Medicare’s Annual Enrollment Period runs October 15 through December 7, 2026, for coverage that starts January 1, 2027. Most people let it pass. That is usually fine — and this year it may not be, because one of the things propping up drug plan premiums for the past two years is going away.
Here is what actually changes, what stays the same, and the short list of things worth checking before the window closes.
The 2027 Numbers
- Part D out-of-pocket cap: $2,400, up from $2,100. Once your covered drug spending hits it, you pay $0 for covered Part D drugs the rest of the year. That protection is not going anywhere.
- Maximum Part D deductible: $700, up from $615.
- National base beneficiary premium: $41.33, up from $38.99 — exactly the 6% annual growth cap the Inflation Reduction Act allows through 2029.
- Insulin stays capped at $35 a month.
- Extra Help (the Low-Income Subsidy) continues. It is not affected by anything below.
⚠️ The Change That Matters: A Premium Cushion Is Expiring
This is the reason to pay attention this year rather than coasting.
When the Inflation Reduction Act redesigned Part D and capped out-of-pocket costs, it shifted a large share of catastrophic drug costs onto insurers, and plan bids jumped. CMS created a temporary Part D Premium Stabilization Demonstration to cushion that transition — it lowered monthly premiums by roughly $16 per person in 2026.
That program ends after 2026. CMS concluded that plan sponsors now have enough experience under the redesigned benefit to price without the extra federal support, and is returning Part D to normal market conditions.
Who this hits: people with a stand-alone Part D drug plan paired with Original Medicare — roughly one in four Medicare beneficiaries, about 25 million people. If your drug coverage is bundled inside a Medicare Advantage plan, this particular change is not aimed at you.
How much will premiums rise? CMS Administrator Mehmet Oz has said most beneficiaries will pay less than $10 more per month, and that some will pay less than they do now. Treat that as a projection about averages, not a promise about your specific plan. The only number that matters is the one on your plan’s notice.
15 More Drugs Get Negotiated Prices in January
The second round of Medicare drug price negotiation takes effect January 1, 2027, covering 15 Part D drugs. About 5.3 million Medicare enrollees used them in a single year, and CMS estimates roughly $685 million in out-of-pocket savings.
The headline is the GLP-1s. Ozempic, Rybelsus, and Wegovy drop to $274 for a 30-day supply from a $959 list price — a 71% cut. Other notable reductions:
- Janumet (type 2 diabetes): $526 → $80, an 85% cut, the largest on the list
- Xifaxan (gastrointestinal): $2,696 → $1,000
- Otezla (psoriasis): $4,722 → $1,650
- Austedo (movement disorders): $6,623 → $4,093, the smallest cut at 38%
The rest of the list treats asthma and COPD, prostate and breast cancer, and other chronic conditions — including Trelegy Ellipta, Breo Ellipta, Xtandi, Ibrance, Pomalyst, Ofev, Linzess, Calquence, Tradjenta, and Vraylar.
An important caveat. These negotiated prices are what Medicare pays the manufacturer. What comes out of your pocket still depends on your plan’s formulary, tier placement, and cost-sharing. A negotiated price is good news, but it is not the same as your copay. Look up your actual drugs in your actual plan.
Three Mistakes People Repeat Every Year
1. Not opening the ANOC. Your plan must send an Annual Notice of Change by September 30. It is boring, it looks like junk mail, and it is the single most important document you will get all year. The plan name stays the same while the formulary, the pharmacy network, the copay tiers, and the premium all change underneath it. People discover this in January at the pharmacy counter.
2. Assuming you can switch back to Original Medicare later. You can drop Medicare Advantage and return to Original Medicare during AEP or the January 1 – March 31 Medicare Advantage Open Enrollment Period. The problem is the Medigap half. Outside your one-time six-month Medigap open enrollment window at 65, most states let insurers medically underwrite you — charge more, or decline you entirely. “I’ll switch if my health gets worse” is exactly the plan that fails, because worse health is what triggers the underwriting problem. A handful of states have friendlier rules; most do not.
3. Not re-checking your doctors. Provider networks change every year, and a specialist you rely on can quietly drop out. Verify your doctors for the 2027 plan year rather than assuming continuity.
The Timing Nobody Explains
There is a specific sequence to this, and knowing it saves a lot of pointless worry:
- By September 30 — your ANOC arrives. This is where your own plan’s 2027 premium and formulary become knowable.
- Mid-to-late September — CMS publishes the full 2027 Medicare Advantage and Part D landscape with final average premiums.
- October 15 – December 7 — the window to actually change anything.
- January 1, 2027 — new coverage, new prices, negotiated drug prices take effect.
- January 1 – March 31 — Medicare Advantage Open Enrollment, a second chance if you are already in an MA plan.
Nothing announced over the summer changes your current plan or your current prescriptions. September is when it becomes real.
Your AEP Checklist
- Read the ANOC — specifically the premium, the deductible, and the drug formulary
- Look up every medication you take in the 2027 formulary, and check its tier, not just whether it is listed
- Confirm your doctors and preferred pharmacy are in the 2027 network
- Run your actual drug list through the Plan Finder at medicare.gov — it compares total annual cost, not just premium
- If you had a big income change two years ago, check where you land on IRMAA, the income surcharge on Parts B and D. And if income has dropped since — retirement, a spouse’s death, divorce — file Form SSA-44 to request a reduction
- Compare on total cost for the year, not the monthly premium. A cheap premium with your drug on a high tier can cost far more overall
💡 Tip: Get free, unbiased help from your State Health Insurance Assistance Program (SHIP). Every state runs one, counselors are trained and independent, and they do not sell insurance — which distinguishes them from most of the people who will call you in October. Many programs also arrange interpreters if English is not your first language. It costs nothing, and it is the single most underused resource in Medicare.
Related reading: Medicare Explained: Parts A, B, C, D and When to Enroll · How to Save on Prescription Drugs in the USA
Figures reflect CMS announcements as of September 2026 for the 2027 plan year. Final plan-level premiums are published in the fall landscape files — confirm details for your own plan at medicare.gov. General information, not insurance advice.
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