Medicare Open Enrollment: What's Changing for 2027, Who Gets the $90 Part B Rebate, and What to Check Before Dec 7

What can you change during Medicare open enrollment?

Medicare open enrollment runs October 15 through December 7, 2026, and any change you make takes effect January 1, 2027. This year, many people are also asking about a one-time $90 Part B rebate that started arriving in October. Here's who gets the rebate, what's changing for 2027, and what to check before the deadline.

Open enrollment is your yearly chance to review your coverage and make changes. During this window, you can:

• Switch coverage types: move from Original Medicare to a Medicare Advantage plan, or the other way around.
• Change Medicare Advantage plans: move from one plan to another.
• Change drug coverage: join, switch, or drop a Part D prescription drug plan.

If you do nothing, your current plan usually renews on its own. That includes any changes your plan made for 2027, so it's worth taking a look even if you're happy today.

Who gets the $90 Part B rebate?

The Centers for Medicare & Medicaid Services (CMS) is sending a one-time $90 payment to about 20.8 million people in Original Medicare Part B. The payment is meant to offset part of the October Part B premium. The money comes from the Medicare Improvement Fund, which Congress created in 2008. This is the first time the fund has been used to pay people on Medicare directly.

You qualify if you meet all of these conditions:

• You are enrolled in Original Medicare Part B.
• You live in the United States.
• You don't get help paying your Part B premium through Medicaid or a Medicare Savings Program.
• You don't pay IRMAA, the extra Part B premium charged to people with higher incomes.

You won't get the rebate if you have a Medicare Advantage plan, even if you still pay a Part B premium. People with Part A only don't qualify either. Because of these rules, most people on Medicare won't receive it. About 62.9 million people have Part B, but only about one in three qualify.

How and when does the rebate arrive?

You don't need to apply or sign up. The payment is automatic.

• Direct deposit: most eligible people receive $90 from the Social Security Administration on or around October 8, 2026, in the same account as their Social Security benefits.
• Paper check: if you don't have direct deposit, a U.S. Treasury check arrives later in October at the address Medicare has on file. The memo reads "Medicare Improvement Fund Payment; $90 Payment to Offset October Premium."

For eligibility questions, call 1-800-MEDICARE (1-800-633-4227). To check payment status, call Social Security at 1-800-772-1213, starting October 15, 2026.

The rebate is not a lower premium, a cost-of-living adjustment, or a Medicare Advantage "giveback" benefit. Your monthly Part B premium stays the same.

Watch out for scams. Medicare and Social Security will never call, text, or email you asking for bank details to "claim" or "release" this payment. If someone does, hang up and call 1-800-MEDICARE or Social Security directly.

What's changing for Part D in 2027?

Several Part D numbers change on January 1, 2027. Plans can charge less than these standard amounts, but the deductible and the yearly cap can't be higher.

Once your spending on covered drugs reaches $2,400, you pay $0 for covered Part D drugs for the rest of the year. A few other changes matter, too:

• Some premiums may rise sharply. A federal program that held down stand-alone plan premiums in 2025 and 2026 ends after 2026. CMS projects the average premium will rise less than $1 a month, but a KFF analysis found some plans rising by $50 or more a month.
• Fewer plans to choose from. The average person will have about 9 stand-alone drug plans in 2027, down from 11. Unless you get Extra Help, there will be no $0-premium stand-alone plans.
• New negotiated drug prices start. Medicare-negotiated prices take effect January 1, 2027, for more brand-name drugs, including some GLP-1 medications. What you pay still depends on your plan's tiers and copays.
• Premiums don't count toward the cap. Neither do drugs that aren't on your plan's drug list.

Our Medicare Part D guide explains how deductibles, tiers, and formularies work in more detail.

What's changing for Medicare Advantage in 2027?

CMS projects the average Medicare Advantage premium will drop from $14.37 to $12 a month, and the total number of plans nationally stays about the same. A lower premium isn't the whole story, though. Industry analysts report that many insurers are cutting plans and raising the copays and other costs you pay when you get care.

The highest in-network out-of-pocket limit for Medicare Advantage plans rises to $9,850 in 2027, up from $9,250.

If your plan is ending, you should have received a notice by October 2. That notice gives you a Special Enrollment Period and, in some cases, a guaranteed right to buy a Medigap policy. Still, choose a new plan by December 7 so your coverage doesn't lapse on January 1.

What will Part B cost in 2027?

The official 2027 Part B premium hasn't been announced yet, and it usually comes out in November. The 2026 Medicare Trustees Report estimates $209.50 a month, up $6.60 from $202.90. That works out to about $79 more for the year, which would use up most of the $90 rebate.

What should you check before December 7?

Plans change every year, so a plan that worked in 2026 may not be the best fit in 2027. These steps can help:

1. Read your Annual Notice of Change. Plans mail it by September 30. It lists changes to your premium, deductible, copays, and covered drugs.
2. List every drug you take, with the dose, and check each one on the plan's 2027 drug list. Note its tier and whether it needs prior authorization or step therapy.
3. Check your pharmacy. Preferred pharmacies can change from year to year and usually charge lower copays.
4. Confirm your doctors. If you have Medicare Advantage, make sure your doctors and hospitals are still in network.
5. Compare total yearly cost. The Medicare Plan Finder on Medicare.gov estimates premiums plus drug costs for each plan, so you aren't choosing on premium alone.
6. See if you qualify for Extra Help. If your income and resources are limited, this program may lower your premiums, deductible, and copays. You can apply through Social Security.
7. Review telehealth benefits. Many plans cover virtual visits. Our guide to Medicare telehealth coverage explains what's included.

Your State Health Insurance Assistance Program (SHIP) also offers free, one-on-one Medicare counseling if you'd like help comparing plans.

Frequently Asked Questions

When is Medicare open enrollment for 2027 coverage?

Open enrollment runs October 15 through December 7, 2026. Any change you make takes effect January 1, 2027. If you do nothing, your current plan usually renews with its 2027 changes.

Do I need to apply for the $90 Medicare rebate?

No. The payment is automatic. Most eligible people receive it by direct deposit on or around October 8, 2026. Others get a paper check from the U.S. Treasury later in October. Medicare and Social Security will never ask for your bank information to send it.

Why didn't I get the $90 Part B rebate?

You won't get the rebate if you have a Medicare Advantage plan, pay IRMAA, get help with your Part B premium from Medicaid or a Medicare Savings Program, or live outside the U.S. If you think you qualify, call 1-800-MEDICARE. To check payment status, call Social Security at 1-800-772-1213.

Does the $90 rebate lower my Part B premium?

No. It is a single payment meant to offset part of your October premium. Your monthly Part B premium stays the same, and if it comes out of your Social Security check, that deduction continues as usual.

Can I change my Medicare plan after December 7?

Sometimes. If you have Medicare Advantage, you can switch to another Medicare Advantage plan or return to Original Medicare once between January 1 and March 31, 2027. You may also qualify for a Special Enrollment Period after a move, a loss of other coverage, or if your plan is ending.

The Bottom Line

Open enrollment is your chance to make sure your coverage still fits in 2027. The $90 Part B rebate is a one-time payment for some people in Original Medicare, not a lower premium. Part D costs, drug lists, and Medicare Advantage networks are all changing, so review your plan and compare your options by December 7.

Have questions about a medication you take or what your health needs might look like next year? Doctronic's free AI doctor can help you understand your options any time. When you need a prescription reviewed, licensed physicians are available 24/7 for $39 video visits.

This article is informational and is not a medical diagnosis. Confirm with a licensed clinician, especially for new, worsening, or high-risk symptoms.