Fall marks the annual open enrollment period for many employer-sponsored health insurance plans. For individuals already enrolled in Medicare, the annual Open Enrollment Period runs from October 15 through December 7. This is an opportunity to review Medicaid prescription drug coverage, compare health plan costs, evaluate HSA and FSA contributions, and determine whether your current insurance and retirement benefits still align with your needs.
Medicare Open Enrollment: What to Review for 2027
Medicare open enrollment is from October 15th – December 7th. During this period, Medicare beneficiaries with Original Medicare can join, drop, or switch a standalone Part D prescription drug plan. Beneficiaries can also switch between Original Medicare and Medicare Advantage, or change Medicare Advantage plans. Changes made during this period generally take effect January 1, 2027.
Most Medicare Advantage plans already include prescription drug coverage (Part D). Enrolling in a separate Part D plan while covered by a Medicare Advantage HMO or PPO may result in disenrollment from that Medicare Advantage plan and a return to Original Medicare. Certain other Medicare plan types allow separate Part D coverage, so it’s important to understand how your current plan works before making changes.
If you are happy with your current coverage and have not experienced significant changes in your health, you may not need to switch plans. However, reviewing your coverage each year is still recommended. Provider networks, premiums and what medications are covered by your plan change every year.
There is also a separate, narrower window afterward; the Medicare Advantage Open Enrollment runs January 1 through March 31 each year, but it is only available to people already enrolled in a Medicare Advantage Plan, and it can’t be used to move from Original Medicare into Medicare Advantage plan.
If you’re considering switching from Medicare Advantage to Original Medicare, review your eligibility for a Medicare Supplement Insurance (Medigap) policy before making the change. Depending on your circumstances, you may not have guaranteed access to a Medigap policy outside certain enrollment periods.
Review Your Medicare Annual Notice of Change (ANOC)
One of the most important documents to review during Medicare Open Enrollment is your plan’s Annual Notice of Change (ANOC). Medicare Advantage and Part D plans generally provide this notice by the end of September. It outlines changes to coverage, premiums, copays, deductibles, and other plan details for the coming year. A plan that may have worked well in 2026 may look different in 2027, so reviewing the notice before making your enrollment decision is important.
Projected Medicare Premiums and Costs for 2027
Medicare costs are also expected to change in 2027. Current projections estimate that the standard monthly Part B premium could increase by less than 5 percent, from $202.90 in 2026 to $209.50 in 2027, while the annual Part B deductible could rise from $283 to approximately $292. These figures remain projections until finalized by the Centers for Medicare & Medicaid Services (CMS). Medicare beneficiaries should review the official 2027 amounts once released and account for any changes when evaluating their coverage.
Where to Get Help Comparing Medicare Plans
For assistance navigating Medicare decisions, State Health Insurance Assistance Programs (SHIPs) provide free, unbiased counseling. These programs can help explain Medicare coverage options, compare plans, understand enrollment rules, and navigate appeals or complaints. They do not sell, endorse, or receive commissions for any insurance policies.
Private insurance brokers and agents can also assist with Medicare plan selection, but some receive commissions from insurance carriers and may not represent every available plan. If you are working with a private provider, ask which carriers they represent and how they are compensated.
In Pennsylvania, the SHIP program is called PA MEDI. Residents can find free counseling and enrollment assistance through the Pennsylvania Department of Aging or locate a program in another state using the national SHIP directory.
Medicare Open Enrollment Checklist:
- Read your ANOC in full – look specifically at premium changes, whether your current medications remain covered, whether your doctors and hospitals are still in-network, and whether supplemental benefits like dental, vision, or over-the-counter allowances have shrunk.
- Review prescription drug coverage annually – If you have Original Medicare, compare standalone Part D plans. If you have Medicare Advantage, review the prescription drug benefits included in your plan. Confirm covered medications, pharmacy networks, and costs before making changes.
- Factor in Part D deductibles when budgeting – especially if you are on maintenance medications you fill early in the year, before your deductibles are satisfied.
- Use free help – contacting a SHIP to get advice with how many moving parts the plan year changes may be.
- Don’t wait until December 7th – Start comparing plans early and schedule appointments with Medicare counselors in advance, as availability may become more limited as the enrollment deadline approaches.
Employer Benefit Strategies
Open enrollment is a great time to review changes in your life and determine whether your benefits still meet your needs. Life events such as marriage, the birth of a child, a spouse’s job change, significant income changes or planned retirement can affect healthcare coverage, insurance needs, tax planning and beneficiary designation.
