2027 Medicare Changes Every Senior Needs to Know

1.Medicare Part D Out-of-Pocket Threshold Increases to $2,400

For 2027, the annual out-of-pocket threshold under the defined standard Medicare Part D benefit is $2,400, up from $2,100 in 2026. After reaching the catastrophic phase, beneficiaries pay $0 in cost sharing for covered Part D prescription drugs for the remainder of the year.

2.The Standard Part D Deductible Increases to $700

The defined standard Medicare Part D deductible increases from $615 in 2026 to $700 in 2027. This does not mean every Medicare drug plan will charge a $700 deductible. Individual Medicare Advantage Prescription Drug plans and stand-alone Part D plans may offer a lower deductible or no deductible at all.

3.The 2027 Part D Base Beneficiary Premium Is $41.33

CMS announced a 2027 Part D national base beneficiary premium of $41.33. This is not a universal monthly premium that every beneficiary pays. The national base beneficiary premium is a statutory amount used in calculating plan-specific Part D premiums. Actual premiums vary by plan, location, coverage, and other factors.

CMS also announced a 2027 Part D national average monthly bid amount of $296.05. The Part D Premium Stabilization Demonstration will end after 2026, making it especially important to review the actual 2027 premium and total costs of your plan.

4.More Medicare-Negotiated Drug Prices Take Effect January 1, 2027

Negotiated prices for the next 15 selected Medicare Part D drugs take effect January 1, 2027. Medicare.gov identifies medicines including Linzess®, Otezla®/Otezla XR®, and Xtandi® among the drugs affected. If you take a selected medication, review your plan's 2027 formulary and prescription drug costs carefully.

5.Medicare GLP-1 Bridge Continues Through 2027

Medicare's temporary GLP-1 Bridge program provides certain eligible Medicare Part D beneficiaries access to selected GLP-1 medications. Medicare.gov currently identifies Foundayo®, Wegovy®, and Zepbound® (KwikPen® only) as covered Bridge drugs. Eligibility is not automatic and includes specific program and clinical requirements.

Prior authorization may be required. Medicare.gov states that an approved prior authorization may remain valid through December 31, 2027, unless the beneficiary changes GLP-1 drugs.

6.Electronic Prior Authorization Expands in 2027

Beginning January 1, 2027, Medicare says Medicare drug plans may be able to process certain prior-authorization requests electronically, and beneficiaries may be able to view decisions through a patient portal. Availability can depend on the plan and its systems.

7.Medicare Advantage and Part D Star Ratings Are Changing

CMS is changing the Medicare Advantage and Part D Star Ratings system. CMS is removing 11 measures that it says provide little meaningful distinction among plans and refocusing the system more heavily on clinical care, health outcomes, and patient experience.

Star Ratings are only one factor to consider. Doctors, hospitals, prescription drugs, pharmacies, benefits, premiums, copayments, coinsurance, and maximum out-of-pocket costs are also important when comparing plans.

8.Extra Help Prescription Drug Costs Change for 2027

For people who qualify for Medicare Extra Help, Medicare.gov lists a $0 plan premium and $0 plan deductible for 2027. At participating pharmacies, beneficiaries may pay up to $5.80 for each generic drug and up to $14.40 for each brand-name drug. After the applicable total drug-cost threshold reaches $2,400, qualifying beneficiaries pay $0 for each covered drug.

9.Other Medicare Changes to Watch in 2027

Telehealth: Medicare's 2027 beneficiary materials describe continued access to covered telehealth services, including certain services that may be received from home, subject to Medicare's applicable rules.

Chronic-Care Support: Medicare's ACCESS initiative is designed to provide additional support opportunities for eligible people with Original Medicare who have certain chronic conditions.

Medicare Diabetes Prevention Program: Medicare's 2027 information describes more flexible participation opportunities, including virtual options for approved services.

Medicare Advantage and Part D Enrollment: CMS has finalized changes intended to streamline certain enrollment processes.

What Every Medicare Beneficiary Should Do Before December 7

Medicare's Annual Open Enrollment Period runs from October 15 through December 7.

• Read your 2027 Annual Notice of Change (ANOC) and Evidence of Coverage.
• Verify that your physicians, specialists, hospitals, pharmacies, and other providers participate in your 2027 plan network when network requirements apply.
• Check every prescription against the 2027 formulary, drug tier, deductible, prior-authorization requirements, quantity limits, and preferred-pharmacy pricing.
• Compare total expected annual costs — not only the monthly premium.
• Review dental, vision, hearing, transportation, fitness, OTC, food, utility, and other supplemental benefits carefully. Availability and eligibility rules vary by plan.
• Use Medicare Plan Compare or call 1-800-MEDICARE for official Medicare assistance.

Your Medicare Plan Can Change Every Year

A plan that met your needs in 2026 may change its premiums, copayments, coinsurance, deductibles, prescription drug formulary, pharmacy network, provider network, prior-authorization requirements, or supplemental benefits for 2027. Reviewing your Medicare coverage every year is important.

Official Government Sources

• Medicare.gov — Medicare & You 2027
• Medicare.gov — Your Medicare in 2027: What's New & Changing
• Medicare.gov — Extra Help With Prescription Drug Costs
• Medicare.gov — Medicare GLP-1 Bridge Information
• Centers for Medicare & Medicaid Services (CMS) — Contract Year 2027 Medicare Advantage and Part D Final Rule
• CMS — 2027 Medicare Part D National Average Monthly Bid and Base Beneficiary Premium Information

Last verified: September 23, 2026