Here's the headline you're going to see all week: Medicare Advantage premiums are going down in 2027. It's true. It's also an average, and your mom doesn't live in an average. She lives in one plan, with one drug list, one set of doctors, and one monthly bill that either fits the budget or quietly doesn't.
You know how this usually goes. A thick envelope shows up in September. Your parent sets it on the counter with the other mail from the plan. The news says premiums are falling, so nobody opens it. Then January comes, the pharmacy counter says a number nobody expected, and you're the one on the phone trying to figure out what changed and why nobody caught it.
The federal numbers dropped on September 28. For North Carolina they look good on the surface: the average Medicare Advantage premium in the state roughly halves for 2027. But buried one page down in the same federal fact sheet is a figure that should get your attention if your parent has a standalone drug plan. Only about 53 percent of North Carolinians with one of those plans have access to a plan that costs less than what they paid this year. That means close to half of them can't beat their 2026 premium no matter how hard they shop.
I spent more than eight years on the buying side of houses, sitting across the table from families in transition. The pattern that never changed was this: the monthly budget is what decides everything else. Whether your parent can stay home another year, whether the house has to sell, how fast. A Medicare decision made on autopilot in October shows up in that budget by February. So let's read the numbers the way they'll actually hit your family.
What CMS Announced on September 28
On September 28, 2026, the Centers for Medicare & Medicaid Services released its 2027 outlook for Medicare Advantage and Part D, ahead of Open Enrollment, which runs from October 15 through December 7, 2026. Here's what the agency reported.
Medicare Advantage. According to CMS, the weighted average monthly premium across all Medicare Advantage plans, including plans with drug coverage and Special Needs Plans, is projected to fall from $14.37 in 2026 to $12.00 in 2027, a decline of 16.5 percent. CMS projects Medicare Advantage enrollment at 34 million in 2027, about 47.4 percent of everyone on Medicare. The number of plans nationally goes from 5,553 to about 5,532. CMS also says that approximately eight in ten Medicare Advantage enrollees will be able to stay in their current plan at the same or a lower premium.
Standalone drug plans. Per CMS, the average monthly premium for standalone Part D prescription drug plans is projected to rise less than $1, from $35.09 in 2026 to $36 in 2027. For Medicare Advantage plans that include drug coverage, the average Part D portion of the premium drops from $11.32 to $7, a 38 percent decrease after plan rebates.
North Carolina specifically. CMS publishes a state-by-state fact sheet alongside the national release. For North Carolina in 2027, it reports:
- 2,322,851 people enrolled in Medicare in the state.
- An average monthly Medicare Advantage premium that goes from $12.49 in 2026 to $6.19 in 2027.
- 179 Medicare Advantage plans available, up from 175.
- 100 percent of people with Medicare having access to a $0 premium Medicare Advantage plan.
- 11 standalone prescription drug plans available.
- 52.96 percent of people with a standalone drug plan having access to a plan with a lower premium than what they paid in 2026.
- 22.87 percent of people with a standalone drug plan getting Extra Help.
- $5.30 as the lowest monthly premium for a standalone drug plan.
And the benefit itself moved. In its CY 2027 Rate Announcement, CMS set the standard Part D deductible at $700 for 2027, up from $615, and the annual out-of-pocket threshold, the cap on what your parent pays for covered drugs in a year, at $2,400, up from $2,100.
What the Averages Hide
Two in ten is still a lot of people
CMS's own framing is that about eight in ten Medicare Advantage enrollees can keep their plan at the same or a lower premium. Flip that around and roughly two in ten can't. With 34 million people projected in Medicare Advantage, that's not a rounding error. It's millions of households whose premium goes up or whose plan changes enough that staying put costs more.
You don't know which group your parent is in until you read their plan's own notice. The national average can't tell you. Neither can the state average.
The standalone drug plan is where North Carolina gets tight
If your parent is on Original Medicare with a standalone drug plan, which is common for people who want to keep any doctor who takes Medicare, this is the number that matters most in the whole release. Nationally the average standalone premium barely moves. In North Carolina, only 52.96 percent of standalone enrollees can find a cheaper plan than this year. The other 47 percent or so are looking at the same premium or more, with only 11 standalone plans to choose from.
That doesn't mean your parent's plan got worse. It means you can't assume switching saves money, and you can't assume staying is free. You have to look.
Premium is the smallest number on the page
This is the part families miss most often. The premium is what gets advertised, but for a parent on several medications, the premium is rarely the biggest cost of the year. The deductible, the tier each drug sits on, and whether a drug is covered at all are what drive the real bill.
Here's the math that matters. With the 2027 out-of-pocket threshold at $2,400, a parent who reliably hits the cap will pay up to $300 more for covered drugs in 2027 than in 2026, before you count any premium at all. That's arithmetic on the CMS figures, not a CMS statement, but it's the kind of number that changes whether the monthly budget works.
