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How does Medicare Advantage in 2027 work?

Reviewed by Russell Noga, Licensed Medicare Insurance Broker (all 50 states) | Last updated October 8, 2026

Medicare Advantage is a private plan approved by Medicare that replaces Original Medicare Parts A and B, and usually Part D, in one plan. Medicare pays the plan each month, and you use the plan’s card, network and rules for your care in 2027.

You stay in Medicare and keep paying Part B. The plan may add extra benefits, but it can also use networks, referrals and prior authorization.

See Medicare Advantage plans 2027 and find Medicare Advantage plans by ZIP code.

✔ Licensed across all 50 states
✔ Built on CMS 2027 data
✔ No-cost plan comparison

Key Highlights

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Replaces Parts A and B in one plan.

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You keep paying Part B.

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Average 2027 premium $12.

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About 34 million enrollees projected.

Compare plans and enroll online

Medicare Advantage in Seven Steps

How It Works

1

Enroll in Parts A and B. You must have both to join.

2

Choose a plan in your county. Plans are offered by ZIP code.

3

Use the plan card. You show your plan card, not your red, white and blue Medicare card.

4

Get care in the network. HMOs generally require it; PPOs pay less out of network.

5

Pay your share. Copays and coinsurance apply until you hit the out-of-pocket maximum.

6

Fill prescriptions. Most plans include Part D, with a 2027 cap of $2,400 on covered drugs.

7

Review every fall. Plans change each year; read your Annual Notice of Change.

Who Pays What

Who Pays What
Medicare Pays the private plan a set amount each month to cover your care
You Keep paying the Part B premium, projected at $209.50 for 2027
You Pay any plan premium; the 2027 national average is $12
You Pay copays, coinsurance and deductibles up to the plan’s out-of-pocket maximum
The plan Pays covered claims and sets networks, drug lists and extra benefits

Key Changes to Medicare Advantage Plans in 2026

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2027 by the Numbers

$12

Average monthly premium, down from $14.37.

About 5,532

Plans nationally, from 5,553.

About 34 Million

Projected enrollees, about 47% of Medicare.

$2,400

Part D out-of-pocket cap.

How Medicare Advantage Works

Medicare Advantage, sometimes called Part C, lets you receive your Medicare benefits through a Medicare-approved private insurer. These plans cover everything Original Medicare Part A and Part B cover, with the exception of hospice care, which Original Medicare continues to pay for. Most also bundle Part D drug coverage, and many may tack on extras like routine dental, vision and hearing benefits.

The trade-off is that Medicare Advantage plans generally rely on doctor and hospital networks and may call for referrals or prior authorization for certain services. Each Medicare Advantage plan sets a yearly out-of-pocket maximum for covered medical care, something Original Medicare lacks. You still pay your Part B premium, along with the plan’s premium if there is one.

Feature HMO PPO
Out-of-network care Not covered except emergencies and urgent care Covered at a higher cost
Referrals for specialists Usually required Usually not required
Premiums Usually lower Usually higher
Out-of-pocket maximum In-network limit In-network limit plus a higher combined limit
Best for Lower costs, local care Flexibility, travel, keeping specific doctors

Benefits Plans May Include

Medicare Advantage Plans May Include

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Hospital and medical coverage matching Original Medicare Part A and B

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Part D prescription drug coverage on most plans

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Routine dental, vision and hearing benefits

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Fitness programs and over-the-counter allowances

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Telehealth visits and care coordination programs

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A yearly out-of-pocket maximum on every plan

Benefits are not offered by every plan. They differ by plan and county and may change for 2027. Review the Evidence of Coverage for each plan before enrolling.

Prior Authorization Requirements

Star Ratings

Each fall, Medicare gives every Medicare Advantage and Part D plan a rating of 1 to 5 stars, based on factors such as preventive care, how well chronic conditions are managed, member complaints, customer service and accuracy of drug pricing. You can see the ratings in Medicare Plan Finder.

