Health Insurance Agents Near Me: How to Review 2027 Medicare Changes Before Open Enrollment

2027 MEDICARE STATUS

Available CMS records indicate that Medicare Advantage and Medicare Part D programs are expected to remain broadly stable in 2027. The CMS September 28 press release reports the following national figures:

  • Weighted average Medicare Advantage premium: $14.37 in 2026 and $12.00 in 2027.
  • Average Part D premium inside Medicare Advantage plans: $11.32 in 2026 and $7 in 2027.
  • Average stand-alone Part D premium: $35.09 in 2026 and approximately $36 in 2027.
  • Medicare Advantage plans: approximately 5,532 in 2027 compared with 5,553 in 2026.
  • Medicare beneficiaries with access to 10 or more Medicare Advantage plans: 97%.
  • Medicare Advantage enrollees able to remain in their current plan at the same or a lower premium: approximately eight in 10.

Medicare Open Enrollment, also called the Annual Election Period, runs from October 15 through December 7, 2026. Coverage selected during this period generally begins January 1, 2027.

The Part D Premium Stabilization Demonstration ends in 2027. The national average does not establish the cost for a specific beneficiary, county, prescription list, or plan.

THE TWO 2027 MEDICARE COST FACTS

Two statements can apply at the same time:

  1. The national average Medicare Advantage premium can decline.
  2. A specific beneficiary can receive a higher total bill in 2027.

The CMS average is weighted across plan types. It includes Medicare Advantage plans with prescription coverage and Special Needs Plans. Averages also do not show every change in cost sharing.

The plan-level items requiring review include:

  • Maximum out-of-pocket limit.
  • Part D deductible.
  • Prescription copays and coinsurance.
  • Drug tiers and utilization rules.
  • Prior authorization requirements.
  • Provider and hospital networks.
  • Dental, hearing, vision, and other supplemental benefits.
  • Premium changes after applicable rebates or assistance.

The 2027 Part D out-of-pocket cap is $2,400, compared with $2,100 in 2026. The cap applies to covered Part D drugs and does not mean that every beneficiary will reach that amount.

State records make this distinction concrete. A state average premium can rise while the national weighted average falls. Florida records show an average monthly Medicare Advantage premium of $1.83 in 2026 and $2.13 in 2027, so a beneficiary in Florida should not assume the national $12.00 average applies to that beneficiary.

The appropriate comparison is total expected annual cost. The monthly premium is only one recorded cost field.

PLAN AVAILABILITY BY STATE

Plan availability remains location-specific. CMS state fact sheets show that Florida has 560 Medicare Advantage plans in 2027 compared with 611 in 2026. Ohio has 180 plans compared with 212. Illinois has 136 plans compared with 157.

Florida records show an average monthly Medicare Advantage premium of $1.83 in 2026 and $2.13 in 2027. Available records also show 11 stand-alone Medicare prescription drug plans in Florida for 2027.

Ohio records show an average monthly Medicare Advantage premium of $12.12 in 2026 and $9.00 in 2027. Available records also show 9 stand-alone Medicare prescription drug plans in Ohio for 2027.

Illinois records show an average monthly Medicare Advantage premium of $8.49 in 2026 and $7.11 in 2027. Available records also show 10 stand-alone Medicare prescription drug plans in Illinois for 2027.

These state averages move in different directions from the national weighted average. The recorded average is not a quote for an individual beneficiary. County-level plan availability and plan-level cost sharing should be confirmed on Medicare.gov.

State and county records should be checked before any enrollment decision. Available 2027 plan data is listed in the CMS Medicare Advantage and Part D landscape fact sheets.

VerifiedAgent state pages provide directory records for Florida, Ohio, and Illinois. Additional state records are available through the state directory hub.

PART D PLAN CHANGES

KFF analysis reports that stand-alone Part D plan choices are expected to decline from approximately 360 plans in 2026 to 312 in 2027. HealthSpring Extra and SilverScript Choice are reported as exiting multiple regions. KFF also reports that no $0-premium stand-alone Part D plans are expected in 2027 for beneficiaries who do not receive Extra Help.

The end of the stabilization demonstration may affect individual plan premiums. The demonstration provided approximately $9.8 billion in subsidies during 2025 and 2026. Its effect varied by plan and beneficiary. The KFF analysis should be read as market analysis, not as an individual quote.

Abstract illustration of a Medicare beneficiary comparing plan costs, drug coverage, and provider networks

EXAMPLE RECORD: 71-YEAR-OLD BENEFICIARY IN TAMPA

Assume a 71-year-old beneficiary in Tampa, Florida has a $0-premium Medicare Advantage plan with prescription coverage. The plan remains available, but the drug list changes, the specialist requires prior authorization, and the maximum out-of-pocket limit increases.

A second example involves a $0 stand-alone Part D plan that is discontinued. The beneficiary may receive a notice explaining replacement coverage, a plan mapping, or another available enrollment path. A beneficiary should not assume that a replacement plan has the same drugs, pharmacies, deductibles, or networks.

If coverage is not reviewed, the beneficiary may be placed into another plan from the same carrier or a fallback plan, depending on the plan termination and CMS notice. If no replacement action applies, current coverage may end on December 31, 2026.

The 2027 Part D out-of-pocket cap is $2,400. A prescription list that remained inexpensive in 2026 may produce different costs in 2027 because of tier placement, deductible changes, pharmacy networks, or formulary exclusions.

The required record review is:

  • Confirm whether the current plan is offered in the Tampa county for 2027.
  • Review every prescription in the 2027 drug list.
  • Compare the annual premium, deductible, copays, and maximum out-of-pocket limit.
  • Confirm doctors, specialists, hospitals, and pharmacies.
  • Complete any change by December 7, 2026.
  • Confirm the new enrollment in writing.

