By Austin Senior Advisor Care Team · August 28, 2026
Your parent's Medicare plan will mail an Annual Notice of Change by the end of September. For a parent already living in an Austin community, three things in that letter matter more than the premium, and 2027 is a bad year to skip reading it.
The letter that has to arrive by September 30
Sometime in the next month, a thick envelope will arrive for your parent from their Medicare Advantage plan or their stand-alone drug plan. It is called the Annual Notice of Change, and it is not junk mail. Federal rule 42 CFR 422.111(d)(2) requires the plan to notify every enrollee of changes taking effect January 1 at least 15 days before the Annual Enrollment Period opens. Since that period opens October 15, the practical deadline is September 30.
If your parent lives in an assisted living community in Round Rock or Pflugerville or off Bee Cave Road, there is a decent chance you will never see this letter. It goes to the mailing address on file. Sometimes that is still the house you are trying to sell. Sometimes it lands in a stack at the front desk. Nobody at the community is responsible for handing it to you, and nobody will.
The first practical step is boring and worth doing this week: confirm what address the plan has, and confirm whether you are on file as an authorized representative. A plan will not discuss your parent's coverage with you otherwise, and October is a bad month to discover that.
The second is to actually open it. The Annual Notice of Change is written to be skimmed and it works. Premiums are printed in large type. The things that will actually disrupt a person living in care are printed in tables further back.
What the Annual Enrollment Period does and does not let you do
The Annual Enrollment Period runs October 15 through December 7, and anything you change takes effect January 1. During that window you can move from Original Medicare to a Medicare Advantage plan or back, switch between Advantage plans, join or switch or drop a drug plan. It is the broadest set of choices your parent gets all year.
There is a second window, January 1 through March 31, called the Medicare Advantage Open Enrollment Period. It is narrower than families assume. You get one change, and only if your parent is already in a Medicare Advantage plan. If they are in Original Medicare on January 1, that window does nothing for them. You cannot use it to join an Advantage plan, and you cannot use it to switch stand-alone drug plans.
That asymmetry is why December 7 matters. A decision made badly in the fall is mostly locked in until the following January, with a few exceptions.
A move into care can open a separate window of its own, but the rules there are narrower than most families expect and they hinge on whether the building is licensed as a nursing facility. We walked through that separately in the move-in Special Enrollment Period. If your parent moved this year, read that first, because it may mean you are not waiting for October at all.
Why 2027 is a bad year to let the plan auto-renew
Most years, doing nothing is a defensible choice. This year there is a specific reason to look.
On July 28, 2026, CMS announced that it is ending the Part D Premium Stabilization Demonstration at the close of 2026. That demonstration had been subsidizing stand-alone prescription drug plan premiums since 2025 to cushion the transition into the redesigned Part D benefit. CMS concluded that plan sponsors now have enough experience to bid without it, and that the program should return to ordinary market conditions in 2027.
In the same announcement, CMS set the 2027 Part D base beneficiary premium at $41.33, up from $38.99, the maximum permitted under the law's six percent annual cap. The base premium is not what anyone actually pays. Real premiums vary enormously by plan. But the combination of a rising base and the end of a subsidy that was holding stand-alone plan premiums down is a reasonable signal that some drug plans will look different in January than they did last year.
We are not going to publish the 2027 deductible or the 2027 out-of-pocket cap here, because we could not confirm either figure against a primary CMS document. The 2026 figures are on the record: a $615 deductible and a $2,100 annual out-of-pocket cap under the Final CY 2026 Part D Redesign Program Instructions. Your parent's 2027 numbers will be printed in the letter arriving this month. Use that, not a number you found on a comparison site.
Three checks that matter for a parent already living in a community
For someone still driving themselves to a doctor in Westlake, plan shopping is mostly about premiums and copays. For someone in assisted living or a nursing facility, three other things decide whether a plan works.
The drug list. Ask the community for a current medication list. In a licensed facility this is a real document, kept as part of the medication record, and staff can print it. Then check every drug against the plan's 2027 formulary, not the 2026 one. A tier change on a single medication can cost more over a year than the entire premium difference between two plans. Pay particular attention to anything added during a hospital stay this year, because that is what nobody remembers to check.
The pharmacy. Many Austin-area communities contract with a single long-term care pharmacy that delivers, packages doses, and coordinates with the nurse. Your parent may not have a practical choice about where prescriptions are filled. Before switching drug plans, ask the community which pharmacy they use and confirm it is in the new plan's network. A plan with a great formulary and a pharmacy your parent cannot use is not a great plan.
