Medicare Part D Premiums in 2027: The Subsidy Ends December 31, and December 7 Is Your Deadline

Most of the “Part D 2027” coverage published this fall was written in September, when the national numbers came out and the tone was reassuring. Premiums on average barely moved, the out-of-pocket cap stayed in place, and the story ended there. That framing is accurate and, for millions of households, nearly useless. The people who pay the price for an average that looks calm are the ones sitting in a plan whose premium jumped, a plan that quietly became more expensive than the one beside it, or a $0 plan that no longer exists.

This guide starts from the other end. It begins with what the subsidy actually did, identifies the plans where the removal shows up most sharply, converts the monthly changes into yearly dollars, and then gives you a dated plan that fits between today, October 30, and the December 7 deadline. Everything below uses figures from CMS, KFF, MedPAC, and GAO.

1. The Average Is Stable. Your Premium May Not Be.

On September 28, CMS projected that the enrollment-weighted average premium for a stand-alone Part D plan will be $36 in 2027, up from $35.09 in 2026. A day later the news cycle moved on. Four days after that, KFF published a plan-by-plan analysis of the same federal data and reached a more complicated conclusion: modest changes for many enrollees, but much steeper increases for others who keep their current plan.

The gap between “average” and “your plan” exists because enrollment is concentrated. A handful of national plans hold most stand-alone members, so a $17 cut in one plan and a $100 increase in another can net out to a rounding error nationally while changing two very different households’ budgets. If you are one of roughly 25 million people with a stand-alone Part D plan, the national average tells you almost nothing. Your plan’s own 2027 premium, in your own region, is the only figure that matters.

One group can relax somewhat. KFF reports that 56% of Part D enrollees were in Medicare Advantage drug plans in 2026, and those plans can use federal rebate dollars to buy down drug premiums. CMS projects the average drug premium inside Medicare Advantage plans will fall from $11.32 to $7. The stand-alone market does not have access to those rebates, which is a structural reason premiums there behave so differently.

2. What the Subsidy Did and What Ends December 31

When Congress redesigned Part D, insurers faced a new and uncertain benefit: a hard annual out-of-pocket cap, no coverage gap, and a different distribution of financial risk. To keep stand-alone premiums from lurching while the market adjusted, CMS launched the Part D Premium Stabilization Demonstration for 2025. It pulled two levers at once.

The first lever lowered the base beneficiary premium, the national benchmark from which every plan’s premium is calculated. The second lever limited how much any participating plan could raise its premium from one year to the next. MedPAC estimated the demonstration lowered the average stand-alone premium by $26 in 2025 and by $16 in 2026. GAO reported that CMS officials estimated the cost at $9.8 billion across the two years. Over that period, stand-alone enrollment grew from 22.8 million in 2024 to 24.9 million in 2026.

CMS announced on July 28 that it would not continue the program, arguing that insurers now have enough experience with the redesigned benefit to price plans without extra support. CMS Administrator Mehmet Oz has characterized the subsidy as a bailout for insurers, and the agency framed the end as cutting handouts. KFF, by contrast, noted that the program worked as intended to stabilize increases and keep enrollment steady, and that it had been originally planned to run a third year. Both readings can be supported by the data. What is not in dispute is the mechanical effect: the base beneficiary premium rises to $41.33 in 2027, up 6% from $38.99, which is the maximum the Inflation Reduction Act allows, and the $50 ceiling on increases is gone.

That second point is the one most coverage missed. Under the 2026 rules, no participating plan could raise its premium by more than $50 in a year. Starting in 2027, there is no ceiling. That is why some members now see jumps that would have been impossible under last year’s protections.

3. The Plans Where Premiums Move Most

KFF compared each national plan’s 2027 premiums to 2026 across all 50 states and D.C. Six of the eight stand-alone plans offered nationally will see premium reductions in at least some states for people who keep them. The picture changes sharply by sponsor.

