Medicare Part D Premiums Are Set for a Sharp 2027 Jump
Millions of older Americans who buy stand-alone Medicare Part D coverage are heading into open enrollment with a far more expensive bill in hand. A new KFF analysis projects that average monthly premiums for these plans will rise 50% in 2027, climbing from $34 to $51. For many beneficiaries, the practical difference between staying put and shopping around will be substantial. One Virginia enrollee, Robert Travis Scott, moved quickly after learning his AARP-UnitedHealthcare premium would surge from $39.60 in 2026 to $121.90 next year. He found a Humana plan with similar benefits for $19.30 and estimated he had saved about $1,000.
The premium increase lands at a politically charged moment, but the financial burden is mechanical and immediate at the bedside of everyday insurance decisions. Medicare beneficiaries cannot rely on broad promises about lower drug prices when their own plan notices arrive with large premium hikes.
Stand-Alone Drug Plans Bear the Brunt
The sharpest increases fall on beneficiaries enrolled in stand-alone prescription drug plans, which are used by nearly 25 million people, according to KFF. In contrast, the average premium for drug coverage embedded in Medicare Advantage plans is projected to rise only slightly, to $9 a month, an increase of less than $2. More than half of Medicare beneficiaries are enrolled in Medicare Advantage plans rather than traditional Medicare, and those enrollees usually receive drug coverage as part of the broader plan. The divergence matters because it splits the Medicare population into two very different cost trajectories for 2027.
For people in stand-alone plans, the stakes are high if they fail to compare options during the annual open enrollment period, which runs through Dec. 7. KFF’s Juliette Cubanski warned that enrollees who sit on the sidelines could face sizeable premium increases, especially when lower-cost alternatives are available in the market. The open enrollment window is not a bureaucratic formality; it is the only realistic chance many beneficiaries have to blunt the premium shock before it reaches their monthly budget.
Deductibles and Coinsurance Add Another Layer of Cost
Premiums are only part of the financial burden. Most beneficiaries with drug coverage next year will also face annual deductibles, and those deductibles are rising. The average deductible for stand-alone plans is expected to reach $643 in 2027, up from $540 in 2026. For Medicare Advantage drug coverage, the average deductible is projected to climb to $489 from $360. Beneath the headline premium increase sits a second cost layer that patients encounter before coverage fully begins.
Coinsurance will also remain common, which means many enrollees will pay a percentage of a drug’s price rather than a fixed copayment. In practice, coinsurance shifts more pricing risk onto patients, especially those taking high-cost medications or multiple therapies. For a beneficiary managing diabetes, cardiovascular disease, cancer, or autoimmune illness, that can translate into unpredictable pharmacy bills from month to month. A low premium does not mean low total out-of-pocket exposure.
A Subsidy Program Ended Early
One likely driver of the premium spike is the Centers for Medicare & Medicaid Services’ decision in July to end early a temporary subsidy program designed to hold down stand-alone premiums. The program had paid subsidies to these plans in 2025 and 2026. By ending it after only two years, CMS removed a financial cushion that had softened premiums for many beneficiaries.
CMS Administrator Mehmet Oz has called the subsidy program an insurance industry bailout. KFF’s analysis takes the opposite view: removing the subsidy could push stand-alone premiums higher in 2027. The dispute centers on how much the market can absorb once federal support disappears. A premium increase of this size suggests the adjustment is being passed along directly to enrollees rather than absorbed by insurers or offset through plan design.
The Gap Between KFF and CMS Projections
KFF’s projection differs sharply from CMS’ own forecast of just a $1 increase in the national average premium, from $35 to $36, based on September 2026 enrollment. CMS has not laid out its calculation method in the materials cited here, and the discrepancy may reflect different assumptions about beneficiary behavior. CMS could be assuming that many people will move to lower-cost plans rather than remain in the same coverage.
That assumption is plausible. It is also exactly why open enrollment matters so much this year. If people switch plans aggressively, the national average premium can look relatively stable even while individual beneficiaries who fail to change plans face steep increases. The aggregate number can flatten what feels like a sharp household-level shock.
Millions Will Pay More If They Stay Put
About 10.4 million Medicare enrollees, or 76% of enrollees in stand-alone drug plans who do not receive low-income subsidies, will pay a higher monthly premium in 2027 if they stay in the same plan, KFF found. The most striking group is the 4.1 million people now in zero-premium plans. Those plans will no longer be available, meaning those beneficiaries will automatically face new monthly charges next year.
For patients on fixed incomes, the loss of a zero-premium option is more than a pricing adjustment. It forces a re-evaluation of whether coverage remains affordable at all, especially for people already paying deductibles and coinsurance for chronic medications. Even modest monthly increases accumulate quickly over a year, and the largest hikes can alter adherence, refill timing, and plan loyalty.
Open Enrollment Becomes a Budget-Critical Clinical Decision
The current premium cycle turns Medicare drug-plan shopping into a high-stakes annual task. Beneficiaries who review plan options can often lower their costs substantially, as Scott did when he moved from a premium of $121.90 to $19.30 for a plan with similar benefits. Those who do not review their coverage may absorb a rise they never intended to accept.
For clinicians, pharmacists, and caregivers, the practical message is straightforward: patients need to be reminded that drug coverage is not passive. Premiums, deductibles, and coinsurance are all changing together, and the combined effect may be far larger than the monthly premium alone suggests. The unresolved question is how many beneficiaries will notice the change before the Dec. 7 deadline, and how many will learn about it only after the higher bill arrives.