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Next Gen Econ > Debt > Medicare Advantage Premiums Are Dropping — But These 5 Costs Could Still Go Up
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Medicare Advantage Premiums Are Dropping — But These 5 Costs Could Still Go Up

NGEC By NGEC Last updated: October 23, 2026 8 Min Read
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Medicare Advantage premiums are projected to decline 16.5% in 2027, but lower premiums don’t guarantee lower healthcare bills. Retirees should review hospital copays, specialist visits, prescription costs, out-of-pocket limits, and provider networks before December 7. J.J. Gouin/Shutterstock

This article contains affiliate links. If you use these links to connect with a Medicare advisor or enroll in coverage, Saving Advice may earn a commission at no additional cost to you.

Millions of retirees could see lower Medicare Advantage premiums in 2027, but that doesn’t necessarily mean their healthcare will become more affordable. A cheaper monthly premium might look appealing until a hospital visit, specialist appointment, or prescription refill reveals that other costs have increased. For older Americans living on fixed incomes, those unexpected expenses can quickly erase the savings.

According to the Centers for Medicare & Medicaid Services (CMS), the average monthly Medicare Advantage premium is projected to fall 16.5%, from $14.37 in 2026 to $12 in 2027. That’s welcome news, particularly for beneficiaries already struggling with rising living expenses. However, Medicare Advantage costs involve much more than monthly premiums. Plans can change their deductibles, copayments, provider networks, and other expenses from one year to the next. Before automatically renewing your coverage, here are five expenses worth examining during Medicare Open Enrollment, which runs through December 7, 2026.

1. Hospital Copayments Could Become More Expensive

Hospital stays are among the most expensive healthcare events retirees may encounter, and Medicare Advantage plans can charge daily copayments for inpatient care. According to KFF’s Medicare Open Enrollment analysis, these charges vary by plan and may apply for several days during a hospital admission. Imagine a retiree whose plan charges $300 per day for the first five days of hospitalization, creating a $1,500 expense before considering other healthcare needs.

Even if that person’s monthly premium drops by $5, the annual savings of $60 would barely offset a fraction of the hospital bill. When comparing Medicare Advantage costs for 2027, examine the inpatient hospital copayment schedule rather than focusing exclusively on the monthly premium.

2. Specialist Visits May Come With Higher Copays

A plan offering a $0 premium can still charge beneficiaries every time they visit certain healthcare providers. Specialist appointments are particularly important for retirees managing diabetes, heart disease, arthritis, or other chronic conditions requiring regular medical attention. Medicare Advantage plans differ in what they charge for physician visits and other services, making it important to compare costs based on your actual healthcare needs.

For example, someone seeing a cardiologist six times annually would spend $300 with a $50 copayment, compared with $210 under a plan charging $35 per visit. If you’re unsure how your current coverage compares, Chapter’s licensed Medicare advisors can help you review available plans based on your doctors, healthcare needs, and budget.

3. Prescription Drug Deductibles and Copayments Could Increase

Prescription medications represent another potential source of higher expenses, even when Medicare Advantage premiums decline. According to Medicare.gov, the maximum permitted Part D deductible increases from $615 in 2026 to $700 in 2027, although individual plans may charge less or have no deductible. Plans can also change their formularies, preferred pharmacies, and cost-sharing requirements, potentially affecting what beneficiaries pay for specific medications. The annual out-of-pocket threshold for covered Part D drugs is increasing to $2,400 in 2027, compared with $2,100 in 2026, although not everyone will reach that threshold.

Before renewing, enter your medications and preferred pharmacy into the Medicare Plan Finder or speak with a Chapter Medicare advisor to compare prescription coverage options and estimated expenses.

4. Your Annual Out-of-Pocket Maximum Could Be Higher

One important protection offered by Medicare Advantage is an annual limit on out-of-pocket spending for Medicare-covered Part A and Part B services. However, that limit can vary significantly between plans, and a higher maximum could expose retirees to thousands of dollars in additional expenses during a serious illness. Federal rules establish maximum allowable limits, but individual plans may set lower amounts, making it important to examine the actual figure listed in your plan’s 2027 coverage documents.

Prescription drug expenses, monthly premiums, and certain other costs generally don’t count toward these medical spending limits. Comparing each plan’s actual out-of-pocket maximum is essential because the financial consequences of a major medical event can outweigh modest premium savings.

5. Out-of-Network Care Could Cost More Than Expected

Provider networks can change from year to year, potentially affecting access to doctors, hospitals, and other healthcare facilities. Some Medicare Advantage plans, particularly HMOs, generally require beneficiaries to use network providers for nonemergency care, while PPO plans may allow out-of-network services at a higher cost. The KFF Medicare Advantage comparison guide recommends checking whether preferred physicians and hospitals participate in a plan before enrolling. Imagine discovering that your longtime specialist is no longer in your plan’s network after you’ve already scheduled several appointments for January.

Before selecting coverage based on lower premiums, verify your doctors’ network status directly with both the insurance company and the providers, or ask a Chapter Medicare advisor to help compare plans that fit your healthcare priorities.

Lower Premiums Don’t Automatically Mean Lower Healthcare Bills

The projected decline in Medicare Advantage premiums for 2027 is encouraging, but retirees should remember that national averages don’t predict what any individual will pay. Someone who rarely visits a doctor may benefit from a lower-premium plan, while a beneficiary managing multiple chronic conditions could face higher expenses through copayments, deductibles, and other cost-sharing requirements. Additionally, most Medicare Advantage beneficiaries must continue paying their Medicare Part B premium, even if their Advantage plan charges $0 monthly.

The smartest approach is to compare your plan’s 2027 Annual Notice of Change with its current benefits, calculate likely yearly Medicare Advantage costs, and explore alternatives through Medicare.gov, free counseling from the State Health Insurance Assistance Program, or personalized assistance from Chapter’s licensed Medicare advisors. Chapter is an independent insurance agency, not affiliated with Medicare, and while its advisors can help compare plans across the market, it does not offer enrollment in every available plan.

Are you seeing lower Medicare Advantage premiums for 2027, or have you noticed increases in copayments, deductibles, or other healthcare expenses? Share your experience in the comments.

What to Read Next

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