As of today, Thursday, September 24, 2026, Medicare planning has reached an important point. Your Annual Notice of Change (ANOC) must arrive by September 30-only six days from now, and CMS has released new information that could affect your prescription costs and healthcare access in 2027.
The biggest new developments include 15 Part D drugs with negotiated Maximum Fair Prices beginning January 1, 2027, along with new electronic prior authorization requirements for certain Medicare Advantage medical services. Consequently, this is the right time to review your current coverage, compare 2027 options, and prepare for the October 15–December 7 Annual Enrollment Period.
The September 30 ANOC deadline is the deadline that matters this week
If you have Medicare Advantage or a stand-alone Part D plan, your plan must send you an Annual Notice of Change by September 30, 2026. The ANOC explains how your current plan will change on January 1, 2027.
When it arrives, do not simply file it away. Compare these specific lines:
- Monthly premium: Has it increased, decreased, or stayed the same?
- Annual deductible: Check both medical and prescription drug deductibles.
- Copayments and coinsurance: Look at primary care, specialists, hospital stays, urgent care, lab work, and prescription tiers (e.g., $10–$50 per prescription or a percentage of the drug’s cost).
- Maximum out-of-pocket limit: This is your protection against high Part A and Part B costs in Medicare Advantage.
- Formulary: A formulary is your plan’s covered drug list. Check whether your medications remain covered and whether their tiers have changed.
- Pharmacy network: A preferred pharmacy may offer lower costs than a standard or out-of-network pharmacy.
- Provider network: Confirm that your doctors, specialists, hospitals, and preferred facilities remain in network.
- Prior authorization and referral rules: These requirements can affect how quickly you receive certain services.
- Supplemental benefits: Review dental, vision, hearing, transportation, over-the-counter allowances, and other benefits. Check whether eligibility or dollar amounts have changed.
The ANOC describes your current plan only. It is not a complete shopping tool. Once 2027 plan information is available, use Medicare.gov Plan Compare to compare alternatives side by side.
New 2027 drug prices could help millions of Part D enrollees
CMS has finalized negotiated Maximum Fair Prices (MFPs) for 15 additional Part D drugs. These prices take effect January 1, 2027, and apply to eligible prescriptions covered through stand-alone Part D plans and Medicare Advantage prescription drug plans.
The 2027 list includes:
- Ozempic, Rybelsus, and Wegovy
- Trelegy Ellipta
- Xtandi
- Pomalyst
- Ibrance
- Ofev
- Linzess
- Calquence
- Austedo and Austedo XR
- Breo Ellipta
- Tradjenta
- Xifaxan
- Vraylar
- Janumet and Janumet XR
- Otezla
CMS reports that approximately 5.3 million people had Part D coverage for these drugs in 2024. The agency estimates about $685 million in beneficiary out-of-pocket savings during 2027.
Your actual cost will still depend on your plan’s formulary, pharmacy network, dosage, coverage rules, and other benefit details. Therefore, do not assume that a negotiated price automatically makes every plan equally affordable. Check your specific medication in each plan’s formulary.
You can review the official information on the CMS Medicare Drug Price Negotiation page.
The 2027 Part D numbers you should know
CMS has released several important 2027 Part D figures:
- $2,400 annual out-of-pocket cap for covered Part D drugs
- $700 maximum standard deductible
- $41.33 base beneficiary premium
- $296.05 national average monthly bid amount
- The end of the Part D Premium Stabilization Demonstration after 2026
The $296.05 national average monthly bid amount is not necessarily your premium. It is an enrollment-weighted measure CMS uses in calculating plan subsidies. Your plan’s actual premium may be higher or lower.
Also, CMS has not yet published the official 2027 Medicare Part B premium and deductible. Those figures typically arrive in the fall. Independent projections based on the 2026 Medicare Trustees Report are near $210 per month for the standard Part B premium and approximately $290 for the annual deductible. These are projections, not confirmed Medicare costs.
Medicare Advantage is changing from 2026 to 2027
For 2027, Medicare Advantage plans may have a maximum out-of-pocket ceiling of up to:
- $9,850 for in-network Part A and Part B services
- $14,800 combined for in-network and out-of-network services on applicable PPO plans
Individual plans may set lower limits, so compare the actual figure in each plan’s Evidence of Coverage.
CMS is also adding guardrails around certain supplemental benefits, including benefits delivered through debit-card-style programs. Check the eligible items, expiration rules, and qualifying conditions rather than focusing only on the advertised dollar amount.
A $0 premium plan is not automatically the cheapest plan. You still need to calculate your total annual cost, including premiums, deductibles, copayments, coinsurance, prescription costs, transportation needs, dental expenses, and your potential maximum out-of-pocket exposure.