Costs continue to climb, with total employer health benefit costs per employee projected to rise by 8.2% on average in 2027, the largest increase since 2003, even after planned cost-reduction measures. These projections reflect employer benefit costs; individual employee premium changes will vary by plan.
When choosing your health plan, it is important to evaluate the total expected annual cost of coverage rather than focusing on premiums alone. Consider deductibles, coinsurance, copays, out-of-pocket maximums, prescription costs and whether your preferred healthcare providers are in network. Understanding how different health plans balance costs and coverage can help make the decision a bit easier.
Health Plan Types
Group health plans offered by employers each have a different balance of flexibility, network access and cost. Common plan types include HMOs, PPOs, EPOs, and POS plans which differ in how they structure provider networks and access to care. High-deductible health plans (HDHPs) are another option, defined primarily by their deductible and out-of-pocket cost structure rather than their provider network.
Health Maintenance Organization (HMO)
With an HMO, employees typically choose a Primary Care Physician (PCP) from within the plan’s network. For specialist visits, they may need to get a PCP referral first. The structure helps keep costs down by having lower monthly premiums and out-of-pocket costs. The trade-off is care is generally restricted to the network’s doctors or hospitals, except in emergencies.
Preferred Provider Organization (PPO)
With a PPO, employees can generally visit any doctor or specialist, both in and out of network, without needing a referral from a PCP. Employees can save money by staying in-network, but they have the freedom to choose. This flexibility can make premiums and deductibles higher than an HMO.
Exclusive Provider Organization (EPO)
An EPO can offer a balance between the cost control of an HMO and some of the flexibility of a PPO. Specialist referrals are often not required, but members generally must receive care from doctors or hospitals in network. Out-of-network providers are not covered, except for emergencies. With the defined network, EPOs tend to have lower premiums than PPOs.
Point of Service (POS)
POS plans combine features of HMOs and PPOs. Like an HMO, members are typically required to obtain PCP referrals for specialist visits. Like a PPO, they have the option to receive out-of-network care, usually at a higher out-of-pocket cost. This provides some additional flexibility when choosing providers.
High-Deductible Health Plan (HDHP)
HDHPs generally have higher deductibles than traditional health plans, often in exchange for lower monthly premiums. This means employees may pay more out of pocket before certain benefits begin, making it important to consider expected healthcare needs and the ability to cover a larger deductible. The plans are designed to cover serious injury or illness while giving employees more control over their routine healthcare costs.
Health Savings Accounts (HSAs): Benefits and 2027 Limits
HSA-eligible high-deductible health plans are often paired with a Health Savings Account (HSA), a tax-advantaged savings account that eligible employees and their employers can contribute to. Unlike a traditional health FSA, unused has funds carry over from year to year and remain yours if you change jobs. Depending on the account provider, HSA funds may also be invested. For individuals who can cover current healthcare costs through normal cash flow, an HSA may provide another great savings option for retirement.
For 2027, the IRS has increased HSA contribution limits to $4,500 for self-only coverage and $9,000 for family coverage. Eligible individuals age 55 and older can contribute an additional $1,000. To qualify as an HSA-compatible HDHP under the standard deductible rules, the plan must have a minimum annual deductible of $1,750 for self-only coverage or $3,500 for family coverage. Maximum annual out-of-pocket expenses are $8,700 and $17,400, respectively.
Flexible Spending Accounts (FSAs)
Depending on their employer’s benefits package, employees may also have access to a healthcare Flexible Spending Account (FSA, which allows employees to set aside pre-tax dollars from their paycheck to use for qualified medical expenses. You will want to make sure whatever you are setting aside, you use during the year, because it does not roll over. It is also not portable if you change jobs.
For 2026, the health FSA contribution limit is $3,400 per employee. The dependent care FSA exclusion limit increased to $7,500 for most households, or $3,750 for married individuals filing separately. Since employees are making elections for 2027, they should confirm the applicable contribution limits and plan provisions in their employer’s open enrollment materials.
If you are eligible for an HSA, check whether any FSA offered by your employer is compatible with HSA contributions. A general-purpose healthcare FSA can affect HSA eligibility, while certain limited-purpose FSAs may be permitted.
Dental and Vision Coverage
Beyond medical coverage and spending accounts, it’s also important to review your dental and vision options. Dental and vision plan costs can also change from year to year, making it important to review the coverage offered and compare premiums, deductibles, and out-of-pocket costs.
