Medicare Changes for 2027: Premiums, Part D, and Advantage Plan Shifts

Medicare changes for 2027 touch almost everyone with coverage. Part D gets a higher deductible and a higher out-of-pocket cap, 15 more drugs get negotiated prices, many people will have fewer Medicare Advantage plans to pick from, and Part B costs are expected to rise again.

Some of these numbers are final and some are still estimates. This guide sorts them out, change by change, as of October 13, 2026, using CMS, Medicare.gov and the 2026 Medicare Trustees Report. Each section links to our deeper guide if you want the full detail before Open Enrollment, October 15 to December 7, 2026.

Key Takeaways

• Part D: the standard deductible rises to $700 (from $615) and the yearly out-of-pocket cap rises to $2,400 (from $2,100) on January 1, 2027. Both are final.
• Part B: the Trustees project a $209.50 monthly premium (from $202.90) and a $292 deductible (from $283). CMS has not announced the official 2027 amounts yet.
• Negotiated prices for 15 more drugs, including Ozempic, Wegovy and Trelegy Ellipta, take effect January 1, 2027.
• KFF counts 28 Medicare Advantage drug plans for the average person in 2027, down from 32, and 193 counties with none open to general enrollment.
• Telehealth from home stays available through December 31, 2027, and Medicare.gov adds ID.me, CLEAR and Login.gov sign-in options.

Medicare changes 2027 at a glance

The biggest 2027 changes are a higher Part D deductible and cap, 15 newly negotiated drug prices, fewer Medicare Advantage choices in many areas and a projected Part B increase. The table shows which numbers are final and which are still estimates.

Item	2026	2027	Status
Part B monthly premium	$202.90	$209.50	Projected (Trustees)
Part B yearly deductible	$283	$292	Projected (Trustees)
Part A hospital deductible	$1,736	$1,788	Projected (Trustees)
Part D standard deductible	$615	$700	Final
Part D out-of-pocket cap	$2,100	$2,400	Final
Part D base beneficiary premium	$38.99	$41.33	Final
Average Medicare Advantage premium	$14.37	$12.00	Projected (CMS)
Average stand-alone drug plan premium	$35.09	$36	Projected (CMS)
Drugs with negotiated prices	10	25	Final

Sources: CMS 2026 Parts A and B fact sheet (November 14, 2025), 2026 Medicare Trustees Report (June 2026), CMS 2027 Rate Announcement (April 6, 2026), CMS bid amount notice (July 28, 2026) and CMS 2027 plan release (September 28, 2026).

Part B premium and deductible for 2027

CMS has not released the 2027 Part B premium yet. The 2026 Medicare Trustees Report estimates it at $209.50 a month, up $6.60 from $202.90, with a $292 deductible, up from $283. Treat these as estimates until CMS publishes the official figures, usually in the fall.

The Trustees say plainly that these projections are estimates and “the actual amounts are likely to be somewhat different as experience emerges.”

If your income is above the IRMAA thresholds ($109,000 single or $218,000 joint in 2026), you pay more. The 2027 brackets are not out yet. See our guides to the Part B premium and IRMAA for how the surcharge works.

Part A deductible and hospital costs for 2027

The Trustees project a 2027 Part A hospital deductible of $1,788, up from $1,736 in 2026. Their estimates also show $447 a day for hospital days 61 to 90 and $223.50 a day for skilled nursing days 21 to 100. These are projections, not official CMS amounts.

Most people pay no Part A premium because they or a spouse worked long enough.

For people who buy in, the Trustees estimate a $330 reduced premium and a $600 full premium in 2027, up from $311 and $565 in 2026. Our Part A premium guide and Medicare deductibles guide will show the official numbers once CMS releases them.

Part D drug costs: higher deductible and cap

In 2027 the standard Part D deductible rises to $700 and the out-of-pocket cap rises to $2,400. Both are final, set in CMS’s 2027 Rate Announcement on April 6, 2026. After your out-of-pocket costs for covered drugs reach $2,400, you pay $0 for covered drugs for the rest of the year.

The increases come from a formula. CMS raises both amounts each year by the growth in Part D spending per person, which it set at 13.65% for 2027, then rounds. Between the deductible and the cap, you still pay 25% of the cost of covered drugs in a standard plan.

