Medicare Part D Premiums for 2027: The Free Drug Plans Are Gone
If your mom or dad is on a stand-alone Medicare drug plan, the envelope that arrived in September is worth reading twice. It is called the Annual Notice of Change, and it is the one piece of mail all year that carries their real numbers: the premium, the deductible, the drug list, and anything that changed.
This year, one line in that letter deserves a second look. For years, a large share of stand-alone drug plans cost nothing per month. In 2027, according to KFF's analysis of the federal plan files, there are no zero-premium stand-alone drug plans anywhere in the country (before any Extra Help, the federal low-income subsidy). About 4.1 million people who pay nothing today will pay something next year. The free plan is not being taken away from your parent specifically. It is being taken away from everyone at once.
Two official numbers, and the gap between them
A month before KFF published, the Centers for Medicare & Medicaid Services said something quite different. In its September 28 release, CMS projected that the average stand-alone Part D premium would rise by less than $1 a month in 2027, from $35 to $36, and described "broad pricing stability across the Part D market."
KFF, using the same federal plan files, put the 2027 average at $51 a month, up 50 percent from $34. Those two numbers cannot both be right.
They can, and the difference matters. KFF weighted its estimate by who is enrolled where today and assumed nobody changes plans. CMS did not explain the method behind its figure. A likely explanation, though CMS has not confirmed it, is that the agency assumed people shop around and switch, which would pull the average down. If so, $36 is not a prediction of what your parent will pay. It is a prediction of what the market averages out to after several million people do paperwork.
KFF is also upfront that $51 is probably too high. Last year the same exercise projected $44 for 2026, and the actual figure came in at $34 once people switched. So treat $51 as the cost of doing nothing and $36 as the cost of a market where everyone does something. Your parent's number is in the letter.
What is not in dispute is the direction for people who sit still: 76 percent of stand-alone drug plan members who do not get financial help will pay more in 2027 if they keep the plan they have, and nearly 30 percent of them will pay $100 a month or more. About 2.4 million people will see an increase above $50 a month, against roughly 38,000 who saw an increase that size last year.
Why it is happening, in plain terms
For 2025 and 2026, CMS ran something called the Part D Premium Stabilization Demonstration. It paid stand-alone drug plans extra money and limited how much participating plans could raise premiums in a single year, by $35 a month in 2025 and $50 in 2026. On July 28, CMS announced it is ending the program after 2026, a year earlier than planned, saying insurers now have "sufficient experience" with the redesigned drug benefit to price their plans without help.
The administration's framing is that those payments were subsidies to insurance companies and that premiums are stable without them. CMS Administrator Mehmet Oz said the previous administration gave billions of taxpayer dollars directly to big insurers and called that unacceptable.
There is a second piece to it, and it is the part that makes the stand-alone market different from Medicare Advantage. Medicare Advantage plans that include drug coverage can use rebate dollars from Medicare to buy down the drug premium. MedPAC puts the average monthly rebate at $199 per enrollee in 2026, and plans spent about $51 of it reducing drug premiums. Stand-alone drug plans have no such mechanism. That is why the average drug premium inside Medicare Advantage is projected at $9 a month for 2027 while the stand-alone average is projected at $51. It is not that one is better run. It is that one has a fund to draw on and the other does not.
What this looks like in Florida
Florida has 5.33 million people with Medicare, according to CMS. Its 2027 state fact sheet adds a detail that cuts against the gloom: 11 stand-alone drug plans will be available in Florida, the lowest monthly premium in the state is $5.30, and 52.69 percent of the state's stand-alone enrollees have access to a plan with a lower premium than what they paid in 2026. About 23.5 percent of them already get Extra Help, which covers most of these costs.
So the savings exist, behind a comparison most people never run. Among the eight plans sold nationwide, the cheapest averages $6.50 a month and the most expensive, AARP Medicare Rx Preferred from UnitedHealthcare, averages $204.50, up from $126 this year. Premiums for the same plan also vary by region, by $90 or more for most of the national plans.
A second group matters too. KFF found 1.2 million stand-alone drug plan members in plans being terminated at the end of 2026, including about 950,000 in CVS Health's SilverScript Choice, which is leaving 13 of the 34 drug plan regions. Those enrollees need to choose a new plan; the year does not roll over for them. Neither CMS's Florida fact sheet nor KFF's analysis says whether Florida is one of the 13 regions, so check the letter rather than assume.
The deductible and the coinsurance trap
The premium is only half the bill. In 2027 the standard Part D deductible rises to $700 from $615, and virtually every stand-alone plan member, 99.8 percent, will be in a plan that charges a deductible. The average deductible for stand-alone plans is $643, up from $540.
The annual cap on out-of-pocket drug spending rises too, to $2,400 from $2,100. That cap is the backstop: once your parent's covered drug spending crosses it, covered prescriptions cost nothing for the rest of the year. The deductible counts toward the cap rather than stacking on top of it.
