Medicare Annual Enrollment runs October 15 – December 7, 2026. Here's what's changing for 2027 in North Carolina — provider networks, drug costs, and insurer pullbacks — and how to review your plan before the deadline.
Written by the licensed agents at Health Plans of NC, an insurance agency authorized by Blue Cross NC.
Medicare Annual Enrollment for 2027 coverage runs October 15 through December 7, 2026. Changes take effect January 1, 2027.
Several national insurers are trimming Medicare Advantage offerings for 2027, and hospital–insurer contract disputes continue, so networks may change.
The Part D out-of-pocket cap rises to $2,400 in 2027, and the maximum standard deductible rises to $700.
Medicare's negotiated prices for 15 more drugs, including Ozempic and Wegovy, take effect in January 2027.
Your Annual Notice of Change (ANOC) is the best place to see exactly what is changing in your own plan.
Medicare Advantage (Medicare Part C) plans are offered by private insurers approved by Medicare. They must cover everything Original Medicare covers, and most bundle prescription drug coverage and extras such as dental or vision. Each year, insurers can change premiums, copays, covered drugs, extra benefits, and provider networks, which is why the fall review matters.
Federal payments to plans are rising for 2027. In its 2027 Rate Announcement, the Centers for Medicare & Medicaid Services (CMS) projected a 2.48% increase in payments to Medicare Advantage plans. Even so, several large insurers have said they are pulling back. Humana told investors in July that it plans to exit Medicare Advantage plans covering about 600,000 members nationwide for 2027. UnitedHealthcare shared a preliminary list with brokers of 34 counties in 12 states it may leave, though the company said that list is not final.
Neither announcement has identified which North Carolina counties, if any, are affected. If your plan is not renewing for 2027, your insurer must notify you in writing, and you will have options, described below.
Contract disputes between hospitals and Medicare Advantage insurers continued through 2026. According to a Becker's Hospital Review tracker updated September 22, at least 33 health systems have ended contracts with some Medicare Advantage insurers, most often citing prior authorization denials and payment disputes. Most systems named in national coverage are outside North Carolina, but the tracker is not exhaustive.
North Carolina has seen its own version. A contract dispute between ECU Health and UnitedHealthcare left some ECU Health physician practices and outpatient facilities out of network for part of 2026, until a new multi-year agreement took effect August 7, 2026. That agreement restored in-network access for UnitedHealthcare commercial, Medicaid, and Medicare Advantage members in eastern North Carolina.
The point is not that any particular plan is at risk, but that networks can change. Before you renew, confirm that your primary care doctor, specialists, and preferred hospital are in network for 2027, not just for this year.
On prior authorization — an insurer's approval before certain care is provided — CMS rules that took effect in 2026 require Medicare Advantage plans to decide standard requests within 7 calendar days and urgent requests within 72 hours. If a request is denied, you have the right to appeal.
Higher out-of-pocket cap. The annual limit on what you pay for covered Part D drugs rises from $2,100 in 2026 to $2,400 in 2027, according to CMS's 2027 Rate Announcement. The cap applies to standalone Part D plans and to the drug coverage in Medicare Advantage plans. Once you reach it, you pay nothing more for covered drugs for the rest of the year.
Higher maximum deductible. The standard Part D deductible can be as high as $700 in 2027, up from $615. Many plans set a lower deductible or none at all, so check each plan's details.
Standalone drug plan premiums. CMS is ending the Part D Premium Stabilization Demonstration after 2026. That program had helped hold down premiums for standalone Part D plans. CMS set the 2027 base beneficiary premium — a national benchmark, not what every plan charges — at $41.33 a month.
Negotiated drug prices. Medicare's negotiated prices for 15 more drugs take effect in January 2027, including semaglutide (Ozempic, Wegovy, and Rybelsus). The negotiated price is what Medicare pays. What you pay at the pharmacy still depends on your plan's formulary — its list of covered drugs — and its cost-sharing.
For a deeper look, see our guide to Medicare Part D in North Carolina.
Several important details were not public as of late September 2026.
Part B premium and deductible. The 2027 standard Part B premium is typically announced in the fall. It applies whether you have Original Medicare or Medicare Advantage.
Plan-by-plan details. CMS said it would release the full 2027 plan landscape in mid-to-late September, and insurers can begin marketing 2027 plans October 1. Specific premiums, copays, and networks for Blue Cross NC and other carriers' 2027 plans should be confirmed on Medicare.gov or with the insurer.
Final county exits. UnitedHealthcare's preliminary county list could change, and other insurers' market changes will show up in the plan landscape and in member notices.
If your doctor or hospital leaves your plan's network, or your plan changes in a way that no longer works for you, you generally have three paths.
1. Switch to a different Medicare Advantage plan. During Annual Enrollment, you can move to any plan available in your area that includes your providers.
2. Return to Original Medicare. You can drop Medicare Advantage and add a standalone Part D plan and a Medicare Supplement (Medigap) policy. Outside of guaranteed-issue situations, Medigap insurers may use medical underwriting, which can affect whether you're accepted and what you pay.
3. Stay and change providers. If the difference in care is manageable, you might see a different in-network provider under your current plan.
If your plan is not renewing at all, you get a Special Enrollment Period that runs from December 8 through the end of February, and you may have federal guaranteed-issue rights to buy certain Medigap policies without medical underwriting. If you do nothing, you would be moved to Original Medicare, but you could be left without drug coverage.
September 30, 2026. Deadline for plans to send members their Annual Notice of Change.
October 1, 2026. Insurers can begin marketing 2027 plans, and 2027 plan details appear in Medicare.gov's Plan Finder.
October 15 – December 7, 2026. Annual Enrollment Period. Join, switch, or drop a Medicare Advantage or Part D plan.
January 1, 2027. New coverage takes effect.
January 1 – March 31, 2027. Medicare Advantage Open Enrollment Period. If you're in a Medicare Advantage plan, you can make one switch to another Medicare Advantage plan or to Original Medicare.
For the full set of windows, including when you first become eligible, see our guide to Medicare enrollment deadlines in NC.
Start with Medicare.gov's Plan Finder. Enter your ZIP code, prescriptions, and pharmacies to see 2027 plans side by side, including premiums, out-of-pocket maximums, and star ratings.
Look at total yearly cost, not just the premium. A $0-premium plan with high copays and a high out-of-pocket maximum can cost more than a plan with a modest premium if you need significant care. Star ratings, from 1 to 5 stars, reflect CMS quality scores, and CMS publishes updated ratings each fall.
Choice varies across North Carolina. Urban counties such as Mecklenburg, Wake, and Guilford usually have more plans than rural mountain and coastal counties, so results for your exact ZIP code matter.
Read your ANOC. It lists your plan's 2027 changes to premiums, benefits, drug coverage, and networks.
Check your doctors and hospital for 2027. Call your plan or your doctor's office and ask whether they will be in network next year. Don't assume nothing has changed.
Check your drugs. Confirm each prescription is on your plan's 2027 formulary and note its tier and any prior authorization requirements.
Compare before December 7. Use Plan Finder, call NC SHIIP (the Seniors' Health Insurance Information Program) at 855-408-1212 for free, unbiased counseling, or talk with a licensed insurance agent who can walk you through the plans available in your area.
Watch for scams. Medicare will not call you to sell a plan or ask for your Medicare number. Be cautious with unsolicited calls, texts, and mailers, and report suspected fraud to 1-800-MEDICARE.
This article is for general information and is not insurance, legal, or tax advice. Contact a licensed agent or the Health Insurance Marketplace for guidance specific to your situation.