Medicare Part D 2027: Anyone shopping for Medicare Part D 2027 coverage faces a thinner market than last year. Open enrollment started today, October 15, and KFF’s early review of plan data shows the number of standalone drug plans dropping about 13 percent, from 360 to 312. KFF also found that no standalone plan will be available at a $0 premium for people who do not get Extra Help. In 2026, 28 percent of those enrollees could still find one. Wellcare plans offer the lowest advertised premiums, starting near $5.30 and $7.30 a month in many regions. Humana is the only company selling three standalone plans in all 34 regions. CMS says the average standalone premium moves only from $35.09 to $36, but averages hide plan-level jumps. Your current plan may have changed its formulary, its pharmacy network or its price, so check the notice mailed to you in September. We will be updating this article monthly.
The second piece of news is good for people who take expensive brand drugs. On January 1, 2027, Medicare’s first big negotiated prices for 15 drugs take effect, including Ozempic, Wegovy and Rybelsus, listed at $959 for a month in 2024 and set at $274 under the deal. CMS projects savings of about $12 billion, and roughly 5.3 million people used these drugs in 2024. The 2027 benefit also raises the maximum standard deductible to $700 and the yearly out-of-pocket cap to $2,400, so higher cost sharing will arrive alongside the lower prices. Which effect wins for you depends on your medications. This guide covers premiums, the cap, the monthly payment option, Extra Help, penalties, enrollment dates and a calculator you can use before the December 7 deadline.
Medicare Part D 2027 Key Highlights
| Item | 2026 | 2027 |
|---|---|---|
| Open enrollment | Oct 15 to Dec 7, 2025 | Oct 15 to Dec 7, 2026 |
| Maximum standard deductible | $615 | $700 |
| Yearly out-of-pocket cap | $2,100 | $2,400 |
| National base beneficiary premium | $38.99 | $41.33 |
| Average standalone plan premium | $35.09 | $36.00 |
| Average Part D premium in Advantage plans with drugs | $11.32 | $7.00 |
| Standalone plans nationwide | 360 | 312 |
| Premium stabilization subsidy | In effect | Ended |
| Negotiated prices | 10 drugs | 25 drugs (15 new, effective Jan 1) |
Medicare Part D 2027 Costs: Deductible, Coinsurance and the Out-of-Pocket Cap
The standard Part D benefit has three stages. First comes the deductible, which is $700 at most in 2027. Many plans set a lower deductible, and some waive it, and most generic drugs and covered insulins are excluded from it. Second comes initial coverage, where you generally pay 25 percent of the drug price. Third comes catastrophic coverage, which begins once your own spending reaches $2,400. After that, you pay nothing for covered drugs for the rest of the year.
Two quick examples show how this plays out. Suppose your plan prices your medications at $500 a month, or $6,000 a year. You pay the $700 deductible, then 25 percent of the remaining $5,300, which adds $1,325. Your yearly drug spending is $2,025, short of the cap. Now suppose the plan prices your drugs at $10,000 a year. You reach the $2,400 cap once total drug costs hit about $7,500, and the plan covers the rest.
Two limits are worth remembering. The cap counts only what you and certain others pay for covered drugs, so premiums do not count toward it. And a plan can charge flat copays instead of the standard percentage, which may beat the standard benefit before the cap but cannot push the cap above $2,400.
Behind the scenes, the cost pressure is real. The national average monthly bid amount for 2027 is $296.05, about 24 percent higher than this year. CMS set the national base beneficiary premium at $41.33, the maximum 6 percent increase allowed by law. The base premium is a benchmark used to price plans, not what you pay, but it also drives the late enrollment penalty. CMS ended the Premium Stabilization Demonstration after 2026. That program paid about $9.8 billion to standalone plans across 2025 and 2026 and capped how much each plan could raise premiums. Without it, plan prices follow the market more closely.
Higher earners pay more. The income-related monthly adjustment amount adds a Part D surcharge on top of the plan premium. For 2026 it runs from $14.50 to $91 a month, and Medicare bills you directly for it even if your employer pays the plan premium. CMS usually releases 2027 income brackets in November, so use 2026 amounts as a planning floor.
