If you’re one of the millions of people in a $0-premium Medicare Advantage plan, here’s some news your insurer probably didn’t put in big type: Your plan may have gotten worse for 2027, even if the price didn’t budge.
Washington’s official line is that everything’s fine. In its 2027 announcement, the Centers for Medicare & Medicaid Services said the average Medicare Advantage premium will fall from $14.37 to $12, and that extras like hearing, dental and vision are expected to stay stable.
Now look at what insurers actually filed.
An analysis of Medicare’s Plan Finder data by investment bank Leerink Partners, reported by Healthcare Dive, found big cuts at some of the biggest names in the business. Insurers aren’t raising sticker prices. They’re shrinking what’s in the box.
Open enrollment runs through Dec. 7. If you do nothing, the Medicare program says your coverage simply continues — cuts and all.
Here are five things to check in your plan’s Annual Notice of Change before you let that happen.
1. Your dental coverage
This is where insurers swung the ax hardest.
According to Leerink’s analysis, nearly 7 in 10 UnitedHealthcare members saw their dental benefits trimmed. Dental reductions hit 45% of members at Centene, which sells plans under the Wellcare name, and 36% at Aetna. Elevance cut dental allowances for 23% of its members.
Why does that matter? Because Original Medicare doesn’t cover most dental care — cleanings, fillings, extractions or dentures, according to Medicare.gov. For many people, dental is a big reason they picked an Advantage plan in the first place.
Look at your notice for changes to your annual dental allowance, the services covered and what you’ll owe per visit. If you’re facing a crown or dentures next year, do the math now.
2. Your Part B ‘giveback’
Some Advantage plans pay part or all of your Part B premium for you. Medicare calls it a Part B premium reduction; the ads call it a “giveback.” Either way, it’s real money in your pocket every month.
It’s also on the chopping block. Axios reported that dropping giveback benefits is among the common ways plans are cutting back for 2027.
Leerink found Humana reduced or eliminated the giveback for 62% of its members.
If your plan had a giveback this year, find that line in your notice.
If it’s shrinking or gone, more of your Part B premium will come out of your Social Security check (or your Part B bill, if you pay it directly) next year, eating into your 2027 cost-of-living raise.
3. Your out-of-pocket maximum
Every Advantage plan has a yearly cap on what you pay for covered medical services. That cap is the most important number in your plan, because it’s what stands between you and financial disaster in a bad health year.
Once you hit that cap, the plan pays the rest of your covered bills for the year, as long as you use doctors in its network.
The government sets the highest cap any plan can have. It’s $9,250 this year and rises to $9,850 in 2027, according to Medicare’s rules for plans. Most plans set theirs lower: the typical member’s cap this year is $5,421, according to KFF, a health policy research group.
Some plans are pushing theirs higher. Leerink found Clover Health lifted its out-of-pocket cap $1,144 for 2027 — what analyst Whit Mayo called a “standout reduction in benefit protection.”
If your cap is rising, ask yourself: could I write a check that size if I got really sick next year?
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4. Your specialist copays and extras
Back in May, Reuters reported that investors and industry experts expected Advantage members to lose extras next year — things like gym perks, eyeglasses and dental care.
Humana CEO Jim Rechtin told analysts the company would adjust benefits to hit its target of at least a 3% profit margin by 2028.
By September, Axios reported that plans were also raising copays for specialist visits.
If you see a cardiologist, an orthopedist or a dermatologist regularly, those copays add up fast. Multiply the new copay by the number of visits you expect next year. Then check what happened to your gym membership, eyeglasses and hearing benefits.
5. Your drugs and your doctors
The cheapest plan in the world is worthless if it doesn’t cover your prescriptions or your doctors won’t take it.
Medicare’s own yearly review guide warns that what you pay, what’s covered and which doctors take your plan can all shift from one year to the next. Check two things:
- Your drugs. Make sure each prescription is still on the plan’s list, and check whether it moved to a pricier tier. If your drug costs are climbing, you can also compare prescription discounts here.
- Your doctors. Confirm each one is in network for 2027, not just 2026. Call the doctor’s office, not just the insurer.
How to fight back before Dec. 7
Don’t just shrug and auto-renew. Here’s what to do:
- Read your Annual Notice of Change. Plans send it in the fall. If you didn’t get yours, Medicare.gov says to contact your plan.
- Compare plans on Medicare’s Plan Finder. It lets you enter your prescriptions and estimate your yearly costs under each plan.
- Get free, unbiased help. Your State Health Insurance Assistance Program, or SHIP, offers one-on-one counseling at no cost. We also rounded up 8 free resources for navigating Medicare open enrollment.
- Know your backup window. If you’re in an Advantage plan on Jan. 1, Medicare says you get one more change between Jan. 1 and March 31: switch Advantage plans or go back to Original Medicare and join a drug plan.
One caution on going back to Original Medicare: you’ll probably want a Medigap policy to cover what Medicare doesn’t. Medicare.gov warns there’s generally no federal guarantee an insurer will sell you one later, and it may cost more because of your health. Check your state’s rules before you jump.
Benefit cuts aren’t the only change this year. Plan choices are limited too — see “Your Medicare Choices Are Shrinking Again. 5 Moves to Make Before Dec. 7.”
A $0 premium sounds like a bargain. But what matters is what you get for it. This year, for a lot of people, the answer is less.
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