Medicare Open Enrollment 2027: New Part D Limits, Drug Price Changes and How to Compare Plans

Every autumn, millions of older Americans get a short window to change their health and drug coverage, and the choices made now will shape what they pay next year. The coming year brings a higher cap on prescription drug spending, a higher deductible and the first negotiated prices on popular medicines.

In this article we will discuss the dates, the new Part D limits, the drug price changes, the rebate payments reported this month, and a practical way to compare plans before the window closes.

Open Enrollment Runs From October 15 to December 7

The Calendar

Medicare’s annual open enrollment period began on October 15 and continues through December 7, 2026. Any changes you make during that window take effect on January 1, 2027. Because the period is short and coverage starts on a fixed date, waiting until the final week leaves little room for mistakes, phone queues or paperwork delays. If you plan to change plans, aim to finish by the end of November.

The Associated Press, in a report carried by ABC News, described the choice in simple terms. People decide between traditional Medicare, which is run by the federal government, and Medicare Advantage, in which private insurers run the plans and take responsibility for your coverage. Prescription drug plans are a third piece. Traditional Medicare does not include drug coverage on its own, so most people in it add a stand-alone Part D plan, while many Medicare Advantage plans bundle drug coverage in.

The Basic Choice

Traditional Medicare lets you see any doctor or hospital that accepts Medicare, nationwide, with no network. It has deductibles and coinsurance, and many people add a supplemental Medigap policy to cover those gaps. Medicare Advantage plans typically bundle hospital, medical and often drug coverage, usually with a cap on yearly out-of-pocket costs for medical care, but they use networks, and they may require approval before certain services. Neither choice is better for everyone. The right one depends on your health, your doctors, your budget and how much you travel.

The AP report did not give plan counts or plan premium amounts, so nothing here should be read as a prediction of what plans in your area will charge. Those figures differ by county, and the official Medicare plan finder will show the real ones for your zip code.

Who needs to act? Anyone whose plan is changing in a way that hurts, anyone whose medicines or doctors have changed during the year, and anyone who has never compared. Loyalty to a plan rarely earns a discount, since insurers can change prices and drug lists every year, so the plan that was the best value three years ago may no longer be. People who are new to Medicare, or who are turning 65 soon, have their own initial enrollment window around their birthday month, and missing it can bring lifelong late penalties for Part B and Part D in many cases. Those who delay Part D without other creditable drug coverage can see a penalty added to their premium for as long as they have the coverage, so it is worth asking before you skip it. The rules are detailed, and the agency or a counselor can confirm how they apply to you.

Part D Limits Rise for 2027

The Out-of-Pocket Cap

According to AP, the cap on what a person with Medicare drug coverage pays out of pocket in a year rises to $2,400 in 2027, from $2,100 in 2026. The cap exists because the drug benefit was redesigned to protect people with very expensive prescriptions. Once your spending on covered drugs reaches the limit, you generally pay nothing more for those covered drugs for the rest of the calendar year. The cap counts what you pay toward deductibles, copays and coinsurance, but it does not count your monthly premium or drugs your plan does not cover.

An illustration with invented round numbers shows how it works. Imagine a plan with a $700 deductible and 25 percent coinsurance afterward, and a patient whose covered drugs would cost $20,000 over the year at full price. The patient pays the first $700, then 25 percent of the remaining $19,300, which would be about $4,825 on paper. Because that total is above the cap, the actual spending stops at $2,400. Real plans vary, so treat this only as a picture of the mechanism.

The Deductible

The standard Part D deductible rises to $700 in 2027, from $615 in 2026. That is an increase of $85. The deductible is the amount you may pay yourself before the plan begins to share the cost. Plans may charge less than the standard deductible, or none, and some do waive it for certain drugs, so the plan details matter more than the headline.

Timing also matters. Because the deductible resets each January, many people face their highest pharmacy bills in the first months of the year, when they are paying the full early cost of a refill. Ask whether a plan lets you spread costs across the year through the Medicare Prescription Payment Plan, a program that lets people smooth out-of-pocket drug costs into monthly payments instead of paying a large amount at once. It does not lower what you owe in total, but it can ease the cash-flow strain. Check whether the plans you are considering offer it and how it works for 2027.