Review what each plan covers, particularly if you anticipate dental procedures or changes in vision needs during the coming year. For dental coverage, pay particular attention to orthodontics, implants, and other major procedures, which may have coverage limitations, waiting periods, or additional out-of-pocket costs.
Review Your Employer-Provided Life Insurance
Open enrollment is also a great time to review your insurance coverage needs. Group term life insurance may offer cost-effective coverage through an employer, often with simplified underwriting and no medical exam for coverage amounts within the plan’s guaranteed-issue threshold. Employer-provided life insurance may not provide enough coverage to meet your family’s financial needs, and coverage can end when you leave your job. Some plans offer portability or conversion options, so it is important to review those provisions and consider whether additional life insurance may be appropriate.
Long-Term Care and Other Supplemental Insurance
Long-term care insurance is another consideration, particularly for individuals approaching retirement. Reviewing existing coverage and potential future care needs can help determine whether additional protection may be appropriate.
Employers may also offer supplemental benefits such as critical illness, hospital indemnity and accident insurance. These policies can provide additional financial support following certain covered illnesses, hospital stays, or accidents. However, coverage terms, exclusions, benefit amounts and premiums vary, so it’s important to evaluate whether the additional protection is worth the cost based on your existing coverage and financial needs.
401(k) Contribution Limits and Employer Matching
Open enrollment is also a great time to review your employer retirement plan. For 2026, the employee 401(k) contribution limit is $24,500, with an additional $8,000 standard catch-up contribution available to eligible individuals age 50 or older. Individuals ages 60-63 may qualify for an enhanced catch-up contribution of $11,250. This enhanced catch-up is new for 2026 under SECURE 2.0 Act.
There is also a new Roth catch-up mandate for 2026. Anyone with FICA wages that exceed $150,000 must make catch-up contributions as Roth, not pre-tax.
Review your current contribution rate and consider contributing enough to receive your full employer match, if available. If you’re not currently receiving the full match, increasing your contribution may be worth considering based on your cash flow and financial priorities. You might also consider increasing your contributions by 1%, as smaller, incremental increases can help build retirement savings over time.
Traditional vs. Roth 401(k) Contributions
Employees can also use this time to review whether their contributions are directed to a traditional 401(k), a Roth 401(k), or a combination of both. The annual contribution limit applies to the combined total of traditional and Roth employee contributions, rather than separately to each account. For 2026, that combined limit is $24,500, plus any applicable catch-up contributions.
The primary difference is how contributions and withdrawals are taxed. Traditional 401(k) contributions are generally made with pre-tax dollars, reducing taxable income in the year they are made. Roth 401(k) contributions are made with after-tax dollars, so switching from traditional to Roth contributions may reduce your take-home pay. While investments in both accounts can grow without annual taxation, traditional 401(k) withdrawals are generally taxable, whereas qualified Roth 401(k) withdrawals can be tax-free.
The right contribution strategy depends on several factors, including your current tax bracket, expected retirement income, time horizon, and overall financial plan. Consider reviewing these factors with a financial advisor or tax professional to determine which approach may be appropriate for your circumstances.
With healthcare and benefits costs continuing to rise, simply clicking through open enrollment without reviewing your options could lead to unexpected expenses or missed opportunities. This annual enrollment period is a chance to evaluate your current needs, compare available benefits, and make adjustments for the coming year.
Employer Benefits Open Enrollment Checklist
- Compare health plan options: Evaluate total expected healthcare costs, including premiums, deductibles, coinsurance, copays, out-of-pocket maximums, prescription costs, and provider networks.
- Review HSA and FSA options: Confirm eligibility, contribution limits, carryover provisions, and how these accounts may support your healthcare spending and savings goals.
- Evaluate dental and vision coverage: Consider anticipated procedures, coverage limitations, and potential out-of-pocket expenses.
- Reassess life and supplemental insurance: Review coverage amounts, portability or conversion options, and whether additional protection may be appropriate for your family’s needs.
- Review retirement plan contributions: Check your employer match, consider whether to increase contributions, and evaluate traditional versus Roth 401(k) options based on your financial circumstances.
Making Your Open Enrollment Decisions Work Together
Open enrollment can be a great time to schedule a meeting with an advisor to review your employer benefits or help with Medicare. An advisor can help evaluate the potential tax and cash-flow implications of health coverage decisions, retirement contributions, and insurance needs, while considering how those choices work together. For Medicare plan-specific questions, a SHIP counselor or qualified insurance professional can also provide guidance on available coverage options.
Taking time to review these decisions before enrollment deadlines can help you make informed choices that align with your financial goals and your family’s needs.
