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What Changes in Medicare in 2027: Drug Costs, Lower Prices, and What to Check by Dec. 7
In 2027, what you pay for covered Medicare Part D drugs is capped at $2,400. A drug plan's deductible can be no more than $700. New Medicare prices for 15 brand-name drugs, including Ozempic, start on January 1, 2027.
Open enrollment runs from October 15 to December 7, 2026. That is your time to check if your plan still fits. The 2027 Part B premium is not out yet.
What is changing with Medicare in 2027?
Here is what CMS (the federal agency that runs Medicare) and Medicare.gov have posted so far.
| Cost | 2026 | 2027 |
|---|---|---|
| Highest drug plan deductible allowed | $615 | $700 |
| Yearly cap on what you pay for covered drugs | $2,100 | $2,400 |
| Standard Part B premium | $202.90 a month | Not out yet |
Other changes:
- Medicare prices for 15 more drugs start January 1, 2027.
- Medicare extended its flexible telehealth rules through December 31, 2027. You can keep getting telehealth anywhere in the U.S., including at home.
Your own plan can change too. Each year, plans can change their premiums, drug lists, and networks. CMS projects the average premium for a stand-alone drug plan (a plan that covers only drugs) will go from $35.09 a month in 2026 to $36 in 2027. Yours may be higher or lower.
What is the out-of-pocket max for Part D in 2027?
It is $2,400. The cap counts what you pay for covered Part D drugs. Some payments made for you, like through Extra Help, count too.
Once you reach $2,400, you pay $0 for covered Part D drugs for the rest of 2027. You still pay your plan's monthly premium, if it has one.
Some plans have no deductible. If your plan has one, it can be no more than $700 in 2027. The top amount was $615 in 2026.
A one-month supply of each covered insulin costs no more than $35.
Money tight? Extra Help can lower drug costs. In 2027, people who get it will generally pay no more than $5.80 for each generic drug. The limit for each brand-name drug is $14.40. See if Extra Help is worth applying for.
Which drugs will be cheaper in 2027 Medicare?
Medicare set new prices for 15 more Part D drugs. The prices start January 1, 2027. CMS counts Ozempic, Rybelsus, and Wegovy as one drug. Here they are, grouped by what CMS says they are often used for:
- Diabetes: Ozempic, Rybelsus, Janumet, and Tradjenta
- Heart disease and weight: Wegovy
- Asthma and COPD: Trelegy Ellipta and Breo Ellipta
- Cancer: Xtandi, Ibrance, Calquence, and Pomalyst
- Gut or liver problems: Linzess and Xifaxan
- A lung scarring disease: Ofev
- Psoriasis and psoriatic arthritis: Otezla
- Some mental health conditions: Vraylar
- Some movement disorders: Austedo
The first 10 drugs got Medicare prices on January 1, 2026. They include Eliquis, Jardiance, and Januvia. Four of those 10, including Xarelto, leave the program on January 1, 2027, because generic or similar versions are now sold. Their Medicare prices stop then.
See the full list on the Medicare.gov drug plan page or the CMS drug price page.
CMS posted each new price for a 30-day supply. Here are a few:
| Drug | 2024 list price | Medicare price in 2027 (not your copay) |
|---|---|---|
| Ozempic, Rybelsus, Wegovy | $959 | $274 |
| Trelegy Ellipta | $654 | $175 |
| Linzess | $539 | $136 |
| Janumet | $526 | $80 |
| Tradjenta | $488 | $78 |
| Breo Ellipta | $397 | $67 |
These are not your copays. What you pay depends on your plan. Medicare says to ask your plan how the new prices may affect you.
In 2024, about 5.3 million people with Part D used these 15 drugs. CMS estimates that people with Medicare drug coverage could save $685 million in total on out-of-pocket costs in 2027.
Is Ozempic covered by Medicare in 2027?
Ozempic is on the 2027 list of drugs with a Medicare price. CMS says Medicare drug plans must put these drugs on their drug lists. CMS lists type 2 diabetes as what Ozempic is often used for.
What you pay still depends on your plan. Call your plan and ask what Ozempic will cost you in 2027.
Weight loss is a different path. A short-term program called the Medicare GLP-1 Bridge runs from July 1, 2026, to December 31, 2027. It covers these drugs:
- Wegovy (shot or pill)
- Zepbound (KwikPen only)
- Foundayo (pill)
Ozempic is not on that list. The copay is $50 for a one-month supply. That $50 does not count toward your $2,400 cap. Extra Help cannot lower it.
You must be 18 or older, have Part D, and meet body weight (BMI) and health rules. Your doctor sends the prescription and may need to send a form for approval. The doctor must also confirm you are in a diet and exercise program.
