Medicare Changes Are Coming in 2027: What to Know Before Open Enrollment
Medicare Open Enrollment runs from October 15 through December 7, 2026. This is the time when people with Medicare can review their coverage and make changes that will take effect January 1, 2027.
This year, reviewing that coverage may be especially important. Medicare Part D prescription drug plans are entering another period of change. And yes, the temporary federal program that helped hold down premiums is ending.
That does not mean Medicare Part D is ending. It does mean that some people with stand-alone prescription drug plans could see higher premiums or fewer plan choices in 2027.
The Part D Premium Stabilization Program Is Ending
When Medicare’s prescription drug benefit was redesigned in 2025, the Centers for Medicare & Medicaid Services (CMS) created a temporary Premium Stabilization Demonstration for participating stand-alone Part D plans.
The program provided additional federal support to help insurers adjust to the redesigned benefit and limit sudden premium increases. For 2026, participating plans received a $10 reduction in the base beneficiary premium and agreed to limit year-over-year premium increases.
CMS has now announced that the demonstration will end on December 31, 2026. According to CMS, Part D insurers have had enough experience with the redesigned benefit to price their plans under traditional market conditions. CMS’s July 2026 announcement confirms that the demonstration will not continue in 2027.
That announcement is significant, but it should be kept in perspective. The elimination of the demonstration does not automatically mean that every Part D premium will increase by a certain amount. Premiums are set by individual plans, and some may increase more than others. A few could even decrease.
The national base beneficiary premium (the figure used as a starting point when calculating plan premiums) will be $41.33 in 2027, up from $38.99 in 2026. The Inflation Reduction Act continues to limit increases in this national base amount to 6% annually through 2029. However, that protection does not necessarily limit the increase in the premium charged by an individual plan. CMS explains the 2027 premium calculation here.
The actual premium a beneficiary pays will depend on the plan selected, where the person lives, the plan’s drug costs, and other factors. Final plan-specific information should be reviewed through Medicare.gov or directly with the plan.
The Part D Deductible and Spending Cap Will Increase
Two important Part D amounts are also increasing in 2027:
The maximum standard Part D deductible will rise from $615 in 2026 to $700 in 2027.
The annual out-of-pocket cap for covered Part D prescriptions will rise from $2,100 to $2,400.
The out-of-pocket cap remains an important protection. Once a beneficiary reaches the $2,400 threshold for covered Part D drugs, the person will not owe additional cost-sharing for covered prescriptions for the remainder of the year.
Keep in mind that monthly premiums do not count toward the cap. Costs for drugs that are not covered by the plan generally do not count either. That is why checking the plan’s formulary (the list of medications it covers) is so important.
The Prescription Payment Plan Will Continue
The Medicare Prescription Payment Plan, sometimes called M3P or “prescription smoothing,” will continue to be available.
This program allows people with Part D to spread their out-of-pocket prescription expenses over the remaining months of the calendar year instead of paying a large amount at the pharmacy all at once.
The program can make costs easier to budget, particularly when an expensive prescription is filled early in the year. However, it does not reduce the total amount owed. It changes when the money is paid, not how much the medication costs.
Participation is voluntary. People who expect high prescription expenses may want to ask their plan whether the payment option would help them manage monthly cash flow.
Some People May Qualify for $50 GLP-1 Medications
Another program worth watching is the Medicare GLP-1 Bridge. Beginning in July 2026, this demonstration gave certain Part D beneficiaries access to designated GLP-1 weight-loss medications for $50 for a monthly supply.
CMS has extended the program through December 31, 2027, after the planned Part D portion of the broader BALANCE Model was delayed. Eligibility is limited and depends on medical criteria, the medication prescribed, and other program requirements. Not everyone who uses or wants to use a GLP-1 medication will qualify. CMS provides current eligibility and program information.
Medicare Advantage Enrollment Caps Could Affect Some Choices
Beginning in 2027, certain Medicare Advantage plans may use enrollment capacity limits established through the plan-bidding process. If an affected plan reaches its approved limit, it may stop accepting new members even though the enrollment period is still open.
These limits are optional, and they do not apply to stand-alone Part D plans through the same process. Still, they could make waiting until the final days of Open Enrollment riskier for someone hoping to join a particular Medicare Advantage plan.
Do not rush into a decision without comparing coverage carefully. But once you have completed that review, there may be an advantage to submitting your enrollment request sooner rather than later.
What Should You Review This Fall?
Do not assume that the plan that worked in 2026 will remain the best choice in 2027.
Before Open Enrollment ends, review:
Your plan’s Annual Notice of Change
The monthly premium and deductible
Copayments and coinsurance for each prescription
Whether every medication you take is still covered
Whether a covered drug has moved to a different pricing tier
Prior-authorization, step-therapy, or quantity-limit requirements
Preferred pharmacies and mail-order options
Provider networks, hospitals, and supplemental benefits if you have Medicare Advantage
When comparing Part D plans, look at the total estimated annual cost, not simply the monthly premium. A low-premium plan can be much more expensive if it does not cover your medications favorably.
Compare plans at Medicare.gov, call Medicare at 1-800-MEDICARE, or request free counseling through GeorgiaCares, Georgia’s State Health Insurance Assistance Program.
Be Ready for 2027 Medicare Changes
For families helping aging parents, this is also a good time to make sure the right person is authorized to assist. Medicare representatives and insurance companies generally cannot discuss someone’s private information with an adult child simply because that person is a family caregiver. Proper Powers of Attorney, Medicare authorization forms, and other planning documents can make it much easier to help when questions or a health crisis arise.
Kimbrough Law does not select or sell Medicare plans. We can, however, help families put the legal pieces in place so that trusted people have the authority they need to advocate, obtain information, and make decisions when necessary. If you need help reviewing your estate plan, Powers of Attorney, or long-term care plan, call us at 706.850.6910.