Medicare.gov puts the choice in practical terms: Medicare Advantage is “another way to get your Medicare coverage,” while Original Medicare can be paired with Part D and supplemental coverage. The right choice depends on how you use care, not just on the monthly premium.
Electronic prior authorization should make access clearer
Beginning January 1, 2027, certain Medicare Advantage prior authorization processes for medical items and services will move toward standardized electronic processing. This can include procedures, tests, equipment, and other non-drug services.
The practical benefits may include:
- Faster electronic submission from a provider’s health record system
- Clearer documentation requirements
- Electronic approval, denial, or requests for additional information
- More visible prior authorization status in a patient portal or connected health app
- Specific reasons when a request is denied
CMS generally requires decisions within 72 hours for expedited requests and 7 calendar days for standard requests under the applicable prior authorization rules.
One important distinction: the January 1 electronic prior authorization API requirements specifically address medical items and services and exclude drugs. Some plan drug workflows may also become more electronic, but you should not assume that every Part D drug authorization will appear in your patient portal in the same way. Check your plan’s 2027 drug rules and ask your prescriber how requests will be submitted.
Medigap has a different clock: understand Plan G and Plan N
Medicare Supplement Insurance, or Medigap, does not follow the Annual Enrollment Period in the same way Medicare Advantage and Part D do. Your key window is the one-time, six-month Medigap Open Enrollment Period.
It begins when you are 65 or older and enrolled in Medicare Part B. During this period, you generally can buy any Medigap policy sold in your state without medical underwriting or a higher premium based on health conditions.
That window does not repeat every year.
Plan G and Plan N are two popular standardized choices:
| Feature | Plan G | Plan N |
|---|---|---|
| Part B coinsurance | Generally covered | Covered, subject to Plan N copays |
| Office visit copay | None under the plan | Up to $20 for some visits |
| Emergency room copay | None under the plan | Up to $50 when you are not admitted |
| Part B excess charges | Covered | Not covered |
| Typical premium | Often higher | Often lower |
Neither Plan G nor Plan N covers the Part B deductible for people new to Medicare. Plan G may provide more predictable costs, while Plan N may offer affordability through a lower premium if you are comfortable with copays and potential excess charges.
Also compare how the insurer prices the policy:
- Community-rated: Generally, everyone pays the same premium regardless of age.
- Issue-age-rated: Your premium is based on your age when you first buy the policy.
- Attained-age-rated: Your premium is based on your current age and generally increases as you get older.
As Medicare.gov explains, Plan N pays Part B coinsurance, but you may owe “up to $20 for some office visits and up to $50 for emergency room visits when you aren’t admitted as an inpatient.” Review both today’s premium and the policy’s long-term pricing method.
Your step-by-step guide to the October 15–December 7 enrollment period
Step 1: Gather your documents.
Keep your ANOC, current insurance card, medication bottles, pharmacy information, and doctor list together.
Step 2: Build your medication checklist.
Write down every prescription, dosage, quantity, refill frequency, and preferred pharmacy. Check each drug’s formulary tier, prior authorization requirement, quantity limit, and estimated annual cost.
Step 3: Build your provider checklist.
Confirm your primary care physician, specialists, hospitals, laboratories, and preferred pharmacies. A plan with a low premium can become expensive if your doctors are out of network.
Step 4: Compare total annual cost.
Look beyond the premium. Add the annual premium, deductible, expected drug costs, medical copays, coinsurance, and likely dental or vision expenses. Then review the maximum out-of-pocket limit.
Step 5: Compare benefits and restrictions.
Review referrals, prior authorization, supplemental benefits, transportation, dental coverage, hearing benefits, and plan service areas.
Step 6: Enroll between October 15 and December 7.
You may join, switch, or leave Medicare Advantage and Part D plans during this period. Enroll by December 7, 2026, and your new coverage generally begins January 1, 2027. Do not wait until the final day if you need time to resolve a formulary or provider question.
Super Senior Services simplifies this process through personalized benefit reviews, transparent plan comparisons, and annual reviews designed to help your coverage keep pace with your health and budget.
Get personalized Medicare guidance before you enroll
Super Senior Services helps Medicare beneficiaries in Florida, Georgia, Texas, Tennessee, North Carolina, South Carolina, Virginia, and New York State compare coverage with confidence.
We can help you review your ANOC, check medications and providers, compare total annual costs, and understand whether Medicare Advantage, Part D, Original Medicare with Medigap, or another option better fits your needs.
Explore Medicare plan support or contact Stephen Jackson to schedule your personalized review.
Compliance note: Individual NPN: Stephen Jackson 20707378; Corporate NPN: Super Senior Services 21536694.
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