Medicare Part D Plans for 2027: What to Check Before Choosing Coverage

Medicare Part D provides prescription drug coverage for people enrolled in Medicare. As 2027 approaches, seniors should review their available drug plans carefully because premiums, deductibles, medication coverage and pharmacy costs can vary significantly between insurers.

Even if you are satisfied with your current plan, its costs and covered medications may change next year. Here are eight important factors to check before choosing Medicare Part D coverage for 2027.

1. Compare Monthly Premiums

The monthly premium is the amount you pay to maintain your prescription drug coverage, even when you do not purchase medications.

For 2027, the Centers for Medicare & Medicaid Services (CMS) projects that the average monthly premium for stand-alone Medicare Part D plans will be approximately $36.

However, individual plan premiums vary considerably. KFF's analysis of 2027 plan data found that average premiums for national stand-alone plans range from approximately $6 to more than $200 per month.

When comparing premiums:

• Check the monthly payment for each available plan.
• Review whether your current plan's premium is increasing.
• Check whether income-related monthly adjustment amounts apply.
• Compare the premium against your expected annual prescription expenses.

A lower monthly premium does not necessarily mean lower total healthcare costs.

2. Check the Annual Deductible

A deductible is the amount you pay for covered prescriptions before your plan begins paying its share.

For 2027, the standard Medicare Part D deductible increases to $700, compared with $615 in 2026. Some plans may offer a lower deductible or no deductible.

Before enrolling, check:

• Whether the plan charges a deductible.
• Whether the deductible applies to all medication tiers.
• Whether certain generic medications are covered before the deductible is met.
• How much you may pay before the plan begins sharing prescription costs.

A plan with a lower premium but a higher deductible may not be the most affordable choice for someone who takes several medications.

3. Review Your Prescription Drug List

One of the most important steps is checking whether the medications you currently take are included in the plan's formulary.

A formulary is the insurer's list of covered prescription drugs.

Before selecting a 2027 plan, verify:

• Whether each prescription is covered.
• Whether generic and brand-name versions are available.
• Which cost-sharing tier applies to each medication.
• Whether the plan requires prior authorization.
• Whether step therapy or quantity limits apply.

A medication covered in 2026 may have different coverage conditions in 2027.

If an important medication is not covered, ask the insurer about its exception process and discuss appropriate alternatives with your healthcare provider.

4. Compare Copayments and Coinsurance

Your prescription costs can differ depending on the medication and its formulary tier.

Copayment: A fixed amount you pay for a prescription.

Coinsurance: A percentage of the medication's covered cost that you pay.

For example, a plan may charge:

• $5 for a preferred generic medication.
• $20 for another generic medication.
• 25% coinsurance for a preferred brand-name drug.
• A higher percentage for certain non-preferred or specialty medications.

These are illustrative examples, not universal 2027 plan prices.

KFF's analysis of 2027 plan data found that many plans use coinsurance for brand-name and non-preferred medications. This can make prescription costs less predictable, particularly for expensive drugs.

5. Understand the 2027 Out-of-Pocket Spending Limit

Medicare Part D includes an annual limit on out-of-pocket spending for covered prescription drugs.

For 2027, the out-of-pocket threshold increases to $2,400, compared with $2,100 in 2026.

Once qualifying out-of-pocket spending reaches this limit, beneficiaries generally pay nothing for covered Part D drugs for the remainder of the calendar year.

This protection can be particularly important for people who take expensive medications or several prescriptions regularly.

Remember that not every healthcare expense counts toward this limit. Premiums, non-covered medications and certain other costs are excluded.

6. Check Your Preferred Pharmacy Network

Medicare Part D plans use pharmacy networks, and prescription costs can vary depending on where you fill your medications.

Some plans offer preferred pharmacies with lower copayments or coinsurance.

Before choosing a plan, check:

• Whether your regular pharmacy is in-network.
• Whether it is classified as a preferred pharmacy.
• Whether mail-order prescriptions are available.
• Whether 90-day supplies offer additional savings.
• Whether your medications are available through the plan's preferred pharmacy arrangements.

A plan with a low premium may become more expensive if your preferred pharmacy is outside its network.

7. Look for Financial Assistance Programs

Eligible Medicare beneficiaries may qualify for programs that help reduce prescription drug expenses.

Extra Help: This federal program assists qualifying individuals with Part D premiums, deductibles and prescription cost-sharing.

Medicare Savings Programs: Depending on eligibility, these programs may help pay Medicare premiums and other healthcare costs. Enrollment in a Medicare Savings Program can also automatically qualify someone for Extra Help.

State Pharmaceutical Assistance Programs: Some states provide additional financial assistance for eligible residents who need prescription coverage.

Medicare Prescription Payment Plan: This program allows eligible enrollees to spread covered out-of-pocket prescription costs across the calendar year through monthly payments. It helps manage payment timing but does not reduce the total amount owed.

8. Compare Stand-Alone Part D and Medicare Advantage Drug Coverage

Medicare beneficiaries can generally receive prescription coverage through two main arrangements.

Stand-alone Medicare Part D plan: This is a separate prescription drug plan that can be combined with Original Medicare.

Medicare Advantage plan with prescription drug coverage (MA-PD): This combines Medicare health coverage and prescription drug benefits in one plan.

Check the medical coverage, provider network and prescription benefits together before switching between these arrangements.

When Can You Change Your Medicare Part D Plan for 2027?

Medicare Open Enrollment for 2027 coverage runs from:

• October 15, 2026: Enrollment period begins.
• December 7, 2026: Enrollment deadline.
• January 1, 2027: New coverage generally begins.

During this period, eligible beneficiaries can join, switch or drop a Medicare prescription drug plan. Changes generally take effect on January 1.

You can compare plans using the official Medicare Plan Finder. Enter your ZIP code, medications and preferred pharmacies to review available coverage and estimated costs.

Final Thoughts

Choosing Medicare Part D coverage for 2027 requires more than comparing monthly premiums. Seniors should review their prescription drug lists, deductibles, copayments, coinsurance, pharmacy networks and annual out-of-pocket limits.

Even if your current plan worked well in 2026, its costs and coverage conditions may change next year. Compare the available plans during Open Enrollment and check whether your medications and preferred pharmacies are included before making a decision.