The yearly limit on what you pay for in-network care in a typical Medicare Advantage plan with drug coverage goes from $5,900 in 2026 to $6,500 in 2027, a jump of $600. "Typical" here means the median, the middle limit across the 3,351 regular Medicare Advantage drug plans offered in 2026 and the 3,196 offered in 2027, according to a BenefitsUSA count of the plan files Medicare published in September. Special needs plans, which only certain groups can join, such as people with both Medicare and Medicaid, are not included.
The median is the middle of the pack. About half of the regular drug plans offered in 2027 have a limit of $6,500 or less, and about half have a limit of $6,500 or more. Among the 2,629 plans that kept the same plan number in both years, 1,631 raised their limit, and the typical (median) increase among those 1,631 plans was $600. Another 865 kept their limit the same, and 133 lowered it.
What the yearly limit is
Medicare Advantage plans have a yearly limit on what members pay out of pocket for covered hospital and doctor care, the services Medicare Part A and Part B cover. Once a member reaches the limit, Medicare.gov says, the member pays nothing more for those covered services for the rest of the year. The numbers in this article are the in-network limit, for care from the plan's own doctors and hospitals. PPO plans have a second limit that counts care from both inside and outside the network.
Prescriptions covered by the plan's drug coverage (Part D) do not count toward either limit. Part D has its own yearly cap on drug costs, which goes from $2,100 in 2026 to $2,400 in 2027. Our guide to Medicare Part D in 2027 explains how the drug cap works.
The yearly limit is the most a member could pay for covered in-network care in a bad year. It is not a bill.
How the plans changed
| What happened to the plan's in-network yearly limit, 2026 to 2027 | Plans |
|---|
| Went down | 133 |
| Stayed the same | 865 |
| Went up $500 or less | 660 |
| Went up $501 to $1,000 | 574 |
| Went up more than $1,000 | 397 |
| Total | 2,629 |
The table covers Medicare Advantage plans with drug coverage that keep the same plan number in 2026 and 2027, with special needs plans left out. Source: CMS plan landscape files for 2026 and 2027, September 2026 releases.
The table counts plans, not people. Medicare's plan files do not say how many members each plan has, so the files cannot show how many people face a higher limit.
Among plans that kept the same plan number, the three companies with the most such plans each raised the limit on most of them. UnitedHealth Group, the parent of UnitedHealthcare, raised the limit on 304 of its 378 such plans. Humana raised the limit on 293 of its 492 such plans. CVS Health, the parent of Aetna, raised the limit on 205 of its 358 such plans.
Medicare also sets a ceiling, the highest in-network limit any plan may use. Under CMS's rules for each year, the ceiling goes from $9,250 in 2026 to $9,850 in 2027. Of the 3,196 regular drug plans offered in 2027, 351 set their limit at the full $9,850. Our guide to the 2027 out-of-pocket maximum explains how Medicare sets the ceiling and its lower tiers.
What to do before December 7
- Read your plan's Annual Notice of Change. Medicare.gov says plans send a printed copy by September 30. The notice lists the changes to your plan's costs and coverage that start in January.
- Look up your own plan's 2027 numbers. Check what your plan's limit is in 2027.
- Compare plans for 2027. Medicare's Plan Finder at Medicare.gov/plan-compare lists the plans in your ZIP code. You can also call 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048.
- Look past the yearly limit. The limit is one cost among several. Weigh it with the monthly premium, your drug costs and whether your doctors are in the plan's network.
- Keep the dates. Medicare Open Enrollment runs October 15 to December 7, 2026, and a change made then takes effect January 1, 2027. People already in a Medicare Advantage plan get one more window, January 1 to March 31, 2027, to make one change. Our Open Enrollment guide lists every date.
Sources
- CMS, Medicare Advantage and Part D plan landscape files for 2026 and 2027 (September 2026 releases): cms.gov
- CMS, "Final Contract Year 2027 Standards for Part C Benefits, Bid Review and Evaluation," April 22, 2026, Table 3: CMS memo
- CMS, "Final Contract Year (CY) 2026 Standards for Part C Benefits, Bid Review and Evaluation," April 16, 2025, Table 3: CMS memo
- CMS, "Announcement of Calendar Year (CY) 2027 Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies," April 6, 2026: cms.gov
- Medicare.gov, "Understanding Medicare Advantage Plans": medicare.gov
- Medicare.gov, "Plan Annual Notice of Change (ANOC)": medicare.gov
- Medicare.gov, "Joining a plan": medicare.gov
- Medicare.gov, "Understanding Medicare Advantage & Medicare Drug Plan Enrollment Periods": medicare.gov