The Premium Subsidy That Ends Early

AP also reported that a temporary Part D premium subsidy, which began in 2024, is ending early. The Centers for Medicare and Medicaid Services, or CMS, projects only modest price increases for most people, according to AP. Notice that this is a projection about averages. Your own plan might raise its premium more than average, or a competitor might cut it, which is exactly why it pays to compare.

It helps to keep premium and cost sharing in separate columns. The premium is the fixed monthly charge for having the plan. The deductible, copays and coinsurance are what you pay when you fill prescriptions. A plan with a very low premium can carry a full deductible and steep tiers, while a plan with a higher premium may waive the deductible and keep copays low. Which one is cheaper depends entirely on how many prescriptions you fill and how costly they are, which is why a healthy person with one cheap pill and a person with several brand-name medicines should not pick the same plan by the same rule.

Item	2026	2027
Part D out-of-pocket cap	$2,100	$2,400
Standard Part D deductible	$615	$700

The cap and the deductible are both higher, but the cap is more important for people who take costly medicines. The deductible matters more for people who take a mix of cheaper drugs and may never reach the cap. If you fall in the second group, your total yearly cost may depend more on the plan’s copay tiers and on which pharmacy you use than on the cap.

People who receive Extra Help, the federal program for those with limited income and resources, usually pay far less than the standard amounts. If your income is modest, it is worth asking whether you qualify, because the program can change what you owe and which plans make the most sense. Eligibility rules and the amounts are set by the government, so rely on the agency or a counselor for the numbers.

Negotiated Prices Begin in January for 15 Drugs

Under the federal negotiation program, Medicare bargains with manufacturers over the price it will pay for a set of high-spending drugs that have no generic competitors. The agreed price then applies across Medicare drug coverage, and pharmacies are paid on that basis. January 2027 is when the first negotiated prices take effect for 15 drugs, according to AP. Ozempic, Rybelsus and Wegovy are among them, and AP named several others as well. AP’s list of names is longer than the count of 15, so the exact set is unclear from that report. Check the official CMS list rather than relying on a news summary, and look up each medicine you take.

CMS estimates that the negotiation lowers prescription drug coverage costs for enrollees by $685 million in 2027, as AP reported. That is an aggregate estimate across the whole program, and it does not tell you what any one person will save. The price that was negotiated is what Medicare pays, and what you pay at the pharmacy depends on your plan’s design, your deductible and your coinsurance or copay. A lower negotiated price tends to lower your share when your cost is a percentage of the price, but it may do little if you pay a flat copay or have already reached the cap.

Two practical points. First, a negotiated price does not guarantee coverage. Each plan sets its own formulary, meaning its list of covered drugs, and decides what tier each drug sits on, which sets your cost. A plan can cover a medicine on a costly tier or add restrictions such as prior authorization. Second, coverage for a given medicine can depend on the condition it is prescribed for, so a medicine you know by name may be covered for one use and not another. Ask your plan, or the plan you are considering, about your specific prescriptions.

If you take one of these medicines, a review of your plan for 2027 deserves extra time. Compare your expected costs in January with your costs under rival plans, not just with your own current plan, since the benefit may be larger in some plans than others.

One trap is assuming the news guarantees a lower bill. If a plan puts a negotiated drug on a high tier, or requires you to try cheaper alternatives first, you could still pay a lot. Another trap is switching to a plan for one drug and discovering that three of your other prescriptions cost more there. That is why the whole-list comparison matters more than any one price. If a drug you rely on is not covered at all, ask your doctor whether an alternative exists, and ask the plan about an exception process, which many plans offer for medically necessary drugs.

Rebate Payments and Part B Costs Run on a Separate Track

What AP Reported About the $90 Payments

Separate from open enrollment, AP described several measures from the Trump administration. One is a one-time $90 payment related to the Part B premium, sent in October to more than 20 million enrollees, which is under one third of all people in Medicare. AP put the cost at about $2 billion. According to AP, about 35 million people in Medicare Advantage, millions of people with disabilities and low-income recipients are not eligible. Most payments go by direct deposit, with others sent as paper checks from the Treasury later in October.

