Medicare Part D Plans 2027

Part D coverage has three stages each year. Where you are in the year determines what you pay at the pharmacy.

If big drug costs hit early in the year, the Medicare Prescription Payment Plan lets you spread your out-of-pocket drug costs into monthly payments across the year instead of paying at the pharmacy counter. It is available with every Part D plan and Medicare Advantage plan with drug coverage, and it does not change the total you owe.

Source: CMS, September 28, 2026, and Part D bid information, July 28, 2026.

Ending the stabilization demonstration means standalone drug plans return to normal market pricing for 2027. Some plans will raise premiums, some will drop them, and some will leave your area, so compare even if you were happy with your plan in 2026.

Tier structures vary by plan. Check each plan’s formulary.

Plans can also apply coverage rules. Prior authorization means the plan must approve a drug before it pays. Step therapy means you may need to try a lower-cost drug first. Quantity limits cap how much you can get at one time. If your doctor believes you need an exception, you can ask your plan for one.

See Part D drug tiers explained and understanding Part D formularies.

If you keep Original Medicare, with or without a Medigap plan, you need a standalone Part D plan for drug coverage. If you join a Medicare Advantage plan with drug coverage, you cannot also have a separate Part D plan; enrolling in one generally ends the other.

See how to choose a Medicare Part D plan and common mistakes when choosing Plan D.

Where you fill prescriptions can change your yearly cost as much as which plan you choose. Most plans divide their network into preferred and standard pharmacies. Preferred pharmacies have lower negotiated prices and often lower copays; standard pharmacies are still in network but usually cost more. Out-of-network pharmacies are generally not covered except in limited situations.

If you take maintenance drugs for blood pressure, cholesterol, diabetes or thyroid, compare a 90-day mail-order fill in the plan finder. For many people it is the single easiest way to cut costs.

Insurers can offer two kinds of standalone Part D plans. A basic plan must cover at least Medicare’s standard benefit. An enhanced plan adds coverage, such as a lower or $0 deductible on certain tiers or lower copays, usually for a higher premium.

For 2027, CMS says 88% of non-low-income beneficiaries can get a basic plan for $10.30 a month or less, and 93% can get an enhanced plan for less than $6 a month. Whether an enhanced plan is worth it depends entirely on your drugs. See standard vs enhanced Part D plans.

Each Part D plan submits a bid to CMS. CMS uses those bids to set the national average monthly bid amount, which is $296.05 for 2027, and the base beneficiary premium, which is $41.33 for 2027. The base premium is used to calculate the late enrollment penalty and premium subsidies; it is not what you pay. Your actual premium depends on your plan and region.

Federal law limits how much the base beneficiary premium can rise each year, to 6% through 2029. That protection applies to the base premium, not to every individual plan, so your plan’s premium can still go up by more.

Part D is voluntary, but most people should have drug coverage from the start, even if they take few or no prescriptions today. If you go without Part D or other creditable coverage when you are first eligible, the late enrollment penalty can follow you for life.

Sometimes a drug you take is not on a plan’s 2027 formulary, or it carries a rule like prior authorization. You still have options:

See steps to appeal a Medicare Part D denial.

If your income and savings are limited, two programs can cut your Medicare costs sharply:

If you qualify for both Medicare and full Medicaid, you may also be able to join a Dual Special Needs Plan. See help for low-income Part D beneficiaries.

You do not have to compare plans alone, and you should not have to pay for help. These are the free options:

Before any call, have your Medicare card, your list of drugs and doses, your doctors and your preferred pharmacies ready. It turns a long conversation into a short one.