Two details deserve emphasis. First, the AARP-branded plans together enroll more than 2 million people without Extra Help, which is why the increases there are the largest consumer-impact story of the year. Second, Wellcare Value Script is both the cheapest plan in much of the country, at $5.30 a month in 45 states, and the largest, with 5.9 million non-Extra-Help members in 2026. If you are in that plan, you are in the group for whom doing nothing may be perfectly reasonable, provided your drugs and pharmacy still fit.

4. What “Doing Nothing” Costs Over a Year

Monthly figures feel small. Annual figures do not. The table converts the changes above into what stays in your pocket or leaves it across 12 months. Premiums do not count toward the out-of-pocket cap, so every dollar here is on top of what you pay for drugs.

KFF’s research on switching behavior explains why these numbers matter. Nearly 7 in 10 Medicare beneficiaries did not compare plans during a recent open enrollment, and most people rarely change coverage. Plans are priced on the assumption that many members will not move. A $600 annual increase is only a cost if you absorb it; a switch to a cheaper plan is available in every region.

5. Why the $0 Stand-Alone Plan Disappeared

In 2026, 28% of stand-alone members without Extra Help, about 4 million people, paid no monthly premium. In 2027, KFF found, there is no $0-premium stand-alone plan available to anyone without Extra Help. The cheapest plans start at $5.30. KFF treats the disappearance as possibly related to the end of the demonstration, since the subsidy had effectively bought down the cheapest premiums.

The behavioral risk is larger than the dollar amount. People who have never paid a Part D premium have never had a reason to open a plan comparison, and a $5.30 charge is easy to ignore. But a premium of any size means a new line on a statement, a new deduction from a Social Security check, or a new bill, and it is also the clearest signal that the plan’s other features may have changed. If you were in a $0 plan, treat the new charge as your cue to compare, not as a rounding error.

6. Premium Is Only One of Four Numbers

A plan with a low premium can be the most expensive one you own, and a plan with a high premium can be the cheapest. Four numbers decide your real yearly cost.

Number 1: The monthly premium

Multiply by 12. It is guaranteed, it is paid whether or not you fill a prescription, and it does not count toward your out-of-pocket cap.

Number 2: The deductible

The maximum standard Part D deductible rises from $615 to $700 in 2027. Plans can charge less and many do, but the average unweighted deductible across stand-alone offerings in the CMS landscape file climbs from about $498 to about $606. Some plans apply the deductible only to higher tiers and exempt generics, which matters enormously if your drugs are mostly low-cost. Check which tiers your plan’s deductible touches.

Number 3: The formulary and tier of your drugs

A plan’s premium says nothing about whether your medication is covered, what tier it sits on, or whether the plan requires prior authorization or step therapy first. KFF notes a trade-off in this market: when premium increases are held down, coverage can become less generous through fewer covered drugs, higher cost sharing, or more utilization management. A $5.30 plan that moves your drug to a higher tier can cost more than a $40 plan that covers it at a flat copay.

Number 4: The out-of-pocket cap

The 2027 cap on covered-drug spending is $2,400, up from $2,100. It is identical in every plan. After you reach it, covered drugs cost $0 for the rest of the year. The cap changes the strategy for people with expensive medications: if you will hit $2,400 regardless of which plan you pick, your yearly drug cost is effectively fixed, and the premium becomes the only thing that differs, provided your drug is covered in both plans.

7. Run Your Own Numbers: Two Quick Calculators

Enter figures from your Annual Notice of Change or from a plan comparison. Both tools run in your browser and nothing is stored.

The starting values illustrate a classic trap using hypothetical figures. Plan A charges $5.30 a month with a $700 deductible; Plan B charges $48 with no deductible. Plan A’s premiums total $63.60 a year and Plan B’s total $576, a $512.40 gap. If your drugs never reach the deductible, Plan A wins by that full amount. If you will certainly spend through the entire $700, Plan A costs $763.60 and Plan B $576, so Plan B wins by $187.60. The cheaper premium is not automatically the cheaper plan, and the expensive premium is not automatically the safe one. Your drug list decides.

