Key takeaways:
Medicare Part D prescription plans will cost more on average in 2027, with increased premiums and a higher out-of-pocket maximum.
Enrollees will have fewer options in 2027, whether they choose a Medicare Advantage plan with prescription coverage or a stand-alone Part D plan.
Part D enrollees could realize savings from the Medicare Drug Price Negotiation program if they are prescribed an included medication or if they qualify for a weight-loss medication at a $50 monthly copay through the Medicare GLP-1 Bridge program.
Medicare enrollees receive prescription medication coverage through Part D. If you have original Medicare (Part A hospital coverage and Part B medical insurance), you must buy a stand-alone Part D prescription plan. Most Medicare Advantage plans, which are private alternatives to Part A and Part B, include Part D coverage.
Typically, Part D costs and benefits change annually. Knowing about these changes can help you make the best choices during the annual Medicare open enrollment period, which is October 15 to December 7. If you have a private plan, you have a second chance to consider whether you want to make changes during Medicare Advantage open enrollment. This is the first 3 months of the year, January 1 to March 31.
Part D is widely used for prescription coverage in the U.S., with more than 57 million enrollees as of July 2026. People eligible for Medicare include adults 65 and older and people of any age with certain disabilities.
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What changes are coming to Medicare Part D in 2027?
Part D shifts for the 2027 coverage year involve costs and coverage options, specifically:
Premium changes, which are your monthly costs for having a prescription plan
Standard deductible, which increases to $700
Out-of-pocket maximum, which increases to $2,400
Fewer prescription plan options for many enrollees
Electronic prior authorization mandate for people with Part D included in Medicare Advantage plans
Coverage restrictions for certain immigrants
Premium changes
A premium stabilization pilot program that provided subsidies and prevented year-over-year plan costs from exceeding $35 will end on December 31, 2026. That means your 2027 Part D premium may be substantially higher. The average monthly premium increase for stand-alone plans in 2027 is 91 cents, according to the Centers for Medicare & Medicaid Services (CMS).
But premiums will increase more than $50 in 2027 for certain stand-alone Part D plans, according to KFF. And unless you receive a low-income subsidy, known as Extra Help, zero-premium Part D plans are not available in 2027. KFF estimates that this change will increase monthly costs in 2027 for 4 million enrollees who had zero-premium plans in 2026.
Certain provisions of the Inflation Reduction Act of 2022 (IRA) were designed to reduce prescription medication costs for Part D enrollees. This included eliminating the donut hole coverage gap as of December 31, 2024. Part D plans are now responsible for a larger share of medication costs. The premium stabilization program was scheduled to last through the end of 2027. But CMS announced an early end to the program effective December 31, 2026.
Standard deductible increase
The standard deductible for Part D plans in 2026 was $615, but this increases to $700 in 2027. Some plans have no deductible. Others will have deductibles in 2027 that are less than $700.
Out-of-pocket maximum increase
The IRA specifically capped annual out-of-pocket costs for Part D enrollees. A Part D enrollee had to spend $8,000 in 2024 to reach the catastrophic phase and pay nothing for covered medications for the rest of the year. Starting in 2025, this limit dropped to $2,000. The amount shifted to $2,100 in 2026 and is set at $2,400 in 2027. Once the cap is reached, Part D pays 100% for covered medications for the rest of the year.
Fewer Part D coverage options
Part D enrollees should expect fewer options for Medicare Advantage plans with prescription coverage in 2027. (Some Medicare Advantage plans do not include Part D, and other plans with Part D are not available for general enrollment.) On average, Part D enrollees will be able to choose from 28 Medicare Advantage plans with prescription coverage in 2027 compared with 32 options in 2026, according to KFF.
If you’re looking for a stand-alone Part D plan, your options have narrowed for the fourth year in a row. KFF estimated that an enrollee looking for a stand-alone plan will have, on average, nine options in 2027 compared with 11 in 2026.
Electronic prior authorization
If you have a Medicare Advantage plan, and care from a healthcare professional requires prior authorization for approval, your plan must respond via electronic communication in 2027. This means a more streamlined, paperwork-free process that skips using the fax machine and waiting on phone calls for coverage decisions.
This change is about technology. Your insurance plan still has 7 days to respond to standard requests and 72 hours for urgent ones. Denials can’t just question medical necessity. They must give a specific reason for not covering the care. The electronic communication requirement doesn’t apply to original Medicare or stand-alone Part D plans.
Certain immigrants lose coverage
Certain lawfully present immigrants who have been eligible for Medicare coverage will no longer qualify as of early 2027. Disenrollments from plans, including Part D coverage, are expected to take effect by February 1, 2027.
