Open enrollment begins Oct. 15. Local counselors say the most common mistake is assuming this year’s coverage will work the same way next year.

Roanoke, VA

Author: Roanoke Rambler Staff, Tina Charisma Lead

Published: 12:01 AM EST October 7, 2026

Edited: 12:01 AM EST October 7, 2026

Listen Here: Roanokesradio.com

For people with Medicare, keeping the same insurance card in 2027 does not necessarily mean keeping the same costs or coverage. A plan’s premium can change. A prescription may cost more at a familiar pharmacy. A doctor or hospital may no longer be in a Medicare Advantage plan’s network. Those are the details Roanoke-area residents need to check during Medicare’s annual open-enrollment period, which runs from Oct. 15 through Dec. 7. Changes made during that period take effect Jan. 1.

Counselors with the Virginia Insurance Counseling and Assistance Program, or VICAP, which operates locally through the Local Office on Aging, helped more than 600 people in the Roanoke area during last year’s enrollment season.

“Last year we assisted over 600, but we always hope to go beyond that goal,” said Robbie A. Boyd, the Local Office on Aging’s director of operations.

Boyd said one of the most common mistakes is renewing automatically. Beneficiaries may not check whether their current plan’s premium has changed or update their medication lists to confirm that each drug is still covered and compare its cost. A plan that was the least expensive choice when someone enrolled may no longer be the least expensive for the prescriptions they take now.

Start with the Letter from your Plan

People enrolled in a Medicare Advantage or Part D prescription drug plan should receive an Annual Notice of Change this fall. It explains changes to the plan’s costs and coverage that take effect in January.

Boyd said some residents have already seen Part D premium increases in their notices. Counselors are still waiting for a complete picture of 2027 changes. A temporary federal program that helped limit premium increases for some stand-alone drug plans is scheduled to end after 2026.

Boyd said he could not yet say whether any plans are leaving the Roanoke market, shrinking their service areas or changing provider networks for 2027. He also could not yet say whether Carilion physicians, LewisGale facilities or local specialists are leaving any networks.

That uncertainty makes it especially important to check a plan’s documents rather than assume a doctor, hospital or prescription will remain covered. Residents in Medicare Advantage plans should look up their physicians and specialists and confirm that the facilities they use will be in network next year. When calling a provider’s office, ask about the specific 2027 plan, not just the insurance company’s name. Different plans from the same insurer can have different networks.

Compare the Whole Year, Not Just the Premium

A lower monthly premium does not always mean lower overall costs. A person who takes several medications may find that another plan costs less over the year once drug prices and pharmacy costs are included.

Before comparing plans, write down every prescription, its dosage and how often it is filled. Check whether each drug is covered, what it is expected to cost and whether your pharmacy is preferred by the plan. Medicare’s Plan Compare tool lets users enter their medications and pharmacies to estimate costs across available plans.

For Medicare Advantage, compare medical costs as well: the deductible, charges for visits and procedures, and the plan’s annual limit on out-of-pocket spending for covered medical services.

Boyd said weight-loss prescriptions are the medication issue causing residents the most trouble. Coverage can depend on the drug, the reason it is prescribed and whether a person qualifies for a separate Medicare program.

What Changes in 2027?

The federal government has set the 2027 Part D out-of-pocket threshold at $2,400, up from $2,100 in 2026. The deductible for the defined standard Part D benefit rises from $615 to $700, though an individual plan may charge less. These figures concern covered Part D drugs; they do not cap premiums or other medical spending.

Negotiated Medicare prices for another 15 drugs are scheduled to take effect Jan. 1, 2027. The list includes Ozempic, Rybelsus and Wegovy. A negotiated price is the maximum price available to Medicare drug plans for a selected drug; it does not mean every person taking that medicine will pay that amount at the pharmacy counter.

Separately, the Medicare GLP-1 Bridge gives eligible Part D enrollees access to certain weight-loss medications for a $50 monthly copay through Dec. 31, 2027. Participants must meet clinical criteria. The program operates outside the regular Part D benefit, so the $50 payments do not count toward the $2,400 threshold, and Extra Help does not reduce them. Having Part D does not automatically qualify someone.

Free Help is Available in Roanoke

VICAP counseling is free and confidential. According to the Local Office on Aging, its counselors do not sell insurance or represent insurance companies or medical providers.

Boyd said counselors remain unbiased by showing beneficiaries the three leading options for their circumstances and leaving the choice to them.

Bring your Medicare card, a list of medications with dosages, the name of your pharmacy and any letters from your current plan or employer-sponsored coverage. Caregivers can attend or book an appointment for a parent or relative. Boyd said counselors can assist people in person with many needs, including limited internet access.

The Local Office on Aging will operate an open-enrollment counseling center at Valley View Mall, on the upper level outside the former Sears space. It will be open Monday through Thursday, 11 a.m. to 3 p.m., from Oct. 15 through Dec. 7, and closed Fridays, major holidays and Thanksgiving week. Walk-ins are welcome, but appointments are recommended. Boyd said most people with appointments wait about 10 minutes. To schedule, call (540) 345-0451 and select Option 4, or email Delaine Caldwell at dcaldwell@loaa.org.

People struggling to afford coverage can ask whether they qualify for Extra Help, which assists with Part D costs, or a Medicare Savings Program, which may help pay Medicare premiums and, for some people, other costs. Boyd said the agency does not have an estimate of how many eligible local residents have not yet enrolled.

Counselors also warn about television advertisements that seem to promise financial benefits to everyone. Boyd said these ads can mislead viewers about assistance for which they may not qualify. Before responding to an ad or changing coverage, residents can compare plans on Medicare.gov, call 1-800-MEDICARE or talk with a VICAP counselor.

Help does not end on Dec. 7. Boyd said residents who discover in January that a doctor or medication is not covered can return for help understanding claims and exploring other options. People already enrolled in Medicare Advantage also have an opportunity to make one plan change between Jan. 1 and March 31.

Counseling is not limited to open enrollment. People approaching 65 can get guidance on when and how to sign up for Medicare by calling (540) 345-0451 and asking for a health insurance counselor.

The most important step is to review the coverage you will actually have in 2027, checking your current doctors, medications and pharmacy, before the Dec. 7 deadline.

The Roanoke Rambler