Medicare Open Enrollment runs from October 15 through December 7, 2026. Whatever you pick takes effect January 1, 2027.
You may not need to change anything. If your plan still covers your doctors and your drugs, staying put is a fine choice. But take ten minutes to check. Alabama has more plans this year, but fewer are open to you than the headline number suggests. And two Medicare drug limits went up.
Alabama has 113 plans, but only 65 are open to anyone
Alabama went from 98 Medicare Advantage plans to 113. Only 65 of them are open to anyone. The other 48 are Special Needs Plans.
CMS counts 113 Medicare Advantage plans in Alabama for 2027. That number includes Special Needs Plans, which you can join only if you fit a certain group. Of Alabama's 48, 28 are for people who also have Medicaid, 17 are for people with certain chronic conditions, and 3 are for people who need nursing home level care.
Plans are also sold county by county. No Alabama county has all 113.
Alabama Medicare Advantage plans, 2027
| Area | All plans | Open to anyone |
|---|---|---|
| Alabama, statewide | 113 | 65 |
| Mobile County | 79 | 46 |
| Jefferson County | 78 | 43 |
| Madison County | 76 | 43 |
| Tuscaloosa County | 32 | 21 |
Scroll the table sideways to see every column.
Counted from the CMS CY2027 Landscape file. The gap between the two columns is Special Needs Plans, which have eligibility rules.
Mobile County has the most plans in the state, 79, with 46 open to anyone. Jefferson County has 78 and 43. Madison County has 76 and 43. Tuscaloosa County has the fewest of any Alabama county: 32 plans, 21 of them open to anyone.
Even 21 is a lot to sort through. The real work is narrowing your county's list to the plans that cover the doctors you see and the drugs you take. That often leaves just a few worth comparing.
Premiums went down, but two drug numbers went up
Alabama's average Medicare Advantage premium fell from $11.25 to $7.76. The Part D out-of-pocket cap rose from $2,100 to $2,400.
On average, premiums are going down for 2027. In Alabama, the average Medicare Advantage premium went from $11.25 to $7.76 a month, according to CMS's 2027 state fact sheet. Nationally, CMS projects the average to fall from $14.37 to $12.00.
But the premium is only part of what you pay. Two drug numbers moved the other way. CMS sets both for Medicare's standard drug benefit.
Medicare's standard Part D benefit, set by CMS
| What it is | 2026 | 2027 |
|---|---|---|
| Highest deductible Medicare allows | $615 | $700 |
| Out-of-pocket cap, after which you pay $0 for covered drugs | $2,100 | $2,400 |
Scroll the table sideways to see every column.
These are program limits, not what any one plan charges. Some plans have a lower deductible or none. Your Annual Notice of Change lists your own plan's numbers.
The cap is the one to watch. Once your out-of-pocket drug costs reach it, you pay nothing more for covered drugs that year. What you pay toward your deductible counts toward the cap. If you reach the cap every year, 2027 can cost you up to $300 more than 2026, before you count a single premium.
If your drug costs are modest, this will not touch you. If you take a costly brand-name drug and hit the cap by spring, it is the most important number in this article.
Drug plans: two in three Alabama enrollees can find a lower premium
Alabama has 11 standalone drug plans for 2027. About two in three people in one can find a lower premium than they pay now.
CMS ran a temporary program called the Part D Premium Stabilization Demonstration. It was meant to steady standalone drug plan premiums, and it ends after 2026. Nationally, CMS projects the average standalone drug plan premium to go from $35.09 to about $36. Averages hide a lot, though. Here is Alabama.
Standalone Part D drug plans in Alabama, 2027
| What CMS reports | Alabama |
|---|---|
| Standalone drug plans available | 11 |
| Share of enrollees who can get a lower premium than in 2026 | 67.98% |
| Share of enrollees who get Extra Help | 28.45% |
Scroll the table sideways to see every column.
From CMS's 2027 state fact sheet. CMS measures the premium only, not your total drug costs.
If you have a standalone drug plan and plan to let it renew, look first. About two in three Alabama enrollees can find a lower premium. A lower premium is not the same as a cheaper year, so check that your drugs are on the new plan's list, and at what tier.
Open Enrollment is not the window for a Medicare Supplement
October 15 to December 7 covers Medicare Advantage and Part D drug plans. A Medicare Supplement runs on its own rules.
Mixing these up can be costly.
What you can do between October 15 and December 7: join, switch, or drop a Medicare Advantage plan, join, switch, or drop a Part D drug plan, and move between Original Medicare and Medicare Advantage. That is the list.
What this window does not do: give you a right to buy a Medicare Supplement, also called Medigap. Your Medigap Open Enrollment Period happens once. It is the six months that start the first month you are 65 or older and have Part B. Federal law also gives you a guaranteed right to buy in certain cases. Two examples: your Medicare Advantage plan leaves your area, or you joined a Medicare Advantage plan when you first got Medicare and leave within the first year. Outside those cases, an Alabama insurer can ask health questions and turn you down.
Two more Alabama rules are worth knowing. If you are under 65 and have Medicare because of a disability, Alabama does not guarantee you a Medigap policy. Your six-month window opens when you turn 65. And an insurer cannot change its Medigap rates in Alabama until the state Department of Insurance approves them.
What to do between now and December 7
Four checks, in this order. The first one is already in your mailbox.
If you plan to stay in your plan, read what changed first.
- Read your Annual Notice of Change. Your plan had to get it to you by September 30. It lists what changes for 2027: premium, copays, deductible, and drug list. If you did not get one, call your plan.
- Check that your drugs are still covered the same way. Drug lists can change each year. A drug can move to a higher tier and cost you more, even if your premium went down.
- Check that your doctors are still in network. Medicare Advantage networks are local, and they can change. People often find out in January, when it is harder to fix.
- Compare total cost among the plans in your county. Premium plus deductible plus what your prescriptions cost. A $0 premium plan is not free if it puts your daily drug on a higher tier.