Choosing a Medicare plan comes down to six questions: whether your doctors are in the network, what your drugs cost on each plan, how much you could owe in a bad year, whether you travel, whether you can still buy a Medigap policy without health questions, and whether you qualify for help with costs. Answer those in order and most people are left with one or two real options. For 2027 coverage, you have until December 7, 2026 to pick, and the new plan starts January 1, 2027.
The premium is the number everyone looks at first, and it is usually the least useful one. A $0 premium plan can cost more over a year than a plan with a premium, depending on your doctors, your prescriptions and how sick you get.
The two paths, side by side
Every Medicare choice starts with one fork. You either take Original Medicare (Parts A and B, run by the government), usually adding a drug plan and often a Medigap policy, or you take a Medicare Advantage plan (Part C), sold by a private insurer, which bundles hospital, medical and usually drug coverage into one plan.
| Feature | Original Medicare + Part D + Medigap | Medicare Advantage |
|---|
| Doctors you can see | Any provider in the US that accepts Medicare | Usually a network (HMO or PPO), varies by plan |
| Referrals and prior approval | Rarely needed | Often required for specialists and some services |
| Out-of-pocket limit | None on Original Medicare alone; Medigap fills most gaps | Required. 2027 maximum: $9,850 in network, $14,800 combined in and out of network |
| Drug coverage | Separate Part D plan | Usually built in |
| Extra benefits (dental, vision, hearing) | Not included in Original Medicare | Often included, with limits |
| Premiums | Part B + Part D + Medigap premiums | Part B + plan premium (often $0) |
| Coverage when you travel | Nationwide | Usually limited to a local service area, except emergencies |
Sources: CMS final CY2027 Part C bid review memo (out-of-pocket maximums); medicare.gov plan comparison pages. Those out-of-pocket figures are the highest a plan is allowed to charge. Many plans set a lower limit.
For a deeper side-by-side, see Medicare Advantage vs Original Medicare and Medicare Advantage vs Medigap.
Key 2027 numbers
| Figure | 2026 | 2027 | Source |
|---|
| Part B standard premium | $202.90 a month | Not yet published | CMS 2026 Parts A and B fact sheet |
| Part B deductible | $283 | Not yet published | CMS 2026 Parts A and B fact sheet |
| Part D out-of-pocket cap on covered drugs | $2,100 | $2,400 | CMS CY2027 Rate Announcement |
| Maximum Part D deductible a plan may charge | $615 | $700 | CMS CY2027 Rate Announcement |
| Medicare Advantage in-network out-of-pocket maximum | $9,250 | $9,850 | CMS Part C bid memos |
| High-deductible Medigap Plan G or F deductible | $2,950 | $3,050 | CMS Medigap notices |
| Medigap Plan K / Plan L out-of-pocket limit | $8,000 / $4,000 | $8,360 / $4,180 | CMS Medigap notices |
| Average Medicare Advantage premium (CMS projection) | $14.37 | $12.00 | CMS press release, September 28, 2026 |
| Average stand-alone drug plan premium (CMS projection) | $35.09 | $36.00 | CMS press release, September 28, 2026 |
As of November 10, 2026, CMS has not announced the 2027 Part B premium or deductible. It usually does in mid-November. Until then, $202.90 is the current premium, and any 2027 figure you see online is a projection. Our 2027 Part B premium projections explain where those estimates come from.
Question 1: Are your doctors and hospitals in the network?
Start here, because it rules plans in or out before cost matters.
With Original Medicare, you can see any doctor or hospital in the country that accepts Medicare. Most do. With Medicare Advantage, each plan has its own network, and networks change every year. An HMO generally covers only in-network care except emergencies. A PPO covers out-of-network care but charges more for it.
What to do:
- Write down every doctor, specialist, hospital and clinic you use or expect to use.
- On each Medicare Advantage plan you are considering, check the plan's own 2027 provider directory, then call the doctor's office and ask, "Do you take [plan name] in 2027?" Directories are sometimes wrong.
- If a key specialist or cancer center is out of network on every plan near you, that points toward Original Medicare.
If you already have a Medicare Advantage plan, read your Annual Notice of Change, which plans had to mail by September 30. It lists network and benefit changes for 2027. Our Annual Notice of Change checklist walks through it.
