth conversions, or capital gains before December 31 can push you over a tier by just $1. Qualified charitable distributions from an IRA can satisfy RMDs without adding to income.
For more on how income in retirement is taxed, see our guide to retiree taxes in 2026.
Can You Deduct Medicare Premiums?
Often, yes. How depends on your situation:
- Itemizers: Part B and Part D premiums count as medical expenses. So do Part A premiums if you voluntarily enroll because you aren’t covered through Social Security. Only total medical expenses above 7.5% of AGI are deductible (IRS Publication 502).
- Self-employed: If you have net profit from self-employment, Medicare premiums you voluntarily pay can count toward the self-employed health insurance deduction, which you can take without itemizing. You can’t use it for months you were eligible for an employer-subsidized plan, including through a spouse (IRS Form 7206 instructions). Our guide to 2026 self-employment taxes covers related deductions.
- HSA owners: After 65, you can generally use HSA money tax-free for Medicare premiums, but not Medigap premiums (IRS Publication 969). See our article on HSA qualified medical expenses.
Frequently Asked Questions
When is Medicare open enrollment for 2027 coverage?
It runs from October 15 to December 7, 2026. Changes take effect January 1, 2027.
What is the Part D out-of-pocket maximum for 2027?
The annual out-of-pocket cap for covered drugs is $2,400 in 2027, up from $2,100 in 2026. After you reach it, you pay nothing more for covered drugs for the rest of the year.
How much will Medicare Part B cost in 2027?
The official figure hasn’t been announced. The Medicare Trustees projected $209.50 a month, up from $202.90 in 2026. Higher earners pay more through IRMAA.
What happens if I miss the December 7 deadline?
Your current coverage generally continues. If you’re in Medicare Advantage, you get one more chance to change between January 1 and March 31. Otherwise, you usually need a special enrollment period.
Are Medicare premiums tax deductible?
Part B and Part D premiums can be deducted as medical expenses if you itemize and exceed 7.5% of AGI. Self-employed people may deduct them without itemizing.
Plan Your Medicare Costs and Taxes Together
Medicare open enrollment 2027 is the right time to look at your premiums and your income plan side by side. A well-timed Roth conversion, IRA withdrawal, or charitable gift can keep you below an IRMAA tier. To review your situation, book a free consultation with Aric.
This article provides information only and should not be construed as advice. It is provided without warranty of any kind.
