Medicare Changes for 2027: Part D Cap, Premiums and Drug Prices
Reviewed October 4, 2026. The biggest Medicare changes for 2027 are in prescription drug coverage: the Part D out-of-pocket cap rises to $2,400 and the standard deductible to $700, while negotiated prices for 15 more drugs, including Ozempic and Wegovy, take effect January 1, 2027. CMS also projects the average Medicare Advantage premium will fall to $12.00 a month. The 2027 Part B premium hasn’t been announced yet.
Quick answer: If you have a Medicare Advantage or Part D plan, read your 2027 Annual Notice of Change and compare plans during Open Enrollment, October 15 to December 7, 2026. Drug costs, plan premiums and networks can change even when your plan name stays the same.
Medicare changes for 2027 at a glance
| Item | 2026 | 2027 |
|---|---|---|
| Part D standard deductible | $615 | $700 |
| Part D out-of-pocket cap | $2,100 | $2,400 |
| Extra Help copays (maximum) | $5.10 generic / $12.65 brand | $5.80 generic / $14.40 brand |
| Average Medicare Advantage premium (weighted, projected) | $14.37 | $12.00 |
| Average stand-alone Part D total premium (projected) | $35.09 | $36.00 |
| Drugs with Medicare-negotiated prices | 10 | 25 (15 added) |
| Part B standard premium | $202.90 | Not yet announced |
Sources: Medicare.gov (2027 drug cap and Extra Help copays), CMS (2026 Extra Help copays), CMS (2027 premiums, September 28, 2026) and CMS (2026 Part B).
Part D drug coverage changes for 2027
Higher deductible and out-of-pocket cap
The Inflation Reduction Act capped what you pay for covered Part D drugs each year. The cap is indexed, so it goes up each year: $2,000 in 2025, $2,100 in 2026 and $2,400 in 2027. Once your out-of-pocket spending on covered drugs reaches the cap, you pay nothing more for covered drugs for the rest of the year. The maximum standard deductible rises from $615 to $700. Many plans charge a lower deductible or none at all, so check each plan.
If you take expensive medicines, the Medicare Prescription Payment Plan lets you spread your out-of-pocket drug costs into monthly payments over the year instead of paying large amounts at the pharmacy. Learn more in our guide to how Medicare Part D works.
15 more drugs with negotiated prices
Medicare’s negotiated prices for a second group of 15 drugs take effect January 1, 2027. According to CMS, they are:
- Ozempic, Rybelsus and Wegovy (semaglutide)
- Trelegy Ellipta
- Xtandi
- Pomalyst
- Ofev
- Ibrance
- Linzess
- Calquence
- Austedo and Austedo XR
- Breo Ellipta
- Xifaxan
- Vraylar
- Tradjenta
- Janumet and Janumet XR
- Otezla and Otezla XR
CMS estimates people with Medicare drug coverage would save about $685 million in out-of-pocket costs under the standard benefit when these prices take effect. What you pay still depends on your plan’s tier and copay structure. Background: how Medicare drug price negotiation works.
Part D premium stabilization demonstration ends
CMS says the voluntary Part D Premium Stabilization Demonstration, which was narrowed for 2026, is planned to be discontinued in 2027. CMS still projects the average total stand-alone Part D premium will rise less than $1 a month, from $35.09 to $36. Individual plans can change much more than the average, so compare your plan’s 2027 premium.
Extra Help costs
With Extra Help in 2027, Medicare.gov lists a $0 deductible, copays of up to $5.80 for generics and $14.40 for brand-name drugs, and $0 once your costs reach the $2,400 cap. Extra Help income limits for 2026 are $23,940 for an individual and $32,460 for a married couple.
Medicare Advantage changes for 2027
- Premiums: CMS projects the weighted average monthly premium will drop more than 16%, from $14.37 to $12.00.
- Plan choices: about 5,532 Medicare Advantage plans nationally in 2027, compared with 5,553 in 2026. More than 99% of people with Medicare can choose at least one plan.
- Enrollment: CMS estimates about 34 million people, about 47.4% of everyone with Medicare, will be in Medicare Advantage in 2027.
- Extra benefits: CMS expects supplemental benefits like dental, vision and hearing to remain stable overall. Benefits still differ plan by plan, and some plans change allowances or networks every year.
- Star ratings: CMS updated the measures used in plan star ratings to put more weight on clinical quality and health outcomes.
Some plans also offer a Part B premium reduction (“giveback”). Check whether your plan is keeping, changing or dropping it for 2027.
Part A and Part B costs
CMS usually announces the next year’s Part A and Part B premiums and deductibles in the fall. As of this review, the 2027 amounts haven’t been published. For 2026:
- Part B standard premium: $202.90 a month (Part B premium guide)
- Part B deductible: $283 (Part B deductible guide)
- Part A inpatient hospital deductible: $1,736 per benefit period
Higher-income beneficiaries also pay an income-related surcharge (IRMAA) on Part B and Part D. 2027 IRMAA is based on your 2025 tax return. See our IRMAA guide. We’ll update this page when CMS publishes 2027 Part A and Part B amounts.
What to do now
- Read your plan’s 2027 Annual Notice of Change.
- Check that your drugs are still on the formulary and at what tier for 2027.
- Compare plans in Medicare Plan Finder starting in October.
- Make any changes during Medicare Open Enrollment, October 15 to December 7, 2026.
- If your income is limited, apply for Extra Help or a Medicare Savings Program.
Frequently asked questions
What is the Part D out-of-pocket maximum for 2027?
$2,400. After your out-of-pocket costs for covered drugs reach $2,400, you pay $0 for covered Part D drugs for the rest of 2027.
What is the Medicare Part D deductible for 2027?
The standard deductible is $700, up from $615 in 2026. Plans can charge less.
What is the Medicare Part B premium for 2027?
It hasn’t been announced yet. CMS typically releases it in the fall. The 2026 standard premium is $202.90 a month.
Will Ozempic cost less on Medicare in 2027?
Medicare’s negotiated price for semaglutide (Ozempic, Rybelsus and Wegovy) takes effect January 1, 2027. Your copay depends on your plan, and Medicare drug plans still can’t cover drugs used only for weight loss except in limited cases, so check your plan’s formulary.
When can I change my Medicare plan for 2027?
During Open Enrollment, October 15 to December 7, 2026. If you’re in a Medicare Advantage plan, you can also make one change from January 1 to March 31, 2027.
This article is general information, not individual insurance advice. Medicare365 is not affiliated with or endorsed by the U.S. government or the federal Medicare program.
Official sources
- CMS: Medicare Advantage and Medicare Prescription Drug Programs Expected to Remain Stable in 2027
- Medicare.gov: Help with drug costs
- CMS: Negotiated prices for initial price applicability year 2027
- CMS: 2027 Medicare Advantage and Part D Rate Announcement
- CMS: 2026 Medicare Parts A and B premiums and deductibles