Key Points
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Medicare will change its eligibility requirements in 2027, making them more specific.
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Seniors will face higher deductibles and out-of-pocket maximums for Part D coverage next year.
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Those with pre-diabetes can participate in virtual diabetes prevention classes.
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Social Security isn’t the only government program expected to undergo major changes in 2027. Medicare is also changing, and with the annual open enrollment period just a few days away, it’s the perfect time to review these changes so you know what to expect next year.
Here are the four most important details you should be aware of as you select your Medicare coverage for 2027.
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1. Eligibility changes
Beginning in 2027, you must be either a U.S. citizen or U.S. national, a lawful permanent resident (green card holder), a Cuban-Haitian entrant, or lawfully living in the U.S. as a Compact of Free Association (COFA) migrant to get Medicare coverage. This is a bit more specific than current rules, which require Medicare beneficiaries to either be a U.S. citizen or a lawfully admitted noncitizen who has lived in the U.S. for at least five years.
2. Increased out-of-pocket costs for Part D coverage
Medicare beneficiaries will see their Part D costs increase slightly next year. The deductible will increase from a maximum of $615 in 2026 to $700 in 2027. In addition, the annual out-of-pocket maximum is increasing from $2,100 in 2026 to $2,400 in 2027. This includes any payments made by programs like Extra Help on your behalf.
Keep in mind that the above limits are the most Part D plans can charge you next year. Some plans may charge less or have no deductible at all. Review your options carefully if you’re trying to keep your retirement healthcare costs as low as possible.
3. ACCESS model
Medicare launched a new ACCESS (Advancing Chronic Care with Effective, Scalable Solutions) model designed to help people prevent and manage chronic diseases. This is a voluntary option for those on original Medicare.
It connects your doctor with participating providers and resources to better assist you in managing chronic health conditions. Check with your doctor to see whether this is an option for you.
4. Virtual Medicare Diabetes Prevention Program
Seniors with pre-diabetes or who meet other eligibility requirements have the option to take a Medicare Diabetes Prevention Program that can teach them how to maintain healthy habits. This course has been offered in years past at in-person locations.
Beginning in 2027, seniors on Medicare will also have the option to attend these sessions virtually. Those who choose to attend virtually can attend live sessions or watch prerecorded videos.
Keep these changes in mind as you compare your Medicare options for 2027. If you have any questions about any of the above changes, contact the Centers for Medicare & Medicaid Services to learn more. Do this before you make any decisions about your health coverage for next year. Once the Open Enrollment Period ends, you’ll be locked in to your health insurance policy for 2027, unless you qualify for a special enrollment period.
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