Medicare Part D Plans 2027

Each year, Part D coverage moves through three stages. Which stage you are in sets what you pay at the pharmacy.

When large drug bills arrive early in the year, the Medicare Prescription Payment Plan allows you to break your out-of-pocket drug costs into monthly installments over the year rather than paying at the pharmacy counter. Every Part D plan and every Medicare Advantage plan with drug coverage offers it, and the total amount you owe stays the same.

Source: CMS, September 28, 2026, plus Part D bid information, July 28, 2026.

With the stabilization demonstration ending, standalone drug plans go back to ordinary market pricing for 2027. Some premiums will rise, others will fall, and certain plans will exit your area, so shop around even if your 2026 plan worked well for you.

Each plan sets its own tiers. Review every plan’s formulary.

Plans may also impose coverage rules. With prior authorization, the plan has to sign off on a drug before paying for it. With step therapy, you might have to try a cheaper drug first. Quantity limits restrict how much you can receive at once. If your doctor thinks you need an exception, you can request one from your plan.

See Part D drug tiers explained and understanding Part D formularies.

Staying in Original Medicare, whether or not you have a Medigap plan, means you need a standalone Part D plan to get drug coverage. A Medicare Advantage plan with drug coverage cannot be combined with a separate Part D plan; signing up for one usually cancels the other.

See how to choose a Medicare Part D plan and common mistakes when choosing Plan D.

The pharmacy you use can shift your yearly cost as much as the plan you pick. Most plans split their network into preferred and standard pharmacies. Preferred pharmacies offer lower negotiated prices and frequently lower copays; standard pharmacies remain in network but tend to be pricier. Out-of-network pharmacies are generally not covered outside of limited situations.

For ongoing blood pressure, cholesterol, diabetes or thyroid medications, check a 90-day mail-order fill in the plan finder. For many people, nothing cuts costs more easily.

Standalone Part D plans from insurers come in two types. A basic plan has to cover at least Medicare’s standard benefit. An enhanced plan goes further, for example with a lower or $0 deductible on some tiers or reduced copays, typically at a higher premium.

For 2027, CMS says 88% of non-low-income beneficiaries can get a basic plan for $10.30 a month or less, and 93% can get an enhanced plan for less than $6 a month. Whether an enhanced plan is worth it depends entirely on your drugs. See standard vs enhanced Part D plans.

Every Part D plan sends CMS a bid. From those bids, CMS sets the national average monthly bid amount ($296.05 for 2027) and the base beneficiary premium ($41.33 for 2027). The base premium feeds into the late enrollment penalty and premium subsidy calculations; it is not the amount you are charged. What you actually pay depends on your plan and your region.

Under federal law, yearly growth in the base beneficiary premium is capped at 6% through 2029. The limit covers the base premium rather than each individual plan, so the premium on your plan can still climb faster.

Part D is optional, yet most people should carry drug coverage from day one, even if they fill few or no prescriptions now. Skipping Part D or other creditable coverage when you first become eligible can saddle you with a late enrollment penalty for life.

A drug you take may not be on a plan’s 2027 formulary, or it may come with a rule such as prior authorization. Even then, you have options:

See steps to appeal a Medicare Part D denial.

When your income and savings are limited, two programs can greatly lower your Medicare costs:

If you qualify for both Medicare and full Medicaid, you may also be able to join a Dual Special Needs Plan. See help for low-income Part D beneficiaries.

You do not need to compare plans by yourself, and help should not cost you anything. Here are the free options:

Gather your Medicare card, a list of your drugs and doses, your doctors and your preferred pharmacies before you call. That way a long conversation becomes a quick one.