Using Star Ratings

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Ratings of 4 stars or more are generally a good indicator of quality and service

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A special enrollment period lets you move into a five-star plan once during the year

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A new plan may not have a rating yet, and that alone isn’t a bad sign

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Ratings reflect the plan as a whole, not how well it covers your particular doctors and drugs

If Your Plan Is Ending

A non-renewal notice should have reached you in early October if your plan won’t be available in your county for 2027. Coverage doesn’t end immediately; it runs through December 31, 2026, which gives you time to decide.

If Your Plan Is Ending

1

Review your non-renewal letter. It verifies that your plan is ending and lays out your choices.

2

Write down your doctors and drugs. Comparing replacement plans requires them.

3

Compare your 2027 plan choices. Look at networks, drug coverage and the out-of-pocket maximum, not only the premium.

4

Pick a plan by December 31 to avoid a gap. If you enroll during Annual Enrollment by December 7, your coverage starts January 1, 2027.

5

Rely on your Special Enrollment Period if necessary. If your plan is ending, you generally have until the end of February 2027 to make a choice.

If you take no action: on January 1, 2027, you go back to Original Medicare, and you will have no drug coverage unless you pick a Part D plan. Being without drug coverage may result in a late enrollment penalty.

Medigap rights: if your Medicare Advantage plan exits your area, you generally get a guaranteed issue right, lasting up to 63 days after your coverage ends, to purchase certain Medicare Supplement plans with no health questions.

How to Compare

How to Compare

1

Review your Annual Notice of Change. It spells out every 2027 change to the plan you have now.

2

Verify your doctors and hospitals. Make sure every provider is in the 2027 network, not only the 2026 network.

3

Review your prescriptions. Verify every drug, the tier it falls on and any step therapy or prior authorization rules.

4

Look at the full annual cost. Total up the premium, usual copays and drug costs, and review the out-of-pocket maximum.

5

Look at star ratings. Medicare scores plans on quality and service using a 1 to 5 star scale.

6

Sign up by December 7. Coverage under your new plan begins January 1, 2027.

Enrollment Periods

Enrollment Period Dates What You Can Do
Annual Enrollment Period October 15 to December 7, 2026 Join, change or drop a Medicare Advantage or Part D plan effective January 1, 2027
Medicare Advantage Open Enrollment January 1 to March 31, 2027 In Medicare Advantage, you can change to another plan or go back to Original Medicare one time
Initial Enrollment Period 7 months around your 65th birthday month Sign up for Medicare and choose your first plan
Special Enrollment Periods Varies Switch plans after events such as a move, a loss of other coverage or your plan exiting your area

Annual Enrollment is when most people make changes. If you like your current plan, no action is needed; it renews on its own. Even so, review your Annual Notice of Change, since networks, premiums, copays and drug lists can all change on January 1.

Reading Your Annual Notice of Change

Check Every Line

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Your 2027 premium and deductible

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Doctor, specialist and hospital stay copays

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The out-of-pocket maximum

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Updates to your formulary, drug tiers and coverage rules

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Whether your doctors, hospitals and pharmacy stay in network

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Updates to dental, vision, hearing and other extras

The Annual Notice of Change must reach members by September 30. It is the most useful single document you receive each fall, since it spells out exactly how your plan will change on January 1.

Special Enrollment Periods

Outside of the fall and early-year windows, changing plans generally requires a Special Enrollment Period. Typical reasons include:

You May Qualify If

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Your plan is leaving your area or ending

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You move outside your plan’s service area

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You lose employer or union coverage

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Your Medicaid status changes, or you qualify for a Medicare Savings Program or Extra Help

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You want to join a 5-star plan, once a year

Every Special Enrollment Period has a separate time limit, so move as soon as the event occurs.