Question 2: What do your prescriptions cost on each plan?
Drug costs swing more between plans than almost anything else. The same drug can sit on a $5 tier in one plan and a 40% coinsurance tier in another, or not be covered at all.
For 2027, two things set the outer limits:
- No plan can charge a deductible above $700, up from $615 in 2026.
- Out-of-pocket spending on covered Part D drugs is capped at $2,400 for the year, up from $2,100. After you hit it, you pay nothing more for covered drugs for the rest of 2027. Premiums do not count toward the cap.
What to do:
- List every prescription with its dose and how often you take it.
- Enter that list in the Medicare Plan Finder at medicare.gov. It totals premiums plus drug costs for each plan for the year.
- Sort by "lowest drug + premium cost," not "lowest premium."
- Check whether your pharmacy is "preferred" in each plan. Preferred pharmacies often charge less.
If you are on Original Medicare and skip Part D when you first become eligible, you can owe a late enrollment penalty for as long as you have drug coverage, unless you had other coverage at least as good. For the 2027 drug plan landscape, see Medicare Part D plans 2027.
Question 3: How much could you pay in a bad year?
A cheap plan is cheap in a healthy year. The real test is a year with a hospital stay, surgery or cancer treatment.
- Original Medicare alone has no yearly limit. After the Part B deductible, you generally pay 20% of approved costs with no cap, plus the Part A deductible for each hospital benefit period.
- Medigap fills most of those gaps. Plan G, the most popular for people new to Medicare, covers almost everything except the Part B deductible. You pay a monthly premium but your bills in a bad year stay low and predictable. Compare the plans in our 2027 Medigap comparison chart.
- Medicare Advantage caps what you pay for covered in-network care at the plan's out-of-pocket maximum, which can be as high as $9,850 in 2027. Copays add up toward it as you use care. See Medicare Advantage out-of-pocket maximum 2027.
A simple way to compare: for each option, add up a full year of premiums, then add the most you could owe in out-of-pocket costs. That is your worst-case year. If you could not cover that number from savings, weigh it heavily.
Question 4: Do you travel or live in two places?
Medicare Advantage plans are built around a local service area. Emergencies and urgent care are covered anywhere in the US, but routine care in another state usually is not covered, or costs more. A few PPOs have broader networks.
If you spend winters in another state, live near a state line, or see doctors in a different metro area, Original Medicare plus Medigap usually fits better, because any provider in the country that accepts Medicare will take it. Several Medigap plans, including Plan G and Plan N, also cover part of emergency care abroad, which Original Medicare generally does not.
Question 5: Can you still buy Medigap without health questions?
This question surprises people, and it matters most for anyone choosing Medicare Advantage now and thinking they can switch later.
You get a one-time, 6-month Medigap open enrollment period that starts the month you are 65 or older and enrolled in Part B. During it, an insurer must sell you any Medigap policy it offers in your state, and cannot charge you more because of your health. After it ends, in most states insurers can ask health questions and turn you down or charge more, unless you have a specific "guaranteed issue" right. A few states give extra protections, so check with your state.
Two protections worth knowing:
- Trial right: if you join a Medicare Advantage plan when you first become eligible at 65, or you drop a Medigap policy to try Medicare Advantage for the first time, you generally can go back to Original Medicare and get a Medigap policy without health questions if you leave within the first 12 months.
- Losing coverage: certain events, like your Medicare Advantage plan leaving your area, give you a guaranteed issue right, usually for 63 days.
What this means in practice: if you are 65, new to Part B and expect health problems, choosing Original Medicare plus Medigap now keeps that door open. Choosing Medicare Advantage now and switching in five years may mean answering health questions you could fail.
Question 6: Do you qualify for help paying?
