2027 Medicare Changes: What Your Annual Notice of Change Will Show — And What Is Still a Projection
2027 Medicare Changes: What Your Annual Notice of Change Will Show — And What Is Still a Projection
Between September 30 and December 7, every Medicare Advantage and Part D enrollee gets a letter that quietly resets their costs for the year ahead. Here is the vocabulary for reading it — plus an honest line between what CMS has confirmed for 2027 and what is still an estimate.
Most people meet their Medicare plan once a year — in October, when a commercial comes on. But the document that actually determines what a plan will cost in 2027 arrives before that, in a plain envelope, in September. It is called the Annual Notice of Change, and it is the single most concrete piece of information a Medicare Advantage or Part D enrollee receives all year.
This guide is educational. It does not tell anyone what to do with their coverage, and it does not predict what any plan will charge. What it does is separate three things that get blended together every fall: what the federal government has already confirmed for 2027, what is still a projection, and what only an individual plan’s own letter can answer.
The 2026 Fall Calendar: Four Dates That Structure Everything
The Medicare year has a rhythm, and it is unusually strict. Four dates in the second half of 2026 govern the 2027 plan year:
- Mid-to-late September 2026 — CMS has said it will release the 2027 Medicare Advantage and Part D landscape, along with final average premiums, once all plan offerings are finalized.
- By September 30, 2026 — Medicare health and drug plans mail the Annual Notice of Change (ANOC) and the Evidence of Coverage (EOC) to current enrollees.
- October 15 – December 7, 2026 — Medicare Open Enrollment, sometimes called the Annual Enrollment Period. Changes made in this window take effect January 1.
- October 14, 2026 — the Social Security Administration is scheduled to announce the official 2027 cost-of-living adjustment, after the September inflation report.
The sequencing matters. The ANOC lands before the enrollment window opens, which is the only reason the window is long enough to be useful. A letter that arrives September 28 gives someone roughly two and a half weeks of reading time before anything can be changed, and roughly ten weeks before the deadline.
Tip from Alfred:
The ANOC is not marketing mail. It is a required disclosure comparing this year’s plan to next year’s version of the same plan, side by side. It is the one document in the Medicare mailbox that is specific to one person’s actual coverage rather than to Medicare in general — which is exactly why it tends to get thrown away with the brochures.
What an Annual Notice of Change Actually Is
An ANOC is a comparison document. For a single plan, it shows the 2026 value and the 2027 value for each of the plan’s key terms. Medicare health and drug plans are permitted to change costs, coverage, provider networks, and pharmacy networks each year, and the ANOC is where those changes are disclosed.
The distinction between an ANOC and an EOC
The two documents arrive together and are frequently confused:
- The ANOC is short and comparative. It answers: what is different next year?
- The Evidence of Coverage (EOC) is long and complete. It answers: what are all the rules of this plan?
For someone trying to understand a cost change, the ANOC is the shorter path. For someone trying to understand a coverage rule — prior authorization, referral requirements, a specific drug tier — the EOC is where that language lives.
What CMS Has Already Confirmed for 2027
As of mid-August 2026, several 2027 figures are official, published by the Centers for Medicare & Medicaid Services rather than estimated by a third party.
| Item | 2026 (official) | 2027 (official) |
|---|---|---|
| Part D national base beneficiary premium | $38.99 | $41.33 |
| Part D national average monthly bid amount | $239.27 | $296.05 |
| Part D Premium Stabilization Demonstration | In effect | Concluded |
| Coverage gap (“donut hole”) phase | Eliminated | Eliminated in regulation |
| Cost sharing in the catastrophic phase | None | None |
Where these numbers come from. Both years are official CMS figures, not estimates. Every year in late July, CMS’s Office of the Actuary publishes the Part D national average monthly bid amount and the base beneficiary premium for the following calendar year, calculated from the bids Part D plan sponsors actually submitted. The 2026 figures were released July 28, 2025; the 2027 figures were released July 28, 2026. The bid amount is an enrollment-weighted average of every standalone drug plan and Medicare Advantage prescription drug plan bid — it rose from $239.27 to $296.05, an increase of $56.78, or 23.7%. CMS also notes the bid amount itself is not affected by the Premium Stabilization Demonstration, because it is calculated from standardized bids.
A few points of vocabulary, because these terms are routinely misread:
The base beneficiary premium is not anyone’s premium
The national base beneficiary premium — $41.33 for 2027, up from $38.99 in 2026 — is a calculation input, not a bill. CMS describes it as the starting point plans use to calculate their own plan-specific basic Part D premium, and it also factors into the federal subsidy paid to plans. An individual’s actual Part D premium can be higher or lower.