Medicare Plans 2027: What Changes on January 1 and What You Will Pay
Negotiated Drug Prices Start January 1, 2027
The most concrete savings story of the year is price negotiation. CMS selected 15 drugs for the second round, and their negotiated prices apply from January 1, 2027. The agency estimates about $12 billion in savings for Medicare, and the drugs made up roughly 15 percent of gross Part D drug spending in 2024, or about $42.5 billion. Because your coinsurance is a share of the price the plan pays, a lower negotiated price can lower what you pay at the counter.
| Drug | Used for | 2024 list price | 2027 negotiated price | Approximate cut |
|---|---|---|---|---|
| Ozempic, Rybelsus, Wegovy | Diabetes and weight management | $959 | $274 | 71 percent |
| Trelegy Ellipta | Asthma and COPD | $654 | $175 | 73 percent |
| Xtandi | Prostate cancer | $13,480 | $7,004 | 48 percent |
| Linzess | Digestive conditions | $539 | $136 | 75 percent |
| Breo Ellipta | Asthma and COPD | $397 | $67 | 83 percent |
| Tradjenta | Diabetes | $488 | $78 | 84 percent |
| Janumet, Janumet XR | Diabetes | $526 | $80 | 85 percent |
| Otezla, Otezla XR | Psoriasis | $4,722 | $1,650 | 65 percent |
Prices are per 30-day supply, and the percentage cuts are our own arithmetic from the published list and negotiated prices. Cuts to list price do not mean your bill falls by the same share. Your plan decides which tier each drug sits on, and pharmacies and plans may not pass through every saving. Ask your plan how each of your brand drugs will be priced in 2027.
Reports also describe a separate 18-month GLP-1 Bridge pilot that lets Part D members reach some weight-loss drugs for a $50 monthly copay outside normal Part D payment. Rules may change, so confirm eligibility with Medicare before relying on it. Covered insulin continues to be limited to $35 for a month’s supply.
Fewer Standalone Plans, More Special Needs Plans
The market has been shrinking for two years. IPD Analytics counted 464 standalone plans in 2025 and 360 in 2026, a drop of 104. Over the same period, Advantage plans with drug coverage fell from 3,642 to 3,321, while special needs plans with a drug component grew from 1,466 to 1,769. Standalone enrollment rose by about 1.55 million between 2025 and March 2026 as people from closed plans moved to remaining ones, while enrollment in regular Advantage drug plans fell by about 786,000.
Now KFF reports another round of cuts for 2027. HealthSpring Extra and SilverScript Choice are leaving several regions, and plans sold under the AARP name by UnitedHealthcare, which cover more than 2 million people, are expected to see premium increases. The analysis points to rising drug prices, the richer Part D benefit under the 2022 law and growing GLP-1 use as pressure points. KFF’s Juliette Cubanski summed up the advice in plain terms: it will pay to shop around, and you should look past the premium at formulary, copay and coinsurance changes.
Advantage drug plans tell a different story. CMS says the average Part D premium inside an Advantage plan with drugs falls from $11.32 to $7 after rebates, and 5,532 Advantage plans will be offered, 21 fewer than in 2026. CMS expects about 80 percent of Advantage members to keep their current plan at the same or a lower premium. The trade-off is network rules, because Advantage plans use provider networks and prior authorization for medical care. Compare the whole package, not only the drug premium.
Medicare Prescription Payment Plan 2027: How the Monthly Bills Work
The Medicare Prescription Payment Plan is a free, voluntary option that spreads your out-of-pocket drug costs across the calendar year. It does not lower your total costs. Every Part D plan and every Advantage plan with drug coverage must offer it. You stop paying the pharmacy for covered drugs, and the plan bills you monthly instead. Missing a payment carries no interest or fees, but if you do not pay by the reminder’s deadline you are removed from the program.
Here is how the bill is figured, following Medicare’s own 2027 example. Your first monthly bill is the smaller of that month’s actual costs or the maximum possible payment, which is the cap minus what you already paid, divided by the months left. After that, each bill equals your new costs plus your remaining balance, divided by the months left in the year. Take someone with $600 a month in drug costs who joins in January. The bills are $200 in January, $90.91 in February, $150.91 in March and $217.58 in April. The cap is reached after April, and the bill settles at $217.57 a month through December. The total comes to $2,400.
The program renews automatically each year unless you change plans or opt out, and switching plans ends your participation, so you must sign up again with the new plan. Contact your plan any time during the year to join. Joining earlier gives you more months to spread costs. It is most useful if you take costly brand drugs, and less useful if your yearly drug costs are low or steady, or if you qualify for Extra Help.