2027 MEDICARE PLAN REVIEW CHECKLIST

  1. Read the Annual Notice of Change received by late September.
  2. Confirm that the current plan remains available in the county.
  3. Review the 2027 drug list for every prescription, dosage, and frequency.
  4. Check drug tiers, deductibles, copays, coinsurance, and pharmacy restrictions.
  5. Check the Medicare Advantage maximum out-of-pocket limit.
  6. Confirm that doctors, specialists, hospitals, and preferred pharmacies remain in network.
  7. Review prior authorization, referral, and utilization requirements.
  8. Check 2027 Star Ratings after they are posted on or around October 8.
  9. Use the Medicare Plan Finder to compare total estimated annual costs.
  10. Call 1-800-MEDICARE for assistance when plan information cannot be confirmed online.
  11. Verify the insurance agent, state license, health authority, and National Producer Number.
  12. Confirm in writing which plan was selected, when enrollment was submitted, and who submitted it.

Blue abstract Medicare checklist with prescription, provider network, cost, and verification icons

THREE AVAILABLE DECISION PATHS

OPTION 1: KEEP THE CURRENT PLAN

This option applies only after the plan is confirmed for 2027. Drugs, doctors, pharmacies, cost sharing, and supplemental benefits should also be confirmed. Automatic continuation does not confirm that the plan remains suitable.

OPTION 2: CHANGE TO ANOTHER PLAN FROM THE SAME CARRIER

This option may preserve certain carrier relationships or administrative arrangements. The new plan may still have different formularies, networks, premiums, deductibles, or maximum out-of-pocket limits. The plan name should be recorded in writing.

OPTION 3: CHANGE CARRIER OR COVERAGE TYPE

The available comparison may include another Medicare Advantage plan or a move to Original Medicare with a Medigap policy and a separate Part D plan.

Original Medicare may provide broader provider access, but Medigap premiums and underwriting rules apply. Outside an initial enrollment period or another guaranteed-issue right, medical underwriting may affect Medigap eligibility, pricing, or acceptance. This condition should be independently confirmed before leaving Medicare Advantage.

TEN QUESTIONS FOR A LICENSED AGENT

  1. What is the total estimated annual cost, not only the monthly premium?
  2. Is this plan available in the beneficiary’s county in 2027?
  3. Is the beneficiary’s doctor still in network?
  4. What is the 2027 maximum out-of-pocket limit?
  5. Which prescriptions moved tiers or require prior authorization?
  6. What deductible, copay, and pharmacy restrictions apply?
  7. Does the plan require referrals or prior authorization for specialists?
  8. Is the agent appointed with the carriers being presented?
  9. What is the agent’s National Producer Number?
  10. Will the recommendation, enrollment details, compensation source, and compensation amount be provided in writing?

VERIFIEDAGENT RECORD AND LICENSE REVIEW

An NPN is a National Producer Number assigned to an insurance producer. It is not the same as a state license number. An NPN can be used as a starting point when checking an agent’s records through state insurance departments or the National Insurance Producer Registry.

A state license record may show:

  • License type.
  • Lines of authority.
  • Active or inactive status.
  • Effective date and expiration date.
  • State license number.
  • Appointment information, where reported by the state.

An agent selling health insurance generally requires the applicable health line of authority. State rules and appointment records vary. A licensed agent is not automatically appointed with every carrier that the agent discusses.

License verification is generally free and takes minutes. Anyone can identify as a Medicare specialist without providing sufficient licensing information. Consumers should verify the agent before sharing a Medicare number, Social Security number, bank account information, or payment details.

VerifiedAgent provides searchable agent records by state, city, or ZIP code. Profiles may include NPNs, recorded license categories, listed plan categories, carrier appointment records, and customer reviews. For example, Marilee A. Roose is listed under NPN 15489946 with recorded Health and Life licenses and Medicare-related plan categories. Lyn Marcella Silvers is listed under NPN 529802 in Florida with recorded Health and Life licenses and Medicare-related plan categories.

Available profile records may be incomplete or outdated. Current license and appointment status should be independently confirmed.

Administrative insurance agent credential verification illustration with shield, state map, and magnifying glass

2027 MEDICARE TIMELINE

Date Recorded event
October 1, 2026 2027 plan data and prices become available on Medicare.gov.
October 8, 2026 2027 Star Ratings are expected to be posted.
October 15, 2026 Medicare Open Enrollment begins.
December 7, 2026 Medicare Open Enrollment closes. Last day to change coverage.
December 31, 2026 Current coverage ends when a valid termination or plan change applies.
January 1, 2027 New 2027 coverage begins.
January 1–March 31, 2027 Medicare Advantage Open Enrollment Period. This is a limited do-over for Medicare Advantage enrollees only.

FINANCIAL ASSISTANCE RECORDS

Medicare Savings Programs may help eligible beneficiaries pay Medicare premiums and, in some cases, deductibles, coinsurance, and copayments. Extra Help may reduce Part D premiums, deductibles, and cost sharing.

CMS state fact sheets report that fewer than half of eligible people enroll in Medicare Savings Programs. Applications are generally handled through the state Medicaid office. Extra Help applications are handled through Social Security or Medicare channels.

Eligibility depends on income, resources, household status, and other factors. Qualification should be determined through the applicable state Medicaid office or Social Security. Enrollment should not be assumed from age or current plan status.

FINAL RECORD

The 2027 Medicare market contains both stable averages and material plan-level changes. A lower national average premium does not establish a lower cost for a specific beneficiary. The required review includes plan availability, prescriptions, networks, cost sharing, assistance eligibility, and agent verification.

Health insurance agents near me may provide plan comparisons, but licensing, NPN, carrier appointment, recommendation, and enrollment details should be confirmed before Medicare information is shared.