The increase from $38.99 to $41.33 is $2.34, or 6.0%. That figure is not a coincidence: the Inflation Reduction Act caps the annual increase in the base beneficiary premium at 6% per year between 2024 and 2029. For 2027, the increase landed at the cap.
The Part D benefit redesign is now written into regulation
In the Contract Year 2027 Medicare Advantage and Part D final rule, published April 2, 2026, CMS codified provisions of the Inflation Reduction Act that had previously been implemented through subregulatory guidance. Those provisions eliminate the coverage gap phase, establish an annual out-of-pocket threshold, and remove cost sharing for enrollees who reach the catastrophic phase.
The practical translation: the structure of Part D is not changing again for 2027. What changes is the dollar level of the thresholds inside it.
Two other 2027 rule changes worth knowing the names of
- Star Ratings. CMS is streamlining the measure set for 2027 — removing measures focused on administrative processes and measures where plans perform similarly, adding a Part C depression screening and follow-up measure, and retaining the diabetes eye exam measure. CMS also stated it will not implement the Excellent Health Outcomes for All reward for 2027 Star Ratings.
- Supplemental benefit debit cards. CMS is clarifying requirements for the debit cards some Medicare Advantage plans use to administer supplemental benefits, with the stated aims of consistency across plans, informed beneficiary choice, and combating fraud, waste, and abuse.
The Part D Premium Stabilization Demonstration Is Ending
This is the least-discussed item on the 2027 list and arguably the one with the most direct connection to what a standalone drug plan looks like next year.
In 2025, CMS launched a voluntary demonstration for standalone prescription drug plans. Its stated purpose was to address volatility and variation in standalone premiums following the benefit changes the Inflation Reduction Act mandated. In its July 28, 2026 release, CMS announced the demonstration will be discontinued at the end of CY 2026. The reason CMS gave: its bid analysis indicated that Part D plan sponsors had accumulated sufficient experience under the redesigned benefit to support their assumptions in developing bids, so the program returns to what CMS described as traditional market conditions in CY 2027.
Tip from Alfred:
A useful habit when reading Medicare coverage: notice whether a number is a program-wide figure or a plan-specific figure. The base beneficiary premium, the deductible ceiling, and the out-of-pocket cap are program-wide. The premium, copays, drug tiers, and network in a given envelope are plan-specific. Headlines almost always quote the first kind. Household budgets are set by the second.
What Is Still a Projection — and Deserves the Word “Projected”
Several widely circulated 2027 numbers are not final. They are modeled estimates, and they are presented here as estimates.
| Item | Current estimate | Status |
|---|---|---|
| 2027 Part B standard premium | Approximately $209.50 (2026 Medicare Trustees Report, June 2026) | Projection. CMS announces the official figure in the fall. |
| 2027 Social Security COLA | 3.6% (Senior Citizens League estimate, August 12, 2026) | Estimate. SSA is scheduled to announce October 14, 2026. |
| 2027 Part D deductible and out-of-pocket cap | Set by a statutory formula tied to Part D spending growth | Confirmed by CMS in its fall releases. Third-party figures circulating now are unofficial estimates. |
| 2027 IRMAA income brackets | Various third-party models | Estimates. CMS publishes official brackets with the annual premium announcement. |
For scale on the ones that are confirmed for 2026: the standard Part B premium is $202.90 per month, the Part D deductible ceiling is $615, and the Part D annual out-of-pocket cap is $2,100. Those are the 2026 baselines against which any 2027 figure gets compared.
Six Sections People Commonly Compare in an ANOC
Different households care about different lines. These are the six that most often turn out to matter:
1. Monthly plan premium
The most visible number, and often the least decisive one. A plan premium is one component of annual cost; the deductible, copays, and out-of-pocket maximum are the others.
2. Annual deductible
Both the medical deductible (if the plan has one) and the drug deductible. A deductible change is the kind of item that does not show up until the first pharmacy visit in January.
3. Drug formulary and tier placement
A formulary is the plan’s list of covered drugs, organized into cost tiers. A specific medication can remain covered while moving to a higher tier, which changes the copay without changing coverage. It can also move off the formulary entirely.
4. Pharmacy network
Preferred versus standard pharmacy status affects cost. A pharmacy that was preferred in 2026 is not automatically preferred in 2027.