Extra Help 2027: Income and Resource Limits
Extra Help, also called the Part D low-income subsidy, lowers or removes premiums and deductibles and caps copays. Medicare has said that people with Extra Help pay a $0 plan premium and $0 deductible in 2027 on benchmark plans, subject to program rules. Official 2027 income and resource limits have not been published yet. They are normally released in late October or early November, so check the Social Security Administration page before you apply.
| Extra Help limit (confirmed for 2026) | Individual | Married, living together |
|---|---|---|
| Resource limit | $16,590 | $33,100 |
| Resource limit with burial exclusion | $18,090 | $36,100 |
| Annual income limit | $23,475 | $31,725 |
| Maximum generic copay | $5.10 | $5.10 |
| Maximum brand-name copay | $12.65 | $12.65 |
Because KFF found no $0-premium standalone plans for people without Extra Help, a successful application is worth more in 2027 than before. People who already get Medicaid, Supplemental Security Income or help from a Medicare Savings Program generally qualify automatically. Apply through SSA if you think you may be eligible, and a SHIP counselor can help you fill out the form for free.
Medicare Enrollment Starts Today: Key Dates, 2027 Costs and How to Switch Plans Before December 7
Medicare and ACA Open Enrollment 2027 Dates: Full Calendar, Deadlines and What’s Changing
Medicare Part D Late Enrollment Penalty in 2027
If you go 63 days or more in a row without Part D or other creditable drug coverage after you first become eligible, a late enrollment penalty is added to your premium. It equals 1 percent of the national base beneficiary premium for every month you went without. At the 2027 base premium of $41.33, that works out to about $0.41 per month of delay, rounded to the nearest ten cents. You pay it for as long as you have Part D. Someone who waited 30 months would owe roughly $12 extra a month. If you have employer or union drug coverage, ask the plan for written proof that it is creditable.
Medicare Part D Enrollment Dates and Deadlines
| Date | What happens |
|---|---|
| October 15, 2026 | Open enrollment begins and Medicare Plan Finder shows 2027 plans |
| November 2026 | CMS expected to publish Part B figures, income brackets and Extra Help limits |
| December 7, 2026 | Open enrollment ends. Your last choice counts |
| January 1, 2027 | New Part D plan year, $700 deductible limit, $2,400 cap and negotiated prices begin |
| January 1 to March 31, 2027 | Advantage members can switch plans once, but this period does not let people in Original Medicare add a standalone drug plan |
| Any time in 2027 | Join the Medicare Prescription Payment Plan through your plan |
How to Apply for Medicare Part D 2027
You can join, drop or switch a Part D plan during open enrollment. If you are new to Medicare, your Initial Enrollment Period lasts seven months around your 65th birthday and includes the chance to join a drug plan. People with Extra Help can generally switch standalone drug plans more often than once a year, so ask your plan or 1-800-MEDICARE about your options.
Follow these steps:
- Read the Annual Notice of Change from your current plan. It lists your 2027 premium, deductible, formulary changes and pharmacy network.
- Log in to your Medicare account and open Medicare Plan Finder. Enter every medication, the dose and your pharmacy.
- Sort plans by total estimated yearly cost, which combines premiums and expected drug spending, not just by premium.
- Check whether your drugs need prior authorization, step therapy or quantity limits.
- Confirm the plan’s preferred pharmacies, since using one often lowers copays.
- Enroll online through Plan Finder, call the plan or call 1-800-MEDICARE (1-800-633-4227).
You can also get free one-on-one help from your State Health Insurance Assistance Program.
Part D Enrollment Processing Time
No single official processing time covers every enrollment, so treat these as typical rather than promised. Choices made by December 7 are designed to start on January 1, 2027. After you enroll, the new plan normally sends a confirmation notice and a member card before the new year. If nothing has arrived by mid-December, call the plan and ask for written confirmation. Applications for Extra Help are handled by SSA, and the decision time can vary, so apply as early as you can and keep copies of what you submit.
Part D Payment Schedule: How and When You Pay
- Plan premium: paid to the plan by monthly bill or bank draft, or withheld from your Social Security payment if you choose.
- Part D income surcharge: billed directly by Medicare, not by the plan.
