Learn about the new Medicare Advantage rules for 2027, including updates to plan quality ratings, enrollment processes, risk adjustment, payment policies, and prescription drug coverage. This guide explains key changes announced by CMS and what beneficiaries may want to understand when reviewing Medicare Advantage options for the 2027 plan year and preparing for upcoming coverage decisions.
The new Medicare Advantage rules for 2027 include changes affecting plan quality ratings, enrollment processes, payment policies, risk adjustment, and prescription drug coverage. The Centers for Medicare and Medicaid Services finalized several updates intended to improve plan comparisons, strengthen program oversight, and simplify certain administrative requirements. Some changes affect Medicare Advantage organizations more directly than beneficiaries, while others may influence how plans present information and manage benefits. Understanding the finalized rules can help beneficiaries recognize what may change for the 2027 plan year. This guide explains key updates and highlights areas that people may want to review when considering Medicare Advantage coverage.
The Centers for Medicare and Medicaid Services finalized the Contract Year 2027 Medicare Advantage and Part D final rule in April 2026. CMS also released the 2027 Medicare Advantage and Part D Rate Announcement, which finalized payment policies for the year.
The 2027 rules include several policy and technical updates. Some are designed to improve the way Medicare Advantage and prescription drug plans are evaluated, while others affect administrative requirements for plans.
Key areas include:
CMS says the final rule is intended to improve quality and access while streamlining certain processes.
Star Ratings remain an important part of Medicare Advantage because they provide information that can help beneficiaries compare plan quality. The 2027 rules include updates involving Star Ratings measures and related methodologies.
CMS finalized several changes related to how quality performance is evaluated and reported. These changes can affect how plans are assessed and how quality information is presented.
Important areas include:
CMS notes that Star Ratings also influence quality bonus payments and other aspects of Medicare Advantage plan operations.
Another area of the 2027 rules involves enrollment and administrative processes. CMS finalized changes intended to streamline certain requirements and reduce unnecessary administrative work.
Some requirements were also removed or modified. For example, CMS eliminated the requirement for Medicare Advantage plans to send certain midyear notices about unused supplemental benefits. The final rule also changes some requirements involving plan quality improvement programs and utilization management committees.
Beneficiaries may want to pay attention to:
CMS also finalized changes to Medicare Advantage payment policies for 2027. These policies generally affect how Medicare Advantage organizations are paid rather than directly changing a beneficiary's monthly benefits.
For 2027, CMS projects an average increase of 2.48 percent in payments to Medicare Advantage plans, representing more than $13 billion. CMS also decided to continue using the 2024 Medicare Advantage risk adjustment model for 2027 instead of implementing the updated model proposed in the Advance Notice.
These policies involve:
The payment changes do not automatically mean that every beneficiary will experience the same change in premiums, benefits, or out of pocket expenses.
The finalized rules do not mean that every Medicare Advantage plan will change in exactly the same way. Individual plan benefits, provider networks, premiums, drug coverage, and cost sharing can vary.
When reviewing 2027 coverage information, consider checking:
Reading the official plan materials can provide more specific information about individual coverage.