You cannot use this program if you have type 2 diabetes, moderate-to-severe sleep apnea, or fatty liver disease. But your Part D plan might cover a GLP-1 drug for those. You also cannot use it if your Part D plan already pays for your GLP-1 drug. Check the rules on Medicare.gov's weight loss drugs page, or call 1-800-MEDICARE.
What is the Medicare Prescription Payment Plan?
It is a free way to spread your drug costs over the year. You pay a monthly bill to your plan instead of paying the drug store. All Part D plans offer it.
It does not lower your drug costs. You pay no interest or fees, even if a payment is late. But if you do not pay by the date on the reminder, you are taken out of it. You still have to pay what you owe.
It may help most if you have high drug costs early in the year. To join, call your plan or go to its website.
Already in it? If you stay in the same plan, it renews on its own for 2027. If you switch plans, it ends. Ask the new plan to sign you up again.
It may not be the best choice if you get or qualify for Extra Help.
What is the Part B premium for 2027?
It has not been announced. CMS sets the Part B premium each year. In recent years, it posted the new amount in November. The 2026 amount came out on November 14, 2025.
For 2026, the standard Part B premium is $202.90 a month. The Medicare & You 2027 handbook says the 2027 amounts were not ready when it was printed. Guesses you see online are not the official number.
Hard to pay the premium? A Medicare Savings Program may pay it. Your state decides. If you get Social Security, your Part B premium is taken out of your monthly payment. Our 2027 COLA guide shows how that works.
When is Medicare open enrollment 2026?
It runs from October 15 to December 7, 2026. During this time, you can:
- Join, switch, or drop a Medicare Advantage Plan
- Join, switch, or drop a drug plan if you have Original Medicare
- Move from Original Medicare to Medicare Advantage, or back
Changes start January 1, 2027. The plan must get your request by December 7. Want to keep your plan? You generally do not need to sign up again.
In a Medicare Advantage Plan? From January 1 to March 31, 2027, you can make one change. You can switch to another one. Or you can go back to Original Medicare and join a drug plan.
Why should you read your Annual Notice of Change?
Your plan sends this notice each fall, in September. It lists changes to costs, coverage, and more that start in January. Check these items:
- Your monthly premium and deductible
- Each drug you take, and if it is still on the drug list
- Your doctors and drug store, and if they are still in the network
No notice yet? Call your plan. If you keep a plan that changed, the changes start January 1, 2027.
Where can you get free help comparing plans?
- Medicare Plan Finder: Go to Medicare.gov/plan-compare. Add every drug you take regularly. That gives the best cost estimate for each plan.
- SHIP: Your State Health Insurance Assistance Program gives free one-on-one help. SHIPs are not tied to any insurance company or plan.
- 1-800-MEDICARE (1-800-633-4227): Call any time, day or night, except some federal holidays. TTY users can call 1-877-486-2048.
Looking at plan extras? Read what Medicare covers for dental, vision, and hearing.
CalculateBenefits is not the government. We do not suggest any plan, company, or agent. Plans and agents may not call you unless you are a member or said yes to calls. They may not come to your home uninvited. Guard your Medicare number.
Your next step. The free Medicare Savings Program guide explains the checks your state makes for help with Medicare costs and where to apply. All tools →
Sources
- Medicare.gov — How much does Medicare drug coverage cost? (2026 and 2027 deductible and cap)
- Medicare.gov — Medicare & You 2027 handbook (PDF)
- CMS — Negotiated prices for initial price applicability year 2027 (fact sheet, Nov 2025)
- CMS — Medicare Drug Price Negotiation Program: selected drugs and negotiated prices
- Medicare.gov — How do drug plans work? (negotiated drug prices)
- Medicare.gov — Weight loss drugs (Medicare GLP-1 Bridge)
- CMS — Medicare GLP-1 Bridge FAQs
- Medicare.gov — What's the Medicare Prescription Payment Plan?
- CMS — 2026 Medicare Parts A & B Premiums and Deductibles (fact sheet, Nov 14, 2025)
- Medicare.gov — Joining a plan (enrollment periods)
- Medicare.gov — Plan Annual Notice of Change (ANOC)
- CMS — Medicare Advantage and Part D expected to remain stable in 2027 (press release, Sep 28, 2026)
- Medicare.gov — Talk to someone
- Medicare.gov — Costs (2026 Part A and Part B)
- Medicare.gov — Medicare Prescription Payment Plan: before you participate
- Medicare.gov — Medicare Prescription Payment Plan: if you're participating
- CMS — 2025 Medicare Parts A & B Premiums and Deductibles (fact sheet, Nov 8, 2024)
- Medicare.gov — Plan marketing rules
- CMS — Announcement of CY 2027 MA capitation rates and Part C and D payment policies (Apr 6, 2026)