Medicare changes every year. Some of the 2027 numbers are already official, and others (like the Part B premium) come later in the fall. Here's what has been confirmed for 2027 and what it means if you have Medicare Advantage or a Part D plan.
1. Part D Out-of-Pocket Cap Rises to $2,400
Once your out-of-pocket spending on covered Part D drugs reaches $2,400 in 2027 (up from $2,100 in 2026), you pay $0 for covered drugs for the rest of the year. The cap applies to standalone Part D plans and to Medicare Advantage plans that include drug coverage. The yearly increase is set by a formula in federal law.
2. Part D Deductible Can Be Up to $700
The most a Part D plan can charge as a deductible in 2027 is $700, up from $615. That's a ceiling, not a fixed amount. Some plans charge less, some have no deductible, and some skip the deductible for lower-tier drugs.
3. Negotiated Prices for 15 More Drugs
On January 1, 2027, Medicare's negotiated prices take effect for 15 more Part D drugs: Austedo/Austedo XR, Breo Ellipta, Calquence, Ibrance, Janumet/Janumet XR, Linzess, Ofev, Otezla, Ozempic/Rybelsus/Wegovy, Pomalyst, Tradjenta, Trelegy Ellipta, Vraylar, Xifaxan, and Xtandi. These add to the negotiated prices that started in 2026 for drugs such as Eliquis and Jardiance. Four of the original 10 drugs (Entresto, Stelara, Xarelto, and NovoLog/Fiasp) leave the negotiation program on January 1, 2027, because generic or biosimilar versions are now on the market. What you actually pay still depends on your plan's drug list and cost-sharing, so check your own prescriptions.
4. Standalone Part D Premiums
A temporary federal program that held down standalone Part D premiums (the Part D Premium Stabilization Demonstration) ends after 2026. CMS projects the average total standalone Part D premium will go from $35.09 in 2026 to about $36.00 in 2027, but averages hide a wide range. Your own plan's premium could rise or fall more than that, so read your Annual Notice of Change.
5. Medicare Advantage Out-of-Pocket Limits
Every Medicare Advantage plan has a yearly maximum out-of-pocket (MOOP) limit for covered medical care. For 2027, the highest in-network limit a plan can set is $9,850 (up from $9,250), and the highest combined in- and out-of-network limit is $14,800. Many plans set lower limits. In North Carolina, 2027 in-network limits range from $3,400 to $9,850. CMS projects the average Medicare Advantage premium will drop from $14.37 to $12.00 a month nationally, but plan line-ups changed in many counties. See what changed in North Carolina.
6. Insulin Stays Capped at $35
Covered insulin costs no more than $35 for a month's supply, and the Part D deductible doesn't apply.
7. Part A and Part B Costs Come Later
CMS hasn't announced the 2027 Part A deductible, Part B premium, Part B deductible, or the income brackets for higher-income surcharges (IRMAA) yet. Here's where things stand:
| Medicare cost | 2027 | 2026 |
|---|
| Part D deductible (most a plan can charge) | Up to $700 | Up to $615 |
| Part D out-of-pocket cap on covered drugs | $2,400 | $2,100 |
| Covered insulin | $35 per month supply, no deductible | $35 |
| Part D base beneficiary premium (used for the late penalty) | $41.33 | $38.99 |
| Medicare Advantage in-network out-of-pocket limit (highest allowed) | $9,850 | $9,250 |
| Medicare Advantage combined in- and out-of-network limit (PPOs) | $14,800 | $13,900 |
| Part B standard monthly premium | Not yet announced | $202.90 |
| Part B annual deductible | Not yet announced | $283 |
| Part A inpatient deductible (per benefit period) | Not yet announced | $1,736 |
Sources: CMS CY 2027 Rate Announcement (Part D deductible and out-of-pocket threshold); CMS CY 2027 Part D national average bid release (base beneficiary premium); CMS CY 2027 MOOP limits; CMS "2026 Medicare Costs." 2027 Part A and Part B amounts had not been announced as of October 1, 2026.
About Part B: CMS usually announces next year's Part B premium and deductible in the fall. Until it does, any 2027 Part B number you see is an estimate. We'll update this page when CMS releases the official figures.
Still Available in 2027
- Medicare Prescription Payment Plan: spread your out-of-pocket Part D costs into monthly payments instead of paying all at once at the pharmacy. It's voluntary and free to join through any Part D or Medicare Advantage drug plan.
- $0 recommended adult vaccines under Part D, such as shingles and RSV.
- Extra Help with Part D costs for people with limited income and resources.
What Medicare Advantage Members Should Check
Medicare Advantage plans set their own premiums, copays, networks, drug lists, and extra benefits each year within Medicare's rules, so changes are plan-specific. Before AEP ends on December 7, 2026, review:
- Your Annual Notice of Change, or a non-renewal letter if your plan is leaving your area
- Whether your doctors and hospitals are still in-network
- Where your prescriptions fall on the plan's 2027 drug list
- Changes to extra benefits such as dental, vision, hearing, or fitness
- Your plan's maximum out-of-pocket limit for medical care
For step-by-step help, see our 2027 Medicare AEP guide.
Frequently Asked Questions
Which drugs get negotiated Medicare prices in 2027?
Fifteen Part D drugs: Austedo/Austedo XR, Breo Ellipta, Calquence, Ibrance, Janumet/Janumet XR, Linzess, Ofev, Otezla, Ozempic/Rybelsus/Wegovy, Pomalyst, Tradjenta, Trelegy Ellipta, Vraylar, Xifaxan, and Xtandi. The negotiated prices take effect January 1, 2027.
Is the Part D deductible $700 for every plan in 2027?
No. $700 is the most a plan can charge. Plans can set a lower deductible or none at all.
Has the 2027 Part B premium been announced?
Not as of October 1, 2026. The 2026 standard Part B premium is $202.90 a month and the deductible is $283.
Talk It Through With a Local Agent
Triangle Life and Health is an independent agency in Raleigh, licensed since 2013. Our help is free to you. We compare plans from several carriers against your doctors, prescriptions, and budget. Book a free review or call 919-689-6565.
Michael Cubell : Sep 3, 2023, 11:03:17 AM
