Costly Medicare Changes for 2027 could hit your wallet hard

What Medicare’s 2027 Changes Could Mean for Your Benefits

The Centers for Medicare and Medicaid Services (CMS) finalized their 2027 payment policies for Medicare Advantage (MA) and Part D plans with a net average increase of 2.48%. Despite this budget boost, enrollees may see fewer benefits and increases in out-of-pocket costs. Benefits facing restructuring in 2027 may include gym memberships, dental/vision/hearing add-ons, meal delivery, and transportation.

It is looking like Medicare beneficiaries may be paying more for less benefits.

Industry media reports that the health plans have been under pressure due to rising costs – increased plan utilization, and unit prices for hospitals, physicians, and drugs. The 2.48% increase may not fully offset those trends. Also, because many insurance carriers have overshot on rich extras to bring in new enrollees in previous years, there is industry talk about a “competitive reset” in 2027 to get back on track.

Who is most affected?

Beneficiaries most affected by these changes are likely to be Medicare enrollees who value supplemental benefits such as dental, vision, and hearing allowances, over the counter cards, fitness programs, post-procedure meal delivery, and rides to appointments. These benefits are most likely to be downsized, revised, or completely removed from plans in 2027.

Medicare beneficiaries with greater medical and social needs, may want to reassess whether an Advantage plan or an Original Medicare plan (with a Medigap policy) might better fit their situation moving forward.

What this means for your 2027 choices

As a Medicare beneficiary, regardless of the year, know that Part D formularies and preferred pharmacies change annually—review them carefully every year. Come September, it is VERY important to read your Medicare Annual Notice of Change letter, which you should receive no later than September 30^th. It is important to look through and note any changes for the upcoming year. We recommend setting priorities for your benefit use:  list the extras you do use (dental cleanings, hearing aids, vision allowances, fitness) and check if they’re shrinking or have new limitations in 2027. It is also important to check every year that your doctors and pharmacies are in-network with your plan. Confirm their status and 2027 drug tiers/prior authorizations.If you do not receive your Annual Notice of Change by October 1^st, you should reach out to your insurance plan to request a new copy, confirming that they have your correct and updated mailing address.

As a registered Medicare agent, I can help you (at no cost) if you are unsure about what changes are happening to your plan, need help comparing plans, or enrolling in a new plan. Come annual enrollment period this October, feel free to reach out by phone or text us at (503) 310-4504 or email mara@woloshin.com.