8. Smoothing the Bill: The Medicare Prescription Payment Plan

The $2,400 cap protects your yearly total, but it does not protect your January. If you take a costly medication, the first fill of the year can land at the pharmacy counter as a very large payment. The Medicare Prescription Payment Plan lets you spread your out-of-pocket drug costs across the remaining months of the calendar year in equal installments. You opt in through your plan, and it carries no interest or fees.

Three limits are worth knowing. It changes the timing of what you owe, not the amount. It covers your drug costs only, not your monthly premium. And if you opt in at the start of 2027 with spending that reaches the cap, the most you would owe in any single month works out to $200, which is $2,400 divided by 12. For anyone whose budget breaks on a single large pharmacy bill, that predictability is worth more than a few dollars of premium difference between two plans.

9. A Shrinking Market: Fewer Plans, Fewer Exits

Stand-alone drug plans fell from 464 in 2025 to 360 in 2026 and fall again to 316 in 2027, offered by 15 parent organizations, down from 17. The average beneficiary will see 9 stand-alone plans next year compared with 11 this year, the fourth straight annual decline. Fifteen states will have only 8 options.

Much of the contraction comes from two sponsors scaling back. Health Care Service Corporation is withdrawing HealthSpring Extra Rx from 22 regions, and CVS Health is withdrawing SilverScript Choice from 13. Humana is the only insurer that continues to offer three stand-alone plans in all 34 regions. For consumers, a thinner market has two consequences. There are fewer alternatives if your plan raises prices, and there is less competitive pressure on premiums in future years. It also means that a plan that is gone is gone: if yours is among the withdrawals, you will receive a notice and must choose a replacement rather than wait.

10. Extra Help, Medicare Advantage, and Medigap

If you receive Extra Help (the Low-Income Subsidy)

Extra Help pays your premium in full up to a regional benchmark amount, and it also lowers or eliminates your deductible and drug copays. The no-$0-plan problem described above does not apply to you in the same way, because benchmark plans remain free for full-subsidy members. But benchmark status is set region by region and can change from year to year. If you chose a plan above the benchmark, you pay the difference, and a plan that loses benchmark status can leave you with a new charge. Read any letter from your plan or from Medicare about reassignment. People with Extra Help can also change stand-alone plans outside the fall window, which is useful, but you should still confirm for 2027 that your plan is at or below your region’s benchmark.

If you are in a Medicare Advantage plan with drug coverage

Stand-alone premium changes do not apply to you. Your drug premium is bundled into your Advantage plan, where rebates keep it low, and CMS projects the average Medicare Advantage premium overall will fall from $14.37 to $12.00. Your risks in 2027 are different ones: your doctors leaving the network, new prior authorization rules, or your plan leaving your county. Check your Annual Notice of Change for those. If you want to change Medicare Advantage plans, you get another opportunity from January 1 through March 31 that stand-alone members do not.

If you have Original Medicare with a Medigap policy

A Medigap policy does not cover outpatient drugs, so you rely on a stand-alone plan and you are directly exposed to everything in this guide. It is tempting to escape a high drug premium by moving to Medicare Advantage. Do not decide on that basis alone. Giving up Original Medicare and Medigap can make it difficult or impossible to return to your current Medigap coverage later without medical underwriting in most states. A $50 monthly premium difference does not justify that trade; a $600 annual savings in the stand-alone market through a different plan does not require it.

11. The 38-Day Plan to December 7

Open enrollment runs October 15 through December 7. Starting today, October 30, you have 38 days. The schedule below deliberately finishes your enrollment before Thanksgiving, when pharmacy and plan phone lines get busy, and leaves two weeks as a buffer.