The quieter change is coinsurance. Most stand-alone plans charge a percentage of a drug's price rather than a flat copay: typically 25 percent for preferred brand drugs and 35 percent for non-preferred drugs in 2027. On a $600 brand prescription, 25 percent is $150 at the counter, every month, until the cap is reached.
What to check, and what to do about it
Start with the Annual Notice of Change, which plans had to send by September 30. It lists your parent's 2027 premium, deductible, and cost sharing, and it flags any drug that moved to a different tier or dropped off the formulary. Tier changes are where the real money hides.
Then sit down with the drug list, not the premium. Medicare's Plan Finder at Medicare.gov lets you enter every prescription, dose, and frequency and see total yearly cost. A plan that saves $10 a month but moves one brand drug to a non-preferred tier can cost $1,000 more over the year.
Two things worth asking while you are in there: whether the plan charges coinsurance or a copay for the drugs your parent actually takes, and whether anyone in the household might qualify for Extra Help, which covers premiums, deductibles, and most copays for people with limited income.
Do not do this alone if it feels like too much. Florida runs a free counseling program called SHINE, through the Department of Elder Affairs and the local Area Agencies on Aging. Trained volunteers will walk through a drug list and compare plans with you at no cost. The number is 1-800-963-5337.
Last thing: the deadline. Open enrollment closes December 7, 2026, and changes made in that window take effect January 1. After that, most people are locked in until the next fall unless they qualify for a special enrollment period. If your parent's plan is being terminated, the letter says so, and that decision should not wait for December.
The part that is actually good news
A 50 percent average increase describes a specific behavior: keeping the same plan and never looking. More than half of Florida's stand-alone enrollees have access to a plan with a lower premium than they pay now, and the cheapest plan in the state is $5.30 a month.
None of that makes the rest of it fine. Drug costs are moving the wrong way for a lot of families, and the end of the premium program is a policy choice with real consequences for people on fixed incomes. It is a reason to spend one evening on the paperwork instead of assuming the letter is routine. CMS is expected to announce the official 2027 Part B premium in November, and our breakdown of projected 2027 Medicare premiums covers the rest of the math in the meantime. If your parent's Medicare Advantage plan is leaving instead, start with what to do when a plan is non-renewed.
Sources: KFF, "Medicare Part D Premiums and Cost Sharing in 2027," October 30, 2026, and "More Than 4 Million Medicare Beneficiaries Will Have Their Medicare Advantage or Stand-Alone Prescription Drug Plan Terminated at the End of 2026," October 27, 2026; CMS, "Medicare Part D 2027 National Average Monthly Bid Amount Information," July 28, 2026; CMS, "Medicare Advantage and Medicare Prescription Drug Programs Expected to Remain Stable in 2027," September 28, 2026; CMS, "Medicare Open Enrollment in Florida, 2027" fact sheet, September 28, 2026; CMS CY 2027 Rate Announcement, Attachment V; MedPAC, March 2026 Report to Congress, Chapter 12; Florida SHINE, floridashine.org.
Frequently Asked Questions
Are there any $0 premium Medicare drug plans in 2027?
Not for people without Extra Help. KFF's analysis of the federal plan files finds no zero-premium stand-alone Part D plans offered in 2027, which affects about 4.1 million people who paid nothing in 2026. In Florida, the lowest stand-alone premium is $5.30 a month, according to CMS.
Why are Medicare Part D premiums going up in 2027?
CMS is ending the Part D Premium Stabilization Demonstration after 2026. The program paid stand-alone drug plans extra money and limited how much they could raise premiums. KFF projects the average stand-alone premium will rise 50 percent, from $34 to $51, if enrollees keep their current plans, though KFF expects the real figure to be lower once people switch.
Why do CMS and KFF report different Part D premium averages for 2027?
CMS projects the average stand-alone premium will rise from $35 to $36, while KFF projects $51. KFF weighted its estimate by current enrollment and assumed nobody changes plans. CMS did not explain its method; a likely explanation, which CMS has not confirmed, is that it assumed people will switch to cheaper plans.
What are the Part D deductible and out-of-pocket cap in 2027?
The standard deductible rises to $700 from $615, and the annual cap on out-of-pocket drug spending rises to $2,400 from $2,100. Once covered drug spending reaches the cap, covered prescriptions cost nothing for the rest of the year. KFF reports the average stand-alone plan deductible is $643, up from $540.
How can Florida families compare Part D plans for 2027?
Start with the Annual Notice of Change the plan mailed by September 30, then enter every prescription into the Medicare Plan Finder at Medicare.gov to compare total yearly cost, not just the premium. Florida's free SHINE counseling program can help at 1-800-963-5337.
When does Medicare open enrollment end for 2027 drug plans?
Open enrollment closes December 7, 2026, and changes made during the window take effect January 1, 2027. After that, most people cannot change plans until the next fall unless they qualify for a special enrollment period. If a plan is being terminated at the end of 2026, the member needs to choose a new one.