What's changing in Medicare for 2027?

What changes in Medicare Part D in 2027?

Three national Part D figures go up on January 1, 2027. The out-of-pocket cap rises to $2,400 from $2,100; once you, or others on your behalf like Extra Help, reach it, you pay $0 for covered Part D drugs for the rest of the year. The maximum deductible rises to $700 from $615, and some plans have no deductible. The base beneficiary premium rises to $41.33 from $38.99: CMS calls it the starting point for calculating a plan's basic Part D premium, and Medicare uses it to figure the Part D late enrollment penalty, so penalty amounts may go up too.

Other Part D changes and reminders for 2027:

• CMS is ending the Part D Premium Stabilization Demonstration, a voluntary program for stand-alone drug plans that began in 2025, at the end of 2026.
• Changes to your own plan's coverage and costs for 2027 are in its Annual Notice of Change.
• If you use the Medicare Prescription Payment Plan and stay in the same Part D plan, your participation renews automatically for 2027.
• People with Extra Help generally pay no more than a fixed amount for each generic and each brand-name drug at one of their plan's participating pharmacies.
• Part D plans still can't charge more than $35 for a one-month supply of each covered insulin, and there's no deductible for insulin.

Which drugs get Medicare negotiated prices in 2027?

CMS says the negotiated prices for 15 drugs covered under Part D, chosen in the second round of Medicare drug price negotiation, go into effect January 1, 2027. They follow the first 10 negotiated Part D drugs, whose prices began January 1, 2026, and CMS is negotiating a third group of 15 drugs, payable under Part B or covered under Part D, during 2026 for prices that take effect beginning in 2028. CMS also lists four of the first 10 drugs (Entresto, NovoLog/Fiasp, Stelara and Xarelto) with deselection determinations that remove them from the selected drug list effective January 1, 2027; CMS says a drug stops being a selected drug in certain circumstances, such as when a generic or biosimilar version is approved and marketed. The Medicare & You 2027 handbook says to contact your plan for details on how negotiated prices might affect you. See Medicare drug price negotiation.

The 15 drugs with negotiated prices from January 1, 2027:

• Austedo and Austedo XR
• Breo Ellipta
• Calquence
• Ibrance
• Janumet and Janumet XR
• Linzess
• Ofev
• Otezla and Otezla XR
• Ozempic, Rybelsus and Wegovy
• Pomalyst
• Tradjenta
• Trelegy Ellipta
• Vraylar
• Xifaxan
• Xtandi

What will the Medicare Part B premium be in 2027?

CMS announces it in the fall, along with the Part B deductible and the income brackets for IRMAA, the extra amount people with higher incomes pay; CMS released the 2026 amounts on November 14, 2025. The Medicare & You 2027 handbook says the 2027 premium amounts, drug costs and income limits weren't available when it was printed, and to visit Medicare.gov for the most up-to-date information. In 2026, the standard Part B premium is $202.90 a month and the Part B deductible is $283. See the 2027 Part B premium answer, which updates itself when the figures are published.

How much will Social Security go up in 2027?

By 3.6%. The Railroad Retirement Board's October 2026 announcement says the tier I portion of railroad retirement annuities, like Social Security benefits, will increase by 3.6% in January 2027, based on the rise in the Consumer Price Index from the third quarter of 2025 to the third quarter of 2026. The Medicare & You 2027 handbook says that if you get Social Security or Railroad Retirement Board benefits, your Part B premium will be deducted from your monthly benefit payment.

What other Medicare changes start in 2027?

The Medicare & You 2027 handbook highlights these:

• Telehealth: Medicare extended telehealth flexibilities through December 31, 2027, so you can get telehealth services at any location in the U.S., including your home. You pay 20% of the Medicare-approved amount, and the Part B deductible applies.
• Prior authorization: starting January 1, 2027, your Medicare Advantage plan may be able to process prior authorization requests electronically, and you may be able to see the decisions in your patient portal.
• Eligibility: you must now meet certain citizenship, nationality or immigration status requirements to sign up for Medicare.

When can I change my Medicare coverage for 2027?

During Open Enrollment, October 15 to December 7, 2026. You can join, switch or drop a Medicare Advantage plan or a Medicare drug plan, or switch to Original Medicare, and new coverage begins January 1, 2027. If you're in a Medicare Advantage plan, you can also change to a different Medicare Advantage plan or switch to Original Medicare (and join a drug plan) from January 1 to March 31, 2027. Your plan sends its Annual Notice of Change by September 30 and its Evidence of Coverage notice by October 15. See when you can change Medicare plans.