- Pharmacy costs: paid at the counter as you fill prescriptions, unless you join the Prescription Payment Plan.
- Prescription Payment Plan: your plan sends monthly bills for the drug costs you chose to spread out.
- First 2027 premium: due with the January billing cycle, and any premium withheld from Social Security starts in January.
Medicare Open Enrollment 2026-27 Dates and the New Rule Changes Behind Them
Medicare Open Enrollment Changes, Who Must Switch and How to Compare Plans
Medicare Part D Cost Calculator for 2027
Use the calculator below to test your own numbers. Enter your plan premium, deductible, coinsurance and expected yearly drug costs. It estimates your 2027 out-of-pocket drug costs, tells you whether you reach the $2,400 cap, and shows a month-by-month schedule if you join the Medicare Prescription Payment Plan. Replace the default values with your plan’s real numbers from Plan Finder.
Medicare Part D 2027 Drug Cost Calculator
Planning estimate using the standard benefit: deductible, coinsurance, then a $2,400 yearly cap. Use your own plan’s numbers from Medicare Plan Finder.
Official Medicare Part D Websites and Phone Numbers
| Resource | Use it to | Link |
|---|---|---|
| Medicare Plan Finder | Compare 2027 drug plans and costs | https://www.medicare.gov/plan-compare |
| MyMedicare login | See saved drugs, pharmacies and coverage | https://www.mymedicare.gov |
| Medicare drug costs page | Learn how drug coverage works | https://www.medicare.gov/basics/costs/help/drug-costs |
| Prescription Payment Plan guide | Read the official explanation and examples | https://www.medicare.gov/publications/12211-whats-the-medicare-prescription-payment-plan-.pdf |
| SSA Extra Help page | Apply for Extra Help | https://www.ssa.gov/medicare/part-d-extra-help |
| CMS 2027 state fact sheets | See plan data by state | https://www.cms.gov/files/document/2027-medicare-advantage-part-d-landscape-state-state-fact-sheets.pdf |
| CMS newsroom | Read official announcements | https://www.cms.gov/newsroom |
| SHIP locator | Free local counseling | https://www.shiphelp.org |
| 1-800-MEDICARE | Phone help | 1-800-633-4227 |
Medicare Part D 2027 FAQs
What is the Medicare Part D deductible for 2027?
The maximum standard deductible is $700, up from $615. Your plan may charge less or nothing.
What is the Part D out-of-pocket cap for 2027?
It is $2,400, up from $2,100. After you reach it, covered drugs cost nothing for the rest of the year.
When is Part D open enrollment for 2027?
It runs from October 15 to December 7, 2026. Changes start on January 1, 2027.
Will Part D premiums go up in 2027?
The average standalone premium is projected to rise from $35.09 to $36, but your plan could rise more. KFF expects higher premiums across standalone plans for people without Extra Help.
Which drugs get new negotiated prices in 2027?
Fifteen drugs, including Ozempic, Wegovy, Rybelsus, Trelegy Ellipta, Xtandi, Linzess, Otezla and Janumet. Prices apply from January 1.
Does the Prescription Payment Plan save money?
No. It spreads the same costs across the year, so it helps cash flow, not the total.
Is there still a coverage gap in Part D?
No. The donut hole ended, and the cap now limits your yearly drug spending.
Can I switch Part D plans after December 7?
Usually not. Special enrollment periods exist for events such as moving or losing coverage, and people with Extra Help generally have more flexibility. Advantage members can make one change between January 1 and March 31.
Is Medicare Part D mandatory?
No, but going without creditable drug coverage can trigger a lifelong penalty when you enroll later.
How much does Part D cost per month in 2027?
The average standalone premium is about $36, but plans range widely. Advantage plans with drugs average about $7 for the drug portion. Higher earners pay an extra monthly surcharge.
Conclusion
Medicare Part D 2027 asks you to weigh two forces pulling in opposite directions. Negotiated prices on 15 high-cost drugs and a hard $2,400 cap protect you from the worst bills, while a higher deductible, fewer standalone plans and the end of the premium subsidy raise the odds that your current plan costs more. The safest path is simple. Open your Annual Notice of Change, enter every medication into Plan Finder, compare total yearly cost and decide before December 7. If your income is limited, apply for Extra Help as soon as the 2027 limits post. We will keep this page updated as CMS releases new figures.