5. Provider network
For Medicare Advantage enrollees, whether specific physicians and hospitals remain in network for 2027. CMS has also stated that Medicare Advantage plans must include provider network information in the Medicare Plan Finder.
6. Maximum out-of-pocket
For Medicare Advantage, the annual ceiling on what the enrollee pays for covered medical services. It is the number that defines the worst realistic year.
Tip from Alfred:
The most common surprise in January is not a premium increase. It is a formulary change on one prescription. A plan can look identical on every line except tier placement for a single medication, and that one line can move a household’s annual drug cost by more than the premium difference between two plans.
Where Are You in the Timeline?
The relevant questions differ depending on someone’s current position. These are illustrative situations, not recommendations.
Situation A — Enrolled in a Medicare Advantage or Part D plan today
An ANOC is on its way by September 30. The comparison it enables is between the plan as it exists in 2026 and the same plan in 2027. Common questions in this position: which lines changed, whether current prescriptions remain on the formulary at the same tier, and whether current physicians remain in network.
Situation B — Turning 65 between now and early 2027
The Initial Enrollment Period is a separate window from Open Enrollment and is tied to an individual’s own birthday month rather than the October–December calendar. Someone in this position is choosing coverage for the first time rather than comparing an ANOC, which makes the 2027 landscape release in September the more relevant document.
Situation C — Enrolled in Original Medicare with a Medigap policy
Medigap policies do not issue an ANOC in the same form, and Medigap premiums follow their own state-regulated schedules. A Part D drug plan held alongside Medigap does issue an ANOC. The Part B premium and any IRMAA adjustment apply regardless of which path someone is on.
Situation D — Still working, with employer coverage past 65
The coordination rules between employer coverage and Medicare are distinct from the Open Enrollment calendar entirely, and they hinge on details like employer size and whether the plan is a high-deductible plan paired with a health savings account. This is the situation where the general fall Medicare calendar is least likely to be the right frame.
Frequently Asked Questions
When does the Annual Notice of Change arrive?
Medicare health and drug plans mail the ANOC to current enrollees by September 30 for the following plan year.
What are the 2026 Medicare Open Enrollment dates?
October 15 through December 7, 2026. Changes made during that window take effect January 1, 2027, and the plan must receive the enrollment request by December 7.
Is the 2027 Part B premium known yet?
No. The figure circulating — approximately $209.50 per month — comes from the 2026 Medicare Trustees Report and is a projection. CMS announces the official Part B premium and deductible in the fall.
Is the 2027 COLA known yet?
No. The 3.6% figure widely reported in August 2026 is an estimate published by the Senior Citizens League on August 12, 2026, and it moved down from an earlier 3.8% estimate as inflation data came in. The Social Security Administration is scheduled to announce the official 2027 adjustment on October 14, 2026.
What does it mean that the Part D Premium Stabilization Demonstration is ending?
It means a voluntary CMS demonstration for standalone prescription drug plans, launched in 2025 to address premium volatility after the Inflation Reduction Act’s benefit changes, concludes at the end of CY 2026. CMS stated that plan sponsors had sufficient experience under the redesigned benefit to support their bid assumptions, and that the program returns to traditional market conditions in CY 2027.
Does the base beneficiary premium mean Part D will cost $41.33 per month?
No. The national base beneficiary premium is a calculation input used to determine plan-specific premiums and federal subsidy amounts. It is not the premium any particular enrollee pays.
What if a plan’s ANOC never arrives?
Plans are required to send it. Medicare’s own guidance is that enrollees review plan materials including the ANOC and the EOC. Questions about a missing notice can go to the plan directly, or to 1-800-MEDICARE.
Where does the official 2027 plan information come from?
CMS has stated it will release the 2027 Medicare Advantage and Part D landscape, including final average premiums, in mid-to-late September 2026. Plan-specific detail is available through Medicare.gov’s Plan Finder and in each plan’s own documents.
Bringing the Fall Calendar Into a Broader Picture
Medicare costs do not sit in isolation. The Part B premium is typically deducted from a Social Security benefit, which means the COLA announcement on October 14 and the CMS premium announcement interact with each other in the net deposit a household actually sees in January. For households with retirement income above the IRMAA thresholds, a third variable enters. And for households drawing income from retirement accounts, the timing of withdrawals two years prior is what determines the IRMAA tier in the first place.
Those interactions are the subject of a planning conversation rather than a checklist. The point of understanding the vocabulary is that it makes the conversation possible.