People who are not U.S. citizens who still qualify to join original Medicare, another Medicare health plan, or a Medicare prescription drug plan must be lawfully present and have one of the following statuses:
Compact of Free Association migrant
Cuban entrant
Haitian entrant
Permanent resident (green card holder)
U.S. national
Medicare Drug Price Negotiation
The IRA also enabled Medicare to negotiate medication prices directly with pharmaceutical manufacturers. The lower prices for the first set of medications subject to the Medicare Drug Price Negotiation program — all covered by Part D —took effect in January 2026. The next set, 15 drugs covered by Part D, have price drops scheduled for January 2027. How this affects your out-of-pocket costs for these medications depends on your prescription and your coverage.
Medicare GLP-1 Bridge program
A new pilot program offering coverage of glucagon-like peptide-1 (GLP-1) medications for weight loss for Part D enrollees will continue in 2027. But it could also sunset at the end of the year. Before the Medicare GLP-1 Bridge program began in July 2026, Medicare did not cover medications solely for weight loss. For now, eligible Medicare prescription plan enrollees can access certain GLP-1 medications prescribed for weight loss at a $50 monthly copay.
How do you enroll in Medicare Part D?
If you qualify for Extra Help, then you’re automatically enrolled in a Medicare Part D prescription plan. This means you have:
Medicare and Medicaid, which is known as dual eligibility
Assistance paying Medicare costs from a Medicare Savings Program
Supplemental Security Income from the Social Security Administration
If you aren’t automatically enrolled, you can join a Medicare prescription plan at these times to avoid Part D late enrollment penalties:
Initial Medicare enrollment period: This 7-month window includes the 3 months before the month you turn age 65, your birth month, and 3 months after your birth month.
Medicare open enrollment period: After you turn 65, you can join, drop, or switch coverage during the annual Medicare open enrollment period, from October 15 to December 7.
Medicare Advantage open enrollment period: If you’re enrolled in a Medicare Advantage plan and want to switch to a different Medicare Advantage plan, join a different prescription plan, or switch to original Medicare with or without Part D, you can make the changes during the Medicare Advantage open enrollment period, from January 1 to March 31.
The bottom line
If you have a Medicare Part D prescription plan, expect shifts to your costs and benefits in 2027. Part D premiums are expected to rise about $1 on average, according to the Center for Medicare & Medicaid Services. But certain plan premiums could increase by $50 a month. The Part D standard deductible increases from $615 in 2026 to $700 in 2027. And the out-of-pocket limit increases from $2,100 in 2026 to $2,400 in 2027.
In general, enrollees will have fewer options in 2027, whether they select a Medicare Advantage plan with prescription coverage or a stand-alone Part D plan. People with Part D could save if their medication is included in the expanding Medicare Drug Price Negotiation program. They might also be eligible for weight-loss medication at a $50 monthly copay through the Medicare GLP-1 Bridge program.
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References
Biniek, J. F., et al. (2026). The average Medicare beneficiary has 28 Medicare Advantage prescription drug plan options for 2027. KFF.
CMS.gov. (2024). Final CY 2025 Part D redesign program instructions fact sheet. Centers for Medicare & Medicaid Services.
CMS.gov. (2025). Medicare prescription drug affordability. Centers for Medicare & Medicaid Services.
Cubanski, J., et al. (2026). Many Medicare Part D stand-alone drug plan enrollees will see modest premium increases for 2027, but others could pay much more if they don’t switch plans. KFF.
Cubanski, J., et al. (2026). Medicare Part D enrollment, premiums, and cost sharing in 2026. KFF.
Data.CMS.gov. (2026). Medicare enrollment dashboard. Centers for Medicare & Medicaid Services.
Gong, H. (2026). Electronic prior auths are coming. Here’s what physicians must ask their EHR and billing vendors. Medical Economics.
Lipschutz, D. (2026). Administration ends Part D premium stabilization demonstration. Center for Medicare Advocacy.
Lipschutz, D. (2026). Groups of lawfully present immigrants lose Medicaid coverage under HR1 starting today—Medicare and ACA are next. Center for Medicare Advocacy.
Malloy, M. L., et al. (2025). Medicare Part D Premium Stabilization Demonstration. Congress.gov.
Medicare. (2026). Your Medicare in 2027: What’s new & changing. Centers for Medicare & Medicaid Services.
Medicare.gov. (n.d.). Help with drug costs. Centers for Medicare & Medicaid Services.
Medicare.gov. (n.d.). How much does Medicare drug coverage cost? Centers for Medicare & Medicaid Services.
Medicare.gov. (n.d.). Medicare Savings Programs. Centers for Medicare & Medicaid Services.
Oz, M. (2026). Moving prior authorization into the 21st century. Centers for Medicare & Medicaid Services.
