Medicare Open Enrollment begins October 15, and sitting down with nothing but a stack of insurance advertisements isn’t the best way to choose your 2027 coverage. The annual enrollment period runs through December 7, 2026, and Medicare says beneficiaries can use it to join, switch, or drop Medicare Advantage or Medicare drug coverage for the coming year. Even if you’re happy with your current plan, premiums, provider networks, drug coverage, and other costs can change from one year to the next. A productive Medicare Open Enrollment review starts by gathering information about the healthcare you actually use rather than simply comparing advertised premiums. Before you open Medicare’s Plan Compare tool, put these seven things on the table.
1. Your Current Plan’s Annual Notice of Change
Start with the document your existing plan should have sent you in September. Medicare calls it the Annual Notice of Change, or ANOC, and it explains changes in costs, coverage, and other plan details taking effect in January. Don’t assume that because your plan worked well in 2026 it will operate exactly the same way in 2027. Circle or highlight changes involving premiums, deductibles, copays, drug coverage, and benefits you regularly use so you can compare them with competing plans. If you didn’t receive your ANOC, Medicare recommends contacting your plan and requesting it.
2. A Complete List of Every Prescription You Take
Write down each medication’s exact name, dosage, quantity and how frequently you refill it before beginning your Medicare Open Enrollment comparison. This matters because Medicare says adding all the prescription drugs you regularly take to Medicare Plan Compare produces a more accurate estimate of monthly and yearly plan costs. A medication that’s inexpensive under your current plan could land on a different formulary tier next year, face utilization restrictions, or cost substantially more under another plan. Medicare explains that Part D formularies can place drugs on different tiers, with lower tiers generally carrying lower costs than higher ones. Don’t rely on memory here. Use your medication bottles, pharmacy account, or medication list to make sure nothing gets overlooked.
3. The Doctors and Specialists You Don’t Want to Lose
Next, make a list of every healthcare provider you expect to see in 2027, particularly specialists managing ongoing conditions. This becomes especially important with Medicare Advantage because Medicare explains that beneficiaries may need to use providers within a plan’s network and service area for non-emergency care. Include your primary-care physician, cardiologist, oncologist, orthopedic specialist, physical therapist or any other provider who would be difficult to replace. Provider directories can change, so consider confirming participation with both the prospective plan and the provider’s office before making a final enrollment decision. Saving $20 a month on a premium may look much less attractive if the trade-off is losing access to a physician you’ve relied on for years.
4. Your Preferred Pharmacies
Your neighborhood pharmacy deserves a place on your comparison sheet, too. Medicare notes that actual Part D costs can vary based not only on which medications you take but also on which pharmacy you use. Some plans have preferred pharmacy arrangements that can make the same prescription cheaper at one location than another. Add any mail-order pharmacy you currently use as well, especially if you receive 90-day supplies of maintenance medications. During Medicare Open Enrollment, compare total estimated prescription costs rather than assuming the pharmacy you’ve always used will remain your cheapest choice.
5. What You Actually Spent on Health Care This Year
Pull out your 2026 medical bills, Explanation of Benefits statements, or online claims history and look at where your healthcare dollars actually went. Someone who saw specialists twice a month should evaluate a plan differently from someone whose only medical care was an annual wellness visit and a few prescriptions. Medicare’s cost information points out that Medicare Advantage deductibles, coinsurance, and copayments vary by plan, so the monthly premium tells only part of the story. Add up recurring specialist copays, therapy visits, outpatient procedures, and other predictable expenses when possible. Looking backward at one year’s spending can help expose costs you might otherwise forget while trying to estimate the next one.
6. Your Expected Health Needs for 2027
Past spending is useful, but it can’t tell you everything about the year ahead. Write down any surgery, procedure, therapy, diagnostic testing, or specialist care you already know may happen in 2027. If you’ve recently received a new diagnosis or started an expensive medication, last year’s claims may dramatically understate what you’ll need from your insurance next year. Medicare specifically reminds beneficiaries that changes in health conditions, prescriptions, and providers can alter what coverage best fits their needs from one year to another. The cheapest plan for the healthy version of you from two years ago may not be the cheapest plan for the healthcare you’re expecting next year.
7. The Full Cost of Your Current Coverage
Finally, write down what you’re paying now rather than judging plans solely by the premium printed in an advertisement. Include premiums, deductibles, common copays, coinsurance, drug costs, and the plan’s applicable out-of-pocket limit so you’re comparing more than one number. CMS recently projected that average Medicare Advantage premiums will decline by more than 16% for 2027 while the average stand-alone Part D premium is projected to increase by less than $1 per month, but those are national averages, not promises about your individual plan. CMS says more than 99% of Medicare beneficiaries will have access to at least one Medicare Advantage plan in 2027, while 97% will have access to 10 or more. Having more choices makes comparing total costs and coverage especially important because a low advertised premium doesn’t automatically mean the lowest annual healthcare spending.
Give Yourself More Than One Afternoon to Decide
You don’t have to make your Medicare Open Enrollment decision the moment enrollment opens on October 15, but waiting until December 7 can create unnecessary pressure. Medicare’s Plan Compare tool already allows consumers to select 2027 coverage and compare available plans using their ZIP code, medications, and pharmacies. If the options become confusing, Medicare also points beneficiaries toward their local State Health Insurance Assistance Program for free personalized counseling rather than relying solely on insurance advertising. People satisfied with their existing Medicare coverage generally don’t have to re-enroll, according to CMS, but reviewing the changes can prevent unpleasant surprises after January 1.
What is the first thing you check when comparing Medicare plans each fall? The premium, your prescriptions, your doctors, or something else?
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