Before comparing premiums, check whether you qualify for programs that change the math completely.
| Program | What it pays | Who usually qualifies |
|---|
| Medicare Savings Programs | Part B premium, and sometimes Part A costs, deductibles and coinsurance | Limited income and resources; limits vary by state |
| Extra Help (Part D low-income subsidy) | Drug plan premiums, deductibles and lowers copays to a few dollars | Limited income and resources |
| Medicaid (with Medicare) | Most remaining costs; may add long-term care | Low income; rules set by each state |
If you qualify for full Extra Help, you can choose a stand-alone drug plan with a $0 premium; CMS says every drug plan region still has at least one. For 2027, people with full Extra Help pay no more than $5.80 for a generic and $14.40 for a brand-name drug, and less if they also have full Medicaid. If you have both Medicare and Medicaid, you may also be able to join a Dual Eligible Special Needs Plan built for that situation. Income limits are in our Medicare Savings Programs guide.
How to choose, step by step
- Gather your list. Doctors, hospitals, prescriptions with doses, and your pharmacy.
- Pick the path. Use Questions 1, 4 and 5 to decide between Original Medicare and Medicare Advantage. If you want a quick sort, our which Medicare option fits you tool walks through the same decision.
- Compare plans in Medicare Plan Finder. Enter your drugs and pharmacy at medicare.gov. Compare total yearly cost, not premium.
- Check the worst case. For each finalist, add a year of premiums plus the out-of-pocket maximum.
- Verify networks by phone. Call your most important doctors and confirm they take the plan in 2027.
- Look at star ratings as a tiebreaker. Ratings from 1 to 5 reflect quality and service. See Medicare star ratings explained.
- Get free, unbiased help if you are stuck. Your State Health Insurance Assistance Program (SHIP) gives free one-on-one counseling and does not sell plans. Find yours at shiphelp.org. You can also call 1-800-MEDICARE, 24 hours a day. If you use a broker, ask which companies they represent; see questions to ask a Medicare broker.
- Enroll by December 7, 2026. Join through Medicare Plan Finder, the plan directly, or 1-800-MEDICARE. Joining a new Medicare Advantage or drug plan automatically ends your old one. To leave Medicare Advantage for Original Medicare, enroll in a stand-alone drug plan or call 1-800-MEDICARE.
Key dates for 2027 coverage
| Period | Dates | What you can do |
|---|
| Open Enrollment | October 15 to December 7, 2026 | Switch between Original Medicare and Medicare Advantage, change Medicare Advantage or drug plans |
| Coverage starts | January 1, 2027 | New plan takes effect |
| Medicare Advantage Open Enrollment | January 1 to March 31, 2027 | If you are in Medicare Advantage, switch to another Medicare Advantage plan or to Original Medicare, once |
| Initial Enrollment Period | 7 months around your 65th birthday month | First sign-up for Parts A, B and D |
Medigap is not tied to these dates. You can apply for a Medigap policy any time of year, but outside your open enrollment period or a guaranteed issue right the insurer can usually use your health history.
Frequently Asked Questions
What is the most important factor in choosing a Medicare plan?
For most people, it is whether their doctors and hospitals are covered, followed by the total yearly cost of their prescriptions. The monthly premium matters less than total cost in a year when you need care.
Is Medicare Advantage or Original Medicare better?
Neither is better for everyone. Medicare Advantage often has lower premiums, a yearly out-of-pocket cap and extra benefits, in exchange for a network and prior approval rules. Original Medicare with Medigap costs more each month but lets you see any provider that accepts Medicare, with predictable bills in a bad year.
When can I change my Medicare plan for 2027?
During Open Enrollment, October 15 to December 7, 2026, for coverage starting January 1, 2027. If you are in a Medicare Advantage plan, you also get one change from January 1 to March 31, 2027.
Do I have to choose a new plan every year?
No. If you do nothing, your plan usually renews automatically. But plans change premiums, drug lists and networks every year, so review your Annual Notice of Change and compare before December 7.
Can I have Medigap and Medicare Advantage at the same time?
No. Medigap only works with Original Medicare. It is illegal for anyone to sell you a Medigap policy if they know you are in a Medicare Advantage plan, unless you are switching back to Original Medicare.
What is the 2027 Part B premium?
CMS had not announced it as of November 10, 2026. It usually does in mid-November. The 2026 premium is $202.90 a month and stays in effect through December 31, 2026.
Where can I get free help choosing a Medicare plan?
Your State Health Insurance Assistance Program (SHIP) offers free, unbiased counseling and does not sell insurance. Find your local office at shiphelp.org, or call 1-800-MEDICARE any time.