Compare each plan’s deductible and drug list for the medicines you take. Our guide to Medicare Part D costs in 2026 and 2027 walks through the full math.

The Part D premium stabilization program ends

For 2025 and 2026, a CMS demonstration helped hold down stand-alone drug plan premiums. CMS says it will end the demonstration “at the end of CY 2026.” So 2027 premiums are set without that extra help.

CMS still projects the average stand-alone drug plan premium at about $36 a month in 2027, up less than $1 from $35.09. It also says 88% of people without Extra Help will have a basic drug plan available for $10.30 a month or less. The base beneficiary premium, the starting point plans use, is $41.33 for 2027.

Extra Help copays for 2027

If you get Extra Help (the Low-Income Subsidy), your 2027 drug copays are capped at $5.80 for each generic and $14.40 for each brand-name drug, up from $5.10 and $12.65. Once your costs reach $2,400, you pay $0. People with full Medicaid and income at or below 100% of poverty pay no more than $1.65 and $5.00.

The 2027 income and resource limits for Extra Help have not been posted. Medicare.gov still shows the 2026 limits. See our Extra Help guide to check if you qualify now.

What the 2027 changes mean for your budget: two examples

For someone on one expensive brand-name drug, the higher Part D deductible and cap can add up to $300 a year. For Part B, the projected premium adds about $79 over the year, plus $9 more in deductible. These are illustrations built from the final Part D amounts and the Trustees’ projected Part B amounts, not quotes for any plan.

Example 1: one brand-name drug that costs $600 a month

Say your drug’s full price in your plan is $600 a month and your plan uses the standard Part D design: you pay the full price until you meet the deductible, then 25% until your own spending reaches the yearly cap. Here is how the year adds up.

Step	2026 (deductible $615, cap $2,100)	2027 (deductible $700, cap $2,400)
January	You pay $600	You pay $600
February	$15 to finish the deductible plus 25% of the other $585: $161.25 in all	$100 to finish the deductible plus 25% of the other $500: $225 in all
March onward	$150 a month (25% of $600)	$150 a month (25% of $600)
You reach the cap	In November, at $2,100	Not reached; you finish the year at $2,325
Total for the year	$2,100	$2,325

In this example you pay $225 more in 2027. The extra comes from the $85 higher deductible and from the higher cap, which means you keep paying 25% in late 2027 instead of reaching $0 in November.

Your real numbers will differ. Many plans charge flat copays instead of 25%, some have a lower deductible, and your drug’s price depends on the plan. Use the plan finder with your exact drugs to see your own total.

Example 2: the projected Part B premium over a year

At the 2026 premium of $202.90 a month, you pay $2,434.80 for the year. At the projected 2027 premium of $209.50, you would pay $2,514. That is $79.20 more over 12 months, plus a deductible that is projected to rise by $9, from $283 to $292.

If you pay a higher premium because of IRMAA, your increase will be larger. Wait for the official CMS figures before you set your 2027 budget, since the Trustees warn their estimates can change.

15 more drugs with negotiated prices

On January 1, 2027, negotiated Medicare prices take effect for 15 more Part D drugs, bringing the total to 25. CMS says these prices would have saved about $12 billion, or 44% in net spending, if they had applied in 2024, and about $685 million in out-of-pocket costs for enrollees.

The 15 drugs are Ozempic, Rybelsus and Wegovy (counted as one), Trelegy Ellipta, Xtandi, Pomalyst, Ofev, Ibrance, Linzess, Calquence, Austedo and Austedo XR, Breo Ellipta, Xifaxan, Vraylar, Tradjenta, Janumet and Janumet XR, and Otezla and Otezla XR.

The biggest headline is semaglutide. CMS lists a negotiated price of $274 for a 30-day supply of Ozempic, Rybelsus and Wegovy, 71% below the 2024 list price. About 5.3 million of the 53 million people with Part D used at least one of these drugs in 2024.

The negotiated price is not your copay. Your own cost still depends on your plan’s deductible, drug tier and coinsurance, and it stops at the $2,400 cap.

Medicare Advantage in 2027: fewer plans, lower average premium

Many people will have fewer Medicare Advantage plans in 2027. KFF found the average person can choose from 28 Medicare Advantage plans with drug coverage, down from 32, and 193 counties will have none open to general enrollment, up from 123. CMS still projects the average premium to fall to $12.00 from $14.37.

