Medicare Advantage

Six new Medicare Advantage plans land in Durham for 2027: how to check one before you switch

For 2027, Durham is looking at 69 Medicare Advantage plans: 6 new, 11 gone since 2026, and 25 still here but changed on premium, deductible, plan type or name, 9 of them under a new name. Below, how the lineup shifted in Durham County and what to compare, with no plan ranked or recommended.

DURHAM, N.C. — For the plan year that starts Jan. 1, 2027, six Medicare Advantage plans are brand new to Durham County, joining a lineup that already includes dozens of returning choices. If one of those new plans catches your eye during this fall's Annual Enrollment Period, there is a specific way to vet it — because a plan in its first year has no local track record to lean on.

What Medicare Advantage plans are new in Durham for 2027?

Six Medicare Advantage plans are new in Durham County for 2027, out of 69 plans being offered there. Three carriers are adding them: Humana (3), PruittHealth Premier (1) and UnitedHealthcare (2). Durham sits in Durham County, and Medicare plan availability is set at the county level, so these are the plans that any Medicare-eligible resident of the county can consider during the fall enrollment window.

In alphabetical order by carrier, the new plans are:

• Humana Gold Plus Giveback H1036-343 (HMO-POS) — with drug coverage
• Humana Gold Plus H1036-137 (HMO-POS) — with drug coverage
• HumanaChoice H7617-122 (PPO) — with drug coverage
• PruittHealth Premier (HMO I-SNP) — with drug coverage
• UHC Dual Complete NC-Q2 (HMO-POS D-SNP) — with drug coverage
• UHC Dual Complete NC-S3 (HMO-POS D-SNP) — with drug coverage

The table on this page lists every 2027 Medicare Advantage plan in Durham County, new and returning, so you can see the full field.

Which of the new Durham plans are Special Needs Plans, and what does that mean?

Three of the six new plans in Durham County for 2027 are Special Needs Plans (SNPs): the PruittHealth Premier (HMO I-SNP) and the two UHC Dual Complete entries (HMO-POS D-SNP). SNPs are not open to everyone. A D-SNP serves people who have both Medicare and full or partial Medicaid, and an I-SNP serves people who live in (or need the level of care provided in) a nursing home or similar facility. If you do not meet the eligibility rules, you cannot enroll in that plan — even if it is being offered in your county.

The other three new plans — the two Humana Gold Plus HMO-POS plans and HumanaChoice H7617-122 (PPO) — are general-enrollment Medicare Advantage plans. All six of the new plans include Part D prescription drug coverage.

How does a new plan differ from a renewing one?

A renewing plan has history: it has been offered in the county before, has had members using its network and drug list, and has a CMS Star Rating based on past performance. A new plan has none of that yet. Star Ratings for a brand-new plan are not available in its first year, so you cannot compare it that way.

That is a factual difference, not a reason to avoid new plans or chase them. It just means your homework matters more. Instead of leaning on last year's reputation, you have to check the plan's own documents and the Plan Finder for how it would actually work for you in 2027.

How do I check a new plan against my doctors and prescriptions before Dec. 7?

Use the official Medicare Plan Finder at medicare.gov, or call 1-800-MEDICARE. Both are free and show the same plan data CMS publishes. For each plan you are considering — new or returning — do these four checks:

1. Enter your ZIP code and pull up the 2027 plans for Durham County. 2. Add your prescriptions by name and dose. The tool will show how each plan covers them and the pharmacies where costs are lowest. 3. Search the plan's provider directory (linked from the Plan Finder, or on the carrier's site) for every doctor, specialist and hospital you want to keep. For a PPO, confirm whether they are in-network; for an HMO or HMO-POS, in-network status is usually required for routine care. 4. Open the plan's Summary of Benefits and, if you want the fine print, its Evidence of Coverage. These are the documents that govern what the plan actually pays for.

If your current plan is renewing, read its Annual Notice of Change (ANOC), which was mailed in September. It spells out exactly what is changing for 2027 — premium, drug tiers, network, extras — so you can compare apples to apples.

What else should Durham residents know about the 2027 enrollment window?

The Annual Enrollment Period runs Oct. 15 – Dec. 7, 2026, and any change you make takes effect Jan. 1, 2027. If you do nothing, your current plan renews for 2027 as described in its ANOC — assuming it is still being offered. In Durham County, 11 plans are not returning for 2027 and 9 have been renamed, so even longtime members should at least open the mail from their carrier.

A few 2027 program figures CMS has already confirmed and that apply to Part D drug coverage inside any Medicare Advantage plan with drugs:

• Part D out-of-pocket cap: $2,400 in 2027 (up from $2,100 in 2026).
• Part D maximum deductible: $700 in 2027 (up from $615 in 2026).
• Part D national base beneficiary premium: $41.33 for 2027 (a formula input, not what any plan charges).

The 2027 Part B standard premium and deductible, and the 2027 IRMAA income brackets, had not been published as of early fall 2026. CMS usually announces those in November.