I am relying on AP for all of those details, and CMS did not respond to AP’s request for comment, so the eligibility rules are best confirmed through an official notice or the agency. If you are not sure whether you qualify, wait for the deposit or check rather than contacting anyone who reaches out to you. Scammers like to exploit news about payments. Medicare will not call you out of the blue to ask for bank details, and a text or call promising a rebate in return for a fee or personal information should be treated as fraud.

The $500 Insurance Premium Checks

AP also reported that about 1 million people will receive $500 rebate checks tied to premiums for Affordable Care Act coverage. That group is separate from Medicare, so most readers of this article will not be affected, but it is useful if you have a family member or friend under 65 who buys coverage through the marketplace.

The Part B Premium for 2027

Part B, which covers doctor visits and outpatient care, has a monthly premium that is usually deducted from Social Security. For 2027 the standard Part B premium is projected at $209.50 a month. That figure is a projection and not final. CMS is expected to announce the final 2027 rates later in the fall, and the number could differ from the projection. It is also worth remembering that some people pay more through an income-related surcharge. When the final premium is published, it will also appear in your Social Security online message center. Treat the projected figure as a planning number and not as a bill. If you are still working and enrolled in Part B through payroll or direct billing, the same caution applies: wait for the official notice before adjusting your budget, and then compare the final number with what you assumed. A small gap in either direction is normal for a projection.

AP placed these measures in the context of inflation pressure on seniors and midterm elections a few weeks away. Whatever one thinks of the politics, the practical lesson is that one-time payments are not the same as lower costs next year. Your plan choice has a bigger effect on yearly spending than a $90 payment.

For people who are eligible, the sensible way to treat a one-time payment is as a small cushion, not a reason to change your plan. If you receive one, it may be easier to set it aside toward your first pharmacy bills in January, when the new deductible applies. If you do not receive one, AP reported that large groups are not eligible, so missing out does not necessarily mean a mistake was made. Keep your Medicare and Social Security records current, though, including your bank details and mailing address, so that official payments and notices reach you.

Comparing Plans, One Step at a Time

Nancy LeaMond of AARP, quoted by AP, said “higher healthcare costs are making it harder for older Americans to afford the care they need.” She urged people to “shop around, compare your options, and choose the coverage that’s best for you.” That advice is simple, and a clear process makes it manageable.

Start With Your Medicine List

Write down every prescription you take, with the dose and how often you take it, and the pharmacy you prefer. Enter that list into the official Medicare plan finder. The tool estimates your total yearly cost for each plan, including premiums, deductibles and copays, which is far more useful than comparing premiums alone. A plan with a low premium can be expensive if your drugs sit on high tiers.

Check Doctors, Hospitals and Networks

If you choose Medicare Advantage, confirm that your doctors, specialists and preferred hospital are in the network, and ask how referrals and approvals work. If you stay in traditional Medicare, networks matter less, but pharmacy networks still affect Part D costs. Preferred pharmacies often have lower copays than standard ones.

Add up the Whole Year

Put premiums, deductibles, copays and the out-of-pocket maximums side by side. For Advantage plans, look at the yearly maximum for medical costs, since it caps your worst-case spending for covered services. For traditional Medicare with Medigap, look at the premium for the supplement as well. If you take expensive drugs, the 2027 cap of $2,400 gives a worst-case figure for drug spending, but your premium sits on top of that.

Question to ask	Traditional Medicare with Part D	Medicare Advantage
Can I use any doctor?	Yes, any that accepts Medicare	Usually only in-network
Who covers drugs?	A separate Part D plan	Often bundled in the plan
What caps my yearly cost?	Medigap, if you buy it	A yearly maximum in the plan
Do I need approvals?	Rarely	Sometimes, for certain services
What should I check?	Drug tiers and supplement price	Network, approvals and extras

Look at the Extras and the Rules

Some Advantage plans offer dental, vision or hearing benefits, which can be worth real money, but check the limits. Also check the rules for switching later. In general, if you pick an Advantage plan and regret it, there is a separate window early in the year to leave, but the rules change and are limited, so confirm them on the official site. If you move from Advantage back to traditional Medicare, buying a Medigap policy may require medical underwriting in many states.

