Medicare beneficiaries could face a significant increase in prescription drug coverage costs in 2027, with average premiums for stand-alone Part D plans projected to rise by 50% if current enrollees keep their existing coverage. The changes follow the end of a federal premium stabilization program and come alongside higher deductibles and cost-sharing requirements. Here’s what the latest numbers reveal and why reviewing coverage options could make a difference.
Average Stand-Alone Medicare Drug Plan Premiums Could Jump From $34 to $51
Medicare beneficiaries who rely on a separate prescription drug plan could see a significant change in their monthly bills next year. According to projections, the average enrollment-weighted premium for Medicare Part D stand-alone prescription drug plans could increase from $34 in 2026 to $51 in 2027. That represents a 50% jump, assuming current enrollees remain in their existing plans rather than moving to cheaper alternatives. It is important to understand that this figure applies specifically to stand-alone prescription drug plans, not every type of Medicare coverage. People who receive drug benefits through Medicare Advantage plans face a different premium outlook. The projection also differs from the Centers for Medicare & Medicaid Services estimate, which put the national average premium increase at just $1, from $35 to $36. The difference comes partly from the assumptions used in the calculations. The $51 estimate assumes existing beneficiaries keep their current plans, while actual enrollment changes could bring the average down. During the previous enrollment cycle, switching by existing members and new enrollment helped reduce the actual average premium below earlier projections. This means the 50% figure is a warning about what could happen if people do nothing, rather than a guaranteed increase for every enrollee.
Nearly 3 in 4 Stand-Alone Plan Enrollees Could Face Higher Monthly Premiums
The projected increase could affect millions of people who stay with their current prescription drug coverage. KFF estimates that 76%, or approximately 10.4 million, stand-alone Part D enrollees who do not receive low-income subsidies will face higher monthly premiums in 2027 if they make no changes during open enrollment. That is a considerable increase from 2026, when 56% of comparable enrollees faced higher premiums for their existing plans. The impact will not be identical for everyone. Around 2.4 million people could see their monthly premiums rise by more than $50 if they remain enrolled in the same coverage. At the same time, approximately 3.2 million beneficiaries could receive a lower premium, although most of those reductions are expected to be relatively small. KFF also estimates that 55% of these enrollees, or 7.5 million people, could still pay less than $20 per month in 2027 if they keep their current plans. However, nearly 3.9 million could pay at least $100 monthly. These figures show why beneficiaries should examine their individual plan notices rather than assume the national average reflects their own costs. A plan that worked well this year may no longer offer the best value next year, particularly if its premium changes substantially.
The End of a Federal Premium Stabilization Program Means Zero-Premium Plans Are Disappearing
One of the biggest changes behind the projected premium increases is the end of a federal program that helped keep stand-alone drug coverage more affordable. The Part D Premium Stabilization Demonstration provided additional financial support to participating prescription drug plan sponsors and limited how much their monthly premiums could increase. For 2026, participating plans were subject to a maximum allowable monthly premium increase of $50. The Trump administration’s decision to discontinue the demonstration after 2026 means those additional subsidies and the associated premium increase cap will no longer apply in 2027. One immediate consequence is that no zero-premium stand-alone Part D plans will be available next year. KFF estimates that approximately 4.1 million beneficiaries who currently have zero-premium stand-alone coverage could face a monthly charge if they stay with their existing plans. This does not mean all Medicare drug coverage will become expensive, or that beneficiaries cannot find affordable alternatives. Some national stand-alone plans are projected to have average premiums of around $6 to $11 per month. However, the loss of zero-premium options changes the choices available to people who previously paid nothing for their separate drug coverage. Beneficiaries will need to compare the new premiums with the medications covered, pharmacy networks, deductibles, and other out-of-pocket expenses before deciding whether to remain enrolled.
Higher Deductibles and Cost-Sharing Requirements Could Add to Prescription Drug Expenses
Monthly premiums are only one part of what Medicare beneficiaries pay for prescription medications. The amount they owe before coverage begins, along with their share of each prescription’s cost, can also make a difference to their annual healthcare budget. For 2027, the standard Medicare Part D deductible is increasing from $615 to $700. KFF estimates that the average deductible will reach $643 for stand-alone plan enrollees, compared with $540 in 2026. For beneficiaries receiving drug coverage through Medicare Advantage plans, the projected average deductible is $489, up from $360. Nearly all stand-alone Part D enrollees, or 99.8%, are expected to face a deductible if they keep their current plans. The way plans charge for prescriptions is also important. Many beneficiaries will encounter coinsurance rather than fixed copayments, meaning they pay a percentage of a drug’s cost instead of a set dollar amount. For preferred brand-name medications, the median coinsurance is projected to be 25% among stand-alone plan enrollees. For non-preferred drugs, it reaches 35%. These percentages can make expenses less predictable, particularly for people taking expensive medications. Specialty drugs also carry substantial cost-sharing requirements, with median coinsurance projected at 25% for stand-alone plans. Beneficiaries should look beyond the monthly premium and check how each plan prices their specific prescriptions.
