Medicare Advantage
Dec 7 Medicare deadline: 2027 coverage in Sioux Falls
Minnehaha County has 21 Medicare Advantage plans for 2027. Compared with 2026, 6 plans are not coming back, 5 are new, and 15 continuing plans changed in some way you should check before December 7, 5 of them under a new name. This guide covers what those numbers mean for Sioux Falls, not which plan to pick.
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SIOUX FALLS, S.D. — The clock is ticking on Medicare's Annual Enrollment Period, and the choices people make here before December 7 will shape their coverage for all of 2027. The stakes feel bigger than usual: the Part D out-of-pocket cap on prescription drug costs rises to $2,400 in 2027 (up from $2,100 in 2026), and plans across the country are refreshing their formularies, networks, and premiums to match.
Key takeaways
- Medicare's Annual Enrollment Period runs October 15 through December 7, and any changes made during this window start January 1, 2027.
- Starting January 1, 2027, the Part D out-of-pocket cap rises to $2,400, limiting how much people pay for covered prescription drugs each year.
- Which Medicare Advantage and Part D plans are available to you depends on your county, so options can differ even for neighbors in Minnehaha versus Lincoln County.
- Enrolling in a Medicare Advantage plan during this period does not guarantee you can switch to a Medigap policy without medical underwriting, so it's wise to check with a local SHIP counselor first.
If you have Medicare in the Sioux Falls area, here's a plain-English guide to what you can actually do during this window — and how to make sure you don't miss it.
The deadline that matters: December 7
The Annual Enrollment Period runs October 15 through December 7 every year. Any change you make during this window takes effect on January 1, 2027.
Sioux Falls sits in Minnehaha County (with parts of the metro reaching into Lincoln County), and Medicare plan availability is set at the county level. That means the menu of Medicare Advantage and stand-alone Part D plans available to a neighbor a few blocks away could be different from yours if you cross a county line.
What you're allowed to change right now
During AEP, you can:
- Switch from Original Medicare to a Medicare Advantage plan, or vice versa.
- Switch from one Medicare Advantage plan to another.
- Join, drop, or switch a stand-alone Part D prescription drug plan.
- Go back to Original Medicare and pick up a separate drug plan.
What AEP does not guarantee is the right to buy a Medigap (Medicare Supplement) policy without medical underwriting. South Dakota follows federal rules on Medigap guaranteed-issue windows, so if you're thinking about moving between Advantage and Original Medicare + Medigap, call your local SHIP counselor before you make the switch.
What's actually new for 2027
A few program-level changes worth knowing as you compare plans:
- Part D out-of-pocket cap rises to $2,400 in 2027. Once your covered drug spending hits that ceiling, you pay nothing for covered prescriptions the rest of the year. The cap is $2,100 in 2026.
- Part D deductible maximum: $700 in 2027 (up from $615 in 2026). Plans can charge less, but not more.
- The coverage gap ("donut hole") is gone. Since 2025, Part D has three phases instead of four.
- Medicare Prescription Payment Plan. You can opt in to spread your drug costs into predictable monthly payments instead of paying big amounts at the pharmacy counter. It doesn't lower what you owe — it just smooths it out.
- IRMAA thresholds. Higher-income beneficiaries pay an income-related surcharge on Part B and Part D. For 2026, that starts above $109,000 for a single filer (based on 2024 tax returns).
How to compare plans without getting overwhelmed
The most reliable tool is the Plan Finder at medicare.gov. Enter your ZIP code, your prescriptions, and your preferred pharmacies. The tool will show you every Medicare Advantage and Part D plan available in Minnehaha or Lincoln County and estimate your yearly drug costs under each.
A few practical tips:
- Re-check your drug list every year. Formularies change. A medication that was covered cheaply in 2026 may be in a different tier — or dropped — in 2027.
- Confirm your doctors and hospitals. If you're on Medicare Advantage, provider networks in the Sioux Falls area can shift year to year. Call the clinic directly to verify.
- Read your plan's Annual Notice of Change (ANOC). Your current plan mailed you one in September. It spells out exactly what's changing on January 1.
- Understand Star Ratings. CMS rates plans on a 1-to-5 scale based on quality and member experience. It's one data point — not the whole story.
If you miss December 7
You generally have to wait until the next AEP, with two exceptions:
- Medicare Advantage Open Enrollment (Jan. 1 – March 31, 2027) lets people already in a Medicare Advantage plan switch to a different one or drop back to Original Medicare (with a Part D plan). It does not let someone on Original Medicare join Advantage for the first time.
- Special Enrollment Periods apply if you move, lose other coverage, qualify for Extra Help, or hit certain other life events.
By the numbers
Medicare Part B premium, 2006–2026
The standard monthly Part B premium has climbed from $88.50 in 2006 to $202.90 in 2026. Hover any point for that year’s premium.
Source: CMS. Standard premium shown; in some hold-harmless years many existing enrollees paid less. Confirm at Medicare.gov.
By the numbers
How people get Medicare in Minnehaha County
(MA penetration in Minnehaha County)
MA penetration from CMS enrollment data; Medigap share is an estimate. U.S. average is about 54% Medicare Advantage. These are area-level figures, not plan-specific.
Key dates
Medicare enrollment periods at a glance
- Around your 65thInitial Enrollment PeriodA 7-month window around the month you turn 65 — your first chance to sign up.
- October 15 – December 7Annual Enrollment PeriodAnyone with Medicare can join, switch, or drop a Medicare Advantage or Part D plan.
- January 1 – March 31Medicare Advantage Open EnrollmentIf you're already in a Medicare Advantage plan, you can make one change.
- January 1 – March 31General Enrollment PeriodFor people who missed their first chance to sign up for Part B.
- VariesSpecial Enrollment PeriodTriggered by life events like moving or losing other coverage.
Dates are set by Medicare and apply nationwide. Confirm your personal windows at Medicare.gov or 1-800-MEDICARE.
Explore
When can you enroll? An interactive year
Enrollment windows are federal and the same nationwide. Confirm your personal dates at Medicare.gov or 1-800-MEDICARE.
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The parts of Medicare
Good to know
Frequently asked questions
Do I have to do anything if I like my current plan?
I just turned 65. Is AEP my enrollment window?
Where can I get free, unbiased help in Sioux Falls?
- CMS — MA/Part D Landscape & Plan Finder data
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.