It also helps to check how a plan handles things you cannot predict. Ask how it covers care when you are traveling, what happens if your doctor leaves the network mid-year, how its mail-order pharmacy works, and whether it covers 90-day fills at a lower price. These details seldom show up in a headline comparison, yet they often decide whether a plan feels convenient or maddening in practice. If you rely on caregivers or family members, add them to the process, and consider giving a trusted person permission to speak with the plan on your behalf.

Final Thoughts: A Sensible Order of Choices Before December 7

Start by checking the mail. Your current plan should send a notice of changes each fall that explains next year’s premiums, drug lists and costs. Many people skip it and then find a surprise in January. If you are satisfied, read it anyway, since a plan can change its drug tiers without changing its name.

Next, run the plan finder with your medicine list, and compare at least three options, including your current plan. Look at the total estimated cost, not just the monthly premium. If you take one of the medicines named in the negotiated-price list, check how each plan covers it. Then check doctors and pharmacies. If you help a parent or spouse with their coverage, sit down together with the plan finder and their medicine bottles, because remembered lists often miss a dose or an over-the-counter item that matters. If the best plan costs only a little less than your current one, weigh the hassle of switching against the savings.

A change is worthwhile when it protects you from a real cost, such as a drug moving to a higher tier. It is less worthwhile when the only draw is a small premium difference that disappears once your prescriptions are priced in. Some people also find that a plan they have used for years still fits perfectly, and staying put after a careful check is a perfectly good outcome. What matters is that you made the choice on purpose, using your own numbers, rather than by default.

If you have limited income, ask about programs that help with costs, such as the Extra Help program for Part D and state programs, because eligibility rules can change each year. A State Health Insurance Assistance Program counselor offers free, unbiased help in most states. You can also call 1-800-MEDICARE to ask about your options.

Keep a short log of your decisions with the date, the plan name and any confirmation number. If something goes wrong later, that record makes it much easier to resolve.

Finally, make the change before the deadline, keep a confirmation, and review your first pharmacy bills in January. If a drug costs more than the plan finder predicted, contact the plan right away. Be wary of pressure. Plan advertising is heavy in the fall, and phone calls or mailers that promise big savings often push one product. A good rule is to make decisions from information you looked up yourself or got from a counselor, not from an unsolicited pitch, and to be skeptical of anyone who says a decision must be made on the spot.

This article offers general information only, and Medicare, a counselor or a licensed insurance professional can advise on your personal situation.

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Frequently Asked Questions

1. When Do the New Medicare Part D Limits Start?

They start on January 1, 2027. The out-of-pocket cap rises to $2,400 from $2,100, and the standard deductible rises to $700 from $615, according to AP.

2. Can I Change Medicare Plans After December 7?

Usually not during the fall window, which ends on December 7. Some people qualify for special enrollment periods, for example after a move, and Advantage members may have a limited chance early in the year, so check the rules with Medicare.

3. Who Gets the $90 Medicare Rebate Payment?

AP reported that more than 20 million enrollees were due payments, but about 35 million Medicare Advantage members, millions of people with disabilities and low-income recipients are not eligible. Confirm your situation with an official notice from the agency.

4. Will Ozempic Be Cheaper Under Medicare in 2027?

A negotiated price takes effect in January 2027 for Ozempic, Rybelsus and Wegovy, according to AP. What you pay still depends on your plan, its coverage rules and your cost sharing, so check your plan’s drug list.

5. Is the 2027 Part B Premium Final?

No. It is projected at $209.50 a month, and CMS is expected to announce the final rates later in the fall.

6. Do I Have to Do Anything if I Like My Current Plan?

Not necessarily, since your coverage generally continues. Still, read the notice of changes, because premiums, drug tiers and networks can change from year to year even when the plan stays the same.