Frequently Asked Questions
Will Medicare Part D premiums increase in 2027?
Medicare Part D premiums change annually. The 2027 premiums are finalized and published by plans in October during AEP. The national base beneficiary premium (used to calculate Part D late enrollment penalties) will be announced by CMS in the fall. Individual plan premiums vary significantly — your Annual Notice of Change letter mailed in September shows your specific plan's 2027 premium.
Does the Part D out-of-pocket cap continue in 2027?
Yes — the annual out-of-pocket cap on covered prescription drug costs continues in 2027. It started at $2,000 in 2025, rose to $2,100 in 2026, and is adjusted each year for inflation, so check CMS or your plan's Annual Notice of Change for the exact 2027 amount. After you reach the cap in covered drug costs, you pay $0 for covered drugs for the rest of the year. This cap replaced the old catastrophic coverage phase and applies to all Part D plans.
What is the Part D deductible in 2027?
The 2027 Part D maximum deductible will be announced by CMS in the fall. The 2026 maximum deductible was $615. Many plans have lower deductibles than the maximum, and some plans have $0 deductible for preferred generics. Check your specific plan's 2027 formulary and deductible in the Annual Notice of Change.
What should I do if my drug was removed from my Part D plan's formulary?
If a drug is removed from your current plan's formulary for 2027 (detailed in your Annual Notice of Change), AEP is your window to switch to a plan that covers it. Additionally, you can request a formulary exception from your current plan — your doctor submits documentation that the drug is medically necessary and that formulary alternatives are not appropriate for you. Plans must respond within 72 hours (24 hours expedited).
Can I still use the Medicare Prescription Payment Plan in 2027?
Yes — the Medicare Prescription Payment Plan (M3P), which allows you to spread your annual drug costs into equal monthly payments rather than paying large amounts upfront, continues in 2027. Starting in 2026, plans can automatically renew your participation from year to year, but you must opt in the first time. Contact your Part D plan to confirm your M3P status for 2027.
Part D is the component of Medicare most likely to have meaningful changes from year to year — formularies change, tiers shift, premiums increase, and preferred pharmacies rotate. The annual out-of-pocket cap (introduced at $2,000 in 2025, $2,100 in 2026, and adjusted yearly for inflation) continues in 2027, but everything else needs verification. Here is what to review before December 7.
What Continues from 2026
- Annual out-of-pocket cap: Continues (inflation-adjusted; $2,100 in 2026) — after you reach it in covered drug costs, you pay $0 for the rest of the year
- $35 insulin cap: Continues — all covered insulins capped at $35/month per product
- $0 vaccines: All ACIP-recommended vaccines remain $0 under Part D (flu, COVID, Shingrix, RSV, pneumococcal, etc.)
- Medicare Prescription Payment Plan (M3P): Continues — opt in for monthly spreading of drug costs
- Extra Help low-income subsidy: Continues with updated income thresholds
What to Check in Your Annual Notice of Change
Your ANOC arrives in September and lists every change to your Part D coverage for 2027. Review specifically:
Formulary Changes
Check every medication you take against the 2027 formulary. Look for: tier changes (your $10 generic may move to a $40 preferred brand tier), new restrictions (prior authorization or step therapy added), quantity limit changes, or complete removal from the formulary. Even a single tier change on one medication can represent hundreds of dollars annually.
Premium Changes
Note your new monthly premium. If your premium is increasing significantly (more than $20–30/month), it's particularly worth running a full Plan Finder comparison to see if another plan offers better total cost for your specific medications.
Preferred Pharmacy Changes
Plans can change which pharmacies are "preferred" — affecting your copay tier. If your pharmacy loses preferred status, your drug costs increase even though you're taking the same medications in the same plan. Verify your pharmacy's status in the 2027 plan documents.
Running the 2027 Comparison
Use Medicare.gov Plan Finder with the 2027 plan year selected — this is critical. Medicare.gov typically posts next year's plan details in early October, before enrollment opens on October 15, so you can compare 2027 formularies and premiums ahead of time. Make sure the tool is not still showing 2026 plans. Enter all your medications and sort by total estimated annual cost. Even if you're considering keeping your current plan, run this comparison to verify it's still the lowest-cost option for your specific drugs.
When to Switch vs When to Stay
Strongly consider switching if: Any medication moved to a significantly higher tier, your premium increased by $30+/month, your preferred pharmacy lost preferred status, or Plan Finder shows another plan at $500+ lower annual cost for your drugs.
Consider staying if: Your ANOC shows no significant changes, your medications are all covered at the same tiers, your premium increase is modest ($5–15/month), and a Plan Finder comparison shows your current plan is still competitive.
- Read your ANOC letter — arrives in September, details every 2027 change
- Once 2027 plans are posted (typically early October): run Plan Finder with 2027 data for your specific medications
- Confirm your Medicare Prescription Payment Plan status for 2027 if you want monthly spreading
- Request a formulary exception if any drug was removed — don't just switch without trying
- December 7 is the hard deadline — start the review in October, not December
→ Part D Drug Cap — How It Works
→ Plan Finder Step-by-Step Guide
→ Choose the Best Part D Plan