Getting Help

You do not need to compare plans by yourself, and help should not cost you anything. Here are the free options:

Free Help Comparing Plans

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Available any time: Medicare Plan Finder on Medicare.gov

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1-800-MEDICARE (1-800-633-4227), reachable 24 hours a day on all seven days of the week

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Your State Health Insurance Assistance Program (SHIP), which provides free, unbiased counseling

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A licensed agent or insurance broker, who can compare plans across several insurers for free

Gather your Medicare card, a list of your drugs and doses, your doctors and your preferred pharmacies before you call. That way a long conversation becomes a quick one.

Bottom Line

The Bottom Line

Medicare Advantage bundles your Medicare coverage into one private plan with a network and a yearly out-of-pocket limit. For 2027, compare plans in your county and enroll between October 15 and December 7, 2026.

Compare plans and enroll online

Frequently Asked Questions

➤ How does Medicare Advantage work?

A private insurer approved by Medicare provides your Part A and Part B coverage, and usually drug coverage, in one plan. Medicare pays the plan each month, and you follow the plan’s network and rules while paying its premium and copays.

➤ Do I still have Medicare if I join Medicare Advantage?

Yes. You remain in Medicare and keep your Medicare rights and protections. The plan replaces how your benefits are delivered, so you use the plan’s card instead of your Medicare card for most care, and you can return to Original Medicare during set enrollment periods.

➤ Do I still pay Part B with Medicare Advantage?

Yes. You keep paying the Part B premium, which is $202.90 in 2026 and projected at $209.50 for 2027. Some plans may reduce part of it, but not all plans offer that benefit, and you pay it on top of any plan premium.

➤ What does Medicare Advantage cost in 2027?

The national average premium is $12 a month for 2027, down from $14.37. On top of that you pay Part B, copays and coinsurance up to the plan’s out-of-pocket maximum, plus drug costs up to $2,400.

➤ Does Medicare Advantage include drug coverage?

Most plans do. These are called MA-PD plans and include Part D coverage with a formulary and drug tiers. For 2027 the drug deductible can be up to $700 and the out-of-pocket cap on covered drugs is $2,400.

➤ Do I have to use a network?

Usually, yes. HMOs generally cover only in-network care except emergencies and urgent care, while PPOs also cover out-of-network care at a higher cost. Every plan covers emergencies anywhere in the U.S. Check the network directory for your doctors and hospitals before you enroll.

➤ What extra benefits can Medicare Advantage include?

Plans may include dental, vision, hearing, fitness or over-the-counter allowances. Not all plans offer all benefits, and amounts vary by plan and county, so check the Evidence of Coverage before you enroll. Original Medicare does not cover routine dental, vision or hearing aids, which is why these extras appeal to many people.

➤ How many people use Medicare Advantage in 2027?

About 34 million people are projected to be enrolled in 2027, roughly 47% of everyone with Medicare. They can choose from about 5,532 plans nationally, though the choices in any one county are far fewer.

➤ When can I join Medicare Advantage for 2027?

During Annual Enrollment, October 15 to December 7, 2026, with coverage starting January 1, 2027. New enrollees can also join during their Initial Enrollment Period around their 65th birthday. Members already in Medicare Advantage can also make one change from January 1 to March 31, 2027.

➤ Can I leave Medicare Advantage later?

Yes. You can switch plans or return to Original Medicare during Annual Enrollment, or from January 1 to March 31, 2027. Buying Medigap later may require health questions unless you have a guaranteed issue right.

Have Questions?

Speak with a licensed insurance agent

1-833-641-4938

TTY users 711

Mon-Fri: 8am-9pm ET

Find & Compare Plans Online

Speak with a licensed insurance agent

1-833-641-4938TTY 711

Mon-Fri: 8am-9pm ET

ZRN Health & Financial Services, LLC, a Texas limited liability company

( Medicare Expert )

Russell Noga is the CEO of ZRN Health & Financial Services, and head content editor of several Medicare insurance online publications. He has over 15 years of experience as a licensed Medicare insurance broker helping Medicare beneficiaries learn about Medicare, Medicare Advantage Plans, Medigap insurance, and Medicare Part D prescription drug plans.