Medicare 2026

Before December 7: Your Philly Medicare Checklist

PHILADELPHIA — October 2026. From October 15 through December 7, 2026, people with Medicare in Philadelphia can lock in the coverage they want for 2027. Any choice you make inside that window takes effect January 1, 2027.

This is the once-a-year chance to look at Part D drug coverage and Medicare Advantage plans with fresh eyes. In Philadelphia County, CMS lists 97 Medicare Advantage plans from 17 carriers for the 2026 plan year, and plan details for 2027 are being released this fall in each plan's Annual Notice of Change (ANOC). You don't have to switch — if your current plan is offered next year and you do nothing, it simply renews with whatever changes the ANOC describes.

What you can actually change between Oct. 15 and Dec. 7

The Annual Enrollment Period (AEP) is the broadest window of the year. During it, a person with Medicare can:

• Join a Medicare Advantage plan (with or without drug coverage) if they have Parts A and B.
• Switch from one Medicare Advantage plan to another.
• Drop a Medicare Advantage plan and return to Original Medicare (Parts A and B).
• Join, switch, or drop a stand-alone Part D prescription drug plan.

One important note for Philadelphia: CMS currently lists 0 stand-alone Part D plans tied to Philadelphia County in the file we're working from. Stand-alone Part D is sold statewide in Pennsylvania, so a Philadelphian who wants drug coverage with Original Medicare will still have options on Medicare's Plan Finder at medicare.gov — just confirm the plan serves your ZIP code.

AEP does not cover Medigap (Medicare Supplement). Medigap has its own rules, and in most cases insurers in Pennsylvania can use medical underwriting outside your initial Medigap window. If you're considering a move between Medicare Advantage and Original Medicare + Medigap, that's a good conversation to have with APPRISE before December 7.

When your new coverage starts

Any valid election made between October 15 and December 7, 2026 takes effect January 1, 2027. If you make more than one change in the window, the last one on file wins. You'll get a new member ID card from the plan before coverage begins; keep your red, white, and blue Medicare card either way.

If January rolls around and your Medicare Advantage choice doesn't feel right, there's a second window — the Medicare Advantage Open Enrollment Period, January 1 – March 31, 2027 — when people already in a Medicare Advantage plan can switch once or drop back to Original Medicare.

What's changing in Philadelphia for 2027

In Philadelphia County, 13 Medicare Advantage plans are new for 2027, 12 are not returning, and 9 have been renamed. If one of your plans is leaving, your carrier is required to mail a non-renewal notice; that notice also triggers a Special Enrollment Period so you have more time to pick a replacement. For plans that are continuing, the ANOC — the booklet that arrives in September — spells out next year's premium, deductible, drug formulary, and provider network changes.

The table below lists every 2026 Medicare Advantage plan available in Philadelphia County, grouped by carrier (Aetna, Blue Cross Blue Shield (HCSC), Centene (WellCare), Clover Health, Devoted Health, Geisinger Gold, Highmark, Highmark Wholecare Medicare Assured, Humana, Independence Blue Cross, Jefferson Health Plans, Perennial Advantage, Provider Partners Health Plans, UnitedHealthcare, UPMC for Life, UPMC for Life Complete Care, and VISTA Health Plan). Use it as a starting point, not a shortlist — a plan is only "right" if it covers your doctors, hospitals, and prescriptions.

The 2027 numbers CMS has already set

A few program-level figures for next year are confirmed:

• Part D out-of-pocket cap: $2,400 in 2027 (up from $2,100 in 2026). Once your out-of-pocket spending on covered drugs hits that cap, you pay $0 for covered Part D drugs the rest of the year.
• Part D maximum deductible: $700 in 2027 (up from $615 in 2026). Individual plans may set a lower deductible.
• Part D national base beneficiary premium: $41.33 for 2027. This is a formula input Medicare uses; it is not what any specific plan charges.

The Medicare Prescription Payment Plan — the option to spread drug costs across the year in level monthly bills instead of paying at the pharmacy — continues in 2027. Any Part D or Medicare Advantage drug plan has to offer it if you ask.

The 2027 Part B standard premium and deductible and the 2027 IRMAA income brackets have not been announced yet. CMS typically releases those figures in the fall, usually in November. We'd rather wait and tell you the real numbers than guess.

Where to get unbiased help in Philadelphia

Three places give trustworthy, no-sales-pitch help:

• APPRISE, Pennsylvania's State Health Insurance Assistance Program (SHIP). Trained volunteers help with plan comparisons at no cost. Call the Philadelphia Corporation for Aging's APPRISE line at 215-765-9040, or the statewide line at 1-800-783-7067.
• Medicare.gov Plan Finder. Enter your ZIP code and your prescriptions to see 2027 plan details once they load this fall.
• 1-800-MEDICARE (1-800-633-4227), 24 hours a day, seven days a week.

Steer clear of anyone who shows up uninvited or pressures you to decide on the spot. CMS marketing rules prohibit unsolicited door-knocks and cold calls about Medicare Advantage and Part D.