KFF says the 193 counties without a drug plan option are home to about 638,000 people, or 1% of everyone on Medicare, up from 399,000 people in 2026.

KFF reports that UnitedHealth Group is leaving 228 counties, Humana 62 and HCSC 498, and that Clear Spring Health and Molina Healthcare are leaving the Medicare Advantage drug plan market entirely. No Medicare Advantage drug plans are open to general enrollment anywhere in Alaska.

Nationally, CMS counts about 5,532 Medicare Advantage plans for 2027, close to the 5,553 in 2026. It says more than 99% of people have at least one plan available and 97% have 10 or more. It also projects that about 8 in 10 current members can stay in their plan at the same or a lower premium.

Read your Annual Notice of Change carefully, and use our Medicare Advantage vs Original Medicare guide if you are thinking about going back to Original Medicare.

New Medicare Advantage rules for 2027

CMS’s final rule for 2027, issued April 2, 2026, changes how plans handle extra benefits and star ratings:

• Debit cards for extra benefits must be linked to items and services the plan covers and are limited to the plan year.
• Plans no longer have to send a mid-year notice about extra benefits you have not used.
• Plans must post their eligibility rules for special benefits for the chronically ill, and illegal cannabis products cannot be offered as one.
• CMS removed 11 star rating measures about administrative processes and added a depression screening measure that starts with the 2027 measurement year.
• Earlier limits on when and how you can talk with licensed agents and brokers were removed.

Medicare.gov also says that starting January 1, 2027, your Medicare Advantage plan “may” be able to handle prior authorization requests electronically. CMS expects dental, hearing and vision extras to stay about the same. For dental details, see does Medicare cover dental.

What’s new on Medicare.gov and in care

Medicare’s own 2027 “What’s New” guide lists several changes beyond costs. Telehealth from any U.S. location, including home, continues through December 31, 2027. Medicare.gov now accepts ID.me, CLEAR and Login.gov sign-ins, and the site has a new look with more detail for comparing plans.

The same guide lists these updates:

• Medicare GLP-1 Bridge: a temporary program that started July 1, 2026 covers certain GLP-1 drugs, including Wegovy and Zepbound, with a $50 copay for a one-month supply.
• ACCESS: a new care model for people with Original Medicare who have one or more chronic conditions, which may be available at low or no cost.
• Diabetes Prevention Program: you can now attend sessions in person or online, with no limit on how many times you take part.
• Health apps: apps from private companies can connect to your Medicare information.
• TrumpRx: a free website with drug discounts. Medicare says it is not creditable coverage and does not count toward your deductible or out-of-pocket cap.
• Eligibility: you must be a U.S. citizen or national, a green card holder, a Cuban-Haitian entrant or a lawfully present COFA migrant.

What is not changing in 2027

Some things stay the same. Open Enrollment still runs October 15 to December 7, and new coverage starts January 1, 2027. If you are in a Medicare Advantage plan, the Medicare Advantage Open Enrollment Period still runs from January 1 to March 31.

Medicare’s 2027 “What’s New” guide lists no change to Original Medicare coverage of dental care, hearing aids or routine vision.

Medicare Savings Programs still help pay Medicare costs for people with low income and limited savings, and anyone enrolled in one automatically qualifies for Extra Help. See our Medicare Savings Programs guide.

Still to be announced

As of October 13, 2026, these 2027 numbers have not been released:

• The official 2027 Part A and Part B premiums and deductibles, and the IRMAA income brackets.
• The 2027 income and resource limits for Extra Help and Medicare Savings Programs.
• The 2027 Social Security cost-of-living adjustment, which affects how much of your check is left after the Part B premium.

We will update this guide and our linked guides when CMS and Social Security publish them.

What to do before Open Enrollment

1. Read your Annual Notice of Change. It lists your plan’s 2027 premium, deductible, copays and drug list changes.
2. Check that each drug you take is still covered and at what tier. Use the Medicare.gov plan finder with your exact drug list.
3. If your Medicare Advantage plan is leaving your county, pick a new plan before December 7 so coverage starts January 1.
4. Budget for Part D up to the $2,400 cap if you take expensive drugs, or ask about spreading costs over the year with the Medicare Prescription Payment Plan.
5. If money is tight, apply for Extra Help and a Medicare Savings Program. Our guide to help for people with low income on Medicare lists every option.