1. Today through Sunday, November 1: GatherFind your Annual Notice of Change and your Medicare card. Write down every prescription with its strength and how often you take it, plus the pharmacy you use. Include medications you take only occasionally.
2. By Friday, November 6: CompareOpen Medicare’s Plan Finder, enter your drug list and pharmacy, and view all stand-alone plans for your ZIP code sorted by total estimated yearly cost, not by premium. Include your current plan so you can see exactly what staying costs.
3. By Friday, November 13: Narrow to two or threeFor each finalist, confirm the tier for every drug, any prior authorization or step therapy, the deductible, and whether your pharmacy is preferred or standard. A preferred pharmacy can change a copay noticeably.
4. By Friday, November 20: EnrollEnroll through Plan Finder, the plan, or by calling 1-800-MEDICARE. Write down your confirmation number. Enrolling in a new stand-alone plan automatically ends your old one, so you do not need to cancel separately.
5. November 23 to December 4: BufferWatch for the plan’s welcome materials. If something goes wrong with your enrollment, you still have time to fix it.
6. Monday, December 7: Hard stopThis is the last day. Do not plan to finish on December 7; processing problems and busy lines do not stop for deadlines.
7. January 1 to 15, 2027: TestFill one prescription early in the month. Confirm your new ID card, your cost matches what Plan Finder showed, and, if you want to spread costs, opt in to the Prescription Payment Plan.

If you want a person rather than a website, every state has a State Health Insurance Assistance Program (SHIP) that offers free, unbiased Medicare counseling. Appointments fill up in November, so book now rather than later.

12. What Happens If You Miss December 7

For most people in a stand-alone plan, the answer is that you stay in your 2027 plan, with its new premium, until the next fall window. The January 1 to March 31 Medicare Advantage Open Enrollment Period is only for people already in Medicare Advantage; it does not let a stand-alone member change plans. A handful of exceptions exist through special enrollment periods: receiving Extra Help, moving out of your plan’s service area, or having your plan leave your region (which comes with an extended window past December 7). If none of those apply, the premium you pay in December is the baseline you carry through the next twelve months.

There is a second cost of drifting: going without coverage. If you are eligible for Part D and go 63 days or more without creditable drug coverage, you can owe a lifetime late enrollment penalty of 1% of the national base beneficiary premium for each uncovered month. With the 2027 base premium at $41.33, that is about $0.40 per month for each month you were uncovered, added to your premium for as long as you have Part D. The amount sounds small and compounds the longer a gap lasts.

13. Pharmacy-Counter Moves That Stack With Your Plan

Choosing the right plan is the largest lever, but it is not the only one. The cheapest pharmacy transaction is often not the one run through insurance, and the cheapest plan can still leave gaps that other programs can fill.

• Check cash prices on cheap generics. A discount-card price can beat a plan copay for low-cost generics. Compare the two at the counter, using our Inside Rx review and Inside Rx vs. SingleCare comparison to see which cards tend to price best. The trade-off is that purchases made outside your plan generally do not count toward your deductible or your $2,400 cap, so do not do this for medications that will push you toward the cap.
• Do not use manufacturer copay cards with Medicare. Federal rules bar people in Medicare from using them. Manufacturer patient assistance programs are a different path and may be open to Medicare members who meet income limits; see whether Medicare patients can use patient assistance programs and our overview of prescription assistance programs. Drugs supplied outside the Part D benefit generally do not count toward your cap either, so weigh that when you choose.
• Use the insulin protection. Covered insulin is capped at $35 per month under Part D. If you use insulin, confirm your plan applies it to your specific products, and review our free and $35 insulin guide and the insulin price comparison.
• Ask about 90-day fills. Some plans reduce the cost of a three-month supply, particularly through mail order or preferred pharmacies, which cuts both trips and total copays.
• Review whether a cheaper therapeutic alternative exists. Your prescriber can tell you whether a lower-tier drug in the same class works for you. Never switch on your own; make the change with your care team before you enroll, so the plan you pick covers the drug you will actually use.