The hospitals. This is the one Austin families underestimate. Medicare Advantage networks are not uniform across this metro. Ascension Seton, St. David's HealthCare, and Baylor Scott & White each contract separately, and a plan change can quietly move which system your parent lands in on a bad night. If your parent has a cardiologist at one system and a surgeon at another, verify both against the specific 2027 plan, by name, before December 7. Our notes on how discharge works at each Austin system may help you decide which relationships you actually need to protect.
Nobody at the community gets to change your parent's plan
This one is worth knowing because it does happen. CMS has issued guidance to long-term care facilities specifically because it kept receiving complaints that nursing facilities and skilled nursing facilities had disenrolled residents from their Medicare health plans without the resident's request, consent, or understanding. Families typically found out later, after discharge, when bills arrived for services they believed were covered.
The rule is unambiguous. Only the beneficiary, their authorized or designated representative, or a party authorized to act for them under state law can request enrollment in or disenrollment from a Medicare health or drug plan. If a facility assists with a change, CMS expects the facility to explain the consequences orally and in writing, to obtain a signed acknowledgement from the resident or representative, and to obtain an attestation from the staff member who helped. If a facility cannot produce that documentation, CMS may cancel the enrollment action and reinstate the original coverage.
That guidance is directed at nursing facilities and skilled nursing facilities, not assisted living. But the underlying principle, that coverage decisions belong to the resident and their representative, is not a nursing-home-only idea. If anyone at any community tells you a plan change is required to stay, or handles the paperwork without a conversation, stop and ask who requested it.
The other protection worth knowing in a nursing facility: when the facility changes what it charges for items and services it offers, residents must be told in writing at least 60 days before the change takes effect. A rate letter that shows up in December for a January increase is not how that is supposed to work. Our page on resident rights in Texas covers the rest.
If your parent has Medicaid or Extra Help, the calendar is different
Roughly speaking, a person who has both Medicare and Medicaid, or who qualifies for Extra Help with drug costs, is not confined to the October window. They get one chance to change an Advantage plan with drug coverage or a stand-alone drug plan during each of three periods: January through March, April through June, and July through September. Each change takes effect the first day of the following month. They can also make a change during Annual Enrollment, effective January 1.
There is a carve-out. That quarterly Special Enrollment Period is not available to someone designated a potential at-risk or at-risk beneficiary under the opioid safety rules. It is unusual, but it exists, and it is the kind of thing a plan will mention only when you try to use the window.
If your parent is close to the line financially and not on Extra Help, applying is free and can be done at any time. Social Security takes the application at secure.ssa.gov/i1020/start or at 1-800-772-1213. People who qualify pay little or nothing for prescriptions and are not charged the Part D late enrollment penalty.
Texas Medicaid and assisted living interact in ways that surprise most families, particularly around what the STAR+PLUS waiver will and will not pay for. That is a separate problem from Medicare plan selection, and we cover it on the STAR+PLUS page.
Where to get free help in Central Texas before December 7
Texas runs its State Health Insurance Assistance Program under the name HICAP, the Health Information, Counseling and Advocacy Program. Counselors help with eligibility, plan comparisons, Medigap, Advantage plans, Part D, complaints, and appeals. It is free, it covers all 254 Texas counties, and it is not selling anything. The Texas Department of Insurance lists the statewide number as 800-252-9240.
Locally, benefits counseling is delivered through the Area Agency on Aging of the Capital Area, run by CAPCOG, which serves Bastrop, Blanco, Burnet, Caldwell, Fayette, Hays, Lee, Llano, Travis, and Williamson counties. Their number is 512-916-6062 or 888-622-9111, and their office is at 6800 Burleson Road, Building 310, Suite 165, in southeast Austin. The Aging and Disability Resource Center at 855-937-2372 is the front door if you are not sure who you need.
Book that appointment in early October rather than late November. Counselors are volunteers and paid staff working a fixed calendar, and the last two weeks before December 7 are the worst two weeks to call anyone about Medicare.
One more option most families never hear about: if a plan in your parent's service area carries an overall quality rating of five stars on Medicare.gov, they can switch into it once at any point between December 8 and November 30 of the following year. It is a narrow door, but it exists outside the normal calendar, and it is the reason a missed December 7 deadline is occasionally recoverable.
If plan mechanics are only part of what you are sorting out, our overview of what Medicare does and does not pay for in senior care is the wider picture, and it is the one most families need first.