A $0 premium plan that puts your dad's heart medication on a high tier, or drops it, can cost far more across a year than a plan with a $30 premium that covers it well. The average premium tells you nothing about that.
A move changes the whole answer
If your parent is likely to move in 2027, into assisted living, closer to you, or into a smaller place, the plan's service area and network matter more than the premium. Medicare Advantage plans generally work through networks tied to where your parent lives. A plan that's perfect for their current zip code may be the wrong tool after a move. Choose for where your parent lives now. According to Medicare.gov, a move out of the plan's service area, or to a new address with new plan options, opens a Special Enrollment Period to switch that runs for 2 full months after the move.
Help that half the eligible people never use
CMS's North Carolina fact sheet says it plainly: the Medicare Savings Programs help millions of people with Medicare costs, yet only about half of eligible people are enrolled. These programs, run by the state, help pay Medicare premiums and in some cases deductibles, coinsurance, and copayments. According to Medicare.gov, qualifying for a Medicare Savings Program also gets your parent Extra Help with prescription drug costs automatically.
Medicare.gov also says you may qualify in your state even if income or resources are above the federal limits, because some states don't count certain income or resources, and that you should apply even if you don't think you qualify. If your parent is living on Social Security and not much else, this is worth a phone call before you spend an hour comparing premiums. It can matter more than any plan switch.
What To Do Between Now and December 7
Step 1: Find the plan's notice before it gets filed
CMS's timeline says plans begin notifying enrollees about 2027 changes in September. Ask your parent, today if you can, for the most recent mail from their Medicare plan. You're looking for the notice of changes for 2027, not the Medicare & You handbook (that one goes to every household and isn't specific to their plan). If it's missing, call the plan's member services number on the back of the card and ask them to send it again.
Step 2: Make the drug list before you look at a single plan
Write down every prescription your parent takes, with the dose and how often. Get it from the pill bottles, not from memory. This list is what makes the comparison honest. Without it, every plan looks the same and the cheapest premium wins by default.
Step 3: Use Medicare Plan Finder once it's updated
CMS says Medicare Plan Finder on Medicare.gov will carry 2027 plan information by October 1, 2026, and that starting in October it will show clear messages about changes to your parent's current plan for 2027. CMS also says 2027 Star Ratings post on Medicare.gov on or around October 8. Enter the drug list, the pharmacy your parent actually uses, and compare the estimated total yearly cost, not just the monthly premium. If your parent has a Medicare account, sign in with them so their current plan and drugs load.
Step 4: Check the doctors by name
For any Medicare Advantage plan you're considering, confirm your parent's primary care doctor, key specialists, and preferred hospital are in network for 2027. Call the doctor's office too; the front desk often knows which plans they're leaving. If a move is on the table, check the plan's service area for the new address as well.
Step 5: Decide by December 7, on purpose
CMS says people who want to keep their current coverage generally don't need to re-enroll. That's convenient, and it's also how a plan that got more expensive rolls forward without anyone deciding it should. Open Enrollment closes December 7, 2026, and 2027 coverage begins January 1, 2027. If you want help, 1-800-MEDICARE is available 24 hours a day, seven days a week, per CMS. Put the deadline on your calendar now, and put the Medicare Savings Programs call ahead of it if money is tight.
When you're done, you're not the family that finds out in January. You're the one who read the notice, ran the drugs, checked the doctors, and made the call with numbers in front of you. That's the whole difference.
Frequently Asked Questions
Are Medicare Advantage premiums going down in 2027?
On average, yes. CMS projects the weighted average monthly Medicare Advantage premium will fall from $14.37 in 2026 to $12.00 in 2027, a 16.5 percent decline, and in North Carolina the average goes from $12.49 to $6.19. CMS also says about eight in ten enrollees can keep their plan at the same or a lower premium, which means some will see increases. Check your parent's own plan notice.
How much will a standalone Medicare drug plan cost in 2027?
CMS projects the national average standalone Part D premium will rise less than $1, from $35.09 to $36 a month. In North Carolina, CMS reports 11 standalone plans, a lowest premium of $5.30, and that 52.96 percent of standalone enrollees have access to a plan cheaper than what they paid in 2026. Your parent's actual cost depends on the plan and their drugs.
What is the Part D out-of-pocket cap for 2027?
In its CY 2027 Rate Announcement, CMS set the annual out-of-pocket threshold at $2,400 for 2027, up from $2,100 in 2026. The standard deductible rises from $615 to $700. Once your parent's out-of-pocket spending on covered drugs reaches the threshold, they pay nothing more for covered drugs the rest of that year.
When is Medicare Open Enrollment for 2027 coverage?
Medicare Open Enrollment runs from October 15, 2026, through December 7, 2026, and 2027 coverage begins January 1, 2027. CMS says Medicare Plan Finder will have 2027 plan information by October 1, and 2027 Star Ratings appear on Medicare.gov on or around October 8.
Can my parent get help paying Medicare premiums?
Possibly. Medicare Savings Programs, run by each state, help pay Medicare premiums and sometimes deductibles and copayments, and CMS says only about half of eligible people are enrolled. Medicare.gov says qualifying also gets your parent Extra Help with drug costs automatically, and that you should apply even if you don't think you qualify.
About Ryan Riggins
Ryan Riggins is a senior transition advisor and former house flipper. After 8+ years buying homes from families in transition, he walked away from the cash-buyer side to help families avoid the $50K mistakes he used to profit from. Based in Greensboro, NC. NC Real Estate License #361546, eXp Realty. Founder of Riggins Strategic Solutions and the Hammock365 app.
Not sure what Medicare leaves uncovered? The free Medicare Gap Analyzer shows where your parent's coverage stops: rigginsstrategicsolutions.com/tools/medicare-gap-analyzer
Want a step-by-step guide? The Senior Transition Blueprint is free, all 20 modules and 69 tools: rigginsstrategicsolutions.com/the-blueprint
Not sure where your family stands? The free Family Readiness Score takes five minutes and shows the gaps across the home, the money, the legal documents, care, and family alignment: rigginsstrategicsolutions.com/tools/family-readiness-score
Need a personalized plan? The Senior Transition Roadmap is free, by application. It adds calls with Ryan and 90 days of email support: rigginsstrategicsolutions.com/the-roadmap
Selling a parent's home? Ryan finds and vets the right local agent for your situation and stays in your corner on the whole sale, at no added cost to your family: rigginsstrategicsolutions.com/in-your-corner
Coordinate the family in one place. Hammock365 keeps daily check-ins, medications, and documents where the whole family can see them: hammock365.com
Sources
All sources checked September 30, 2026.
- CMS, Medicare Advantage and Medicare Prescription Drug Programs Expected to Remain Stable in 2027, press release, September 28, 2026. Source for the weighted average Medicare Advantage premium of $14.37 in 2026 and $12.00 in 2027 (16.5 percent decline); 34 million projected Medicare Advantage enrollees, about 47.4 percent of Medicare; 5,553 plans in 2026 and about 5,532 in 2027; about eight in ten enrollees able to keep their plan at the same or a lower premium; the standalone Part D average of $35.09 in 2026 and $36 in 2027; the Medicare Advantage drug premium of $11.32 falling to $7 (38 percent); Open Enrollment October 15 through December 7, 2026; Plan Finder change messages starting in October; 1-800-MEDICARE availability; no need to re-enroll to keep coverage; and Medicare Savings Program enrollees qualifying for Extra Help. https://www.cms.gov/newsroom/press-releases/medicare-advantage-medicare-prescription-drug-programs-expected-remain-stable-2027
- CMS, 2027 Medicare Advantage and Part D Landscape State-by-State Fact Sheets, North Carolina page. Source for 2,322,851 Medicare enrollees in North Carolina; the average Medicare Advantage premium of $12.49 in 2026 and $6.19 in 2027; 179 plans in 2027 against 175 in 2026; 100 percent access to a $0 premium plan; 11 standalone drug plans; 52.96 percent of standalone enrollees with access to a lower premium; 22.87 percent receiving Extra Help; the $5.30 lowest standalone premium; the September plan notices; Plan Finder updated by October 1; Star Ratings on or around October 8; coverage beginning January 1, 2027; and the statement that only about half of people eligible for Medicare Savings Programs are enrolled. https://www.cms.gov/files/document/2027-medicare-advantage-part-d-landscape-state-state-fact-sheets.pdf
- CMS, Announcement of Calendar Year (CY) 2027 Medicare Advantage Capitation Rates and Part C and Part D Payment Policies. Source for the standard Part D deductible of $700 in 2027 against $615 in 2026 and the annual out-of-pocket threshold of $2,400 in 2027 against $2,100 in 2026. https://www.cms.gov/files/document/2027-announcement.pdf
- Medicare.gov, Special Enrollment Periods. Source for the window to switch Medicare Advantage or drug plans after a move out of the service area or to an address with new plan options, running 2 full months after the move. https://www.medicare.gov/basics/get-started-with-medicare/get-more-coverage/joining-a-plan/special-enrollment-periods
- Medicare.gov, Medicare Savings Programs. Source for the programs being run by the state, what they pay, automatic Extra Help for those who qualify, possible eligibility above the federal limits, and the instruction to apply even if you don't think you qualify. https://www.medicare.gov/basics/costs/help/medicare-savings-programs
The North Carolina average premium roughly halving, the roughly 47 percent of standalone enrollees without a cheaper option, the roughly two in ten Medicare Advantage enrollees who can't keep their plan at the same or a lower premium, and the $300 higher out-of-pocket cap are arithmetic on the CMS figures above, not separate CMS statements.
