Medicare Changes 2027: What’s Confirmed and What’s Still Pending

Some Medicare changes for 2027 are already locked in, and some are still waiting on an announcement. This guide sorts them out. It covers the higher Part D out-of-pocket cap, the second round of drug prices that Medicare negotiated, what CMS has said about Medicare Advantage and drug plans for 2027, the Social Security raise, and a new eligibility rule for some noncitizens. For each item, we say whether it is final or still proposed.

If you are turning 65 soon, or helping a parent who is, the main dates to know are Open Enrollment, from October 15 to December 7, and January 1, 2027, when most of these changes start.

Medicare changes 2027 at a glance

Here is where each of the main Medicare changes for 2027 stands as of October 20, 2026.

The 2026 Part A and Part B amounts come from Medicare.gov’s Medicare costs page. Each 2027 figure is sourced in the sections below.

What is the 2027 Part D out-of-pocket cap?

The 2027 Part D out-of-pocket cap is $2,400, up from $2,100 in 2026. Once your out-of-pocket spending on covered Part D drugs reaches the cap, you move into catastrophic coverage and won’t pay out of pocket for covered Part D drugs for the rest of the calendar year. Medicare.gov’s Part D costs page gives both years’ figures. It says stand-alone drug plans and Medicare Advantage plans with drug coverage generally follow the same payment stages.

The deductible limit also rises. No Medicare drug plan may have a deductible above $700 in 2027, up from $615. Some plans have a lower deductible or none at all.

Both figures are final. CMS set them in the CY 2027 Rate Announcement (Tables V-2 and V-6), released April 6, 2026. By law, both amounts grow each year with the average growth in Part D drug spending. CMS put that growth at 13.65% for 2027, which is why the cap went up by $300.

If you get Extra Help, the same table sets your highest 2027 copays before you reach the cap. The limit depends on your income and Medicaid status:

• $5.80 for a generic or preferred multi-source drug and $14.40 for other drugs, for people with full Medicaid and income between 100% and 150% of the federal poverty level, and for other people who get full Extra Help;
• $1.65 and $5.00 for people with full Medicaid and income at or below 100% of the poverty level;
• $0 for people with full Medicaid who live in an institution or get certain home and community-based services.

For more on how drug coverage works, see what is Medicare Part D.

Which 15 drugs have negotiated prices in 2027?

Medicare’s second round of negotiated drug prices takes effect on January 1, 2027. CMS reached agreement on all 15 drugs, according to its fact sheet on negotiated prices for 2027. The table lists the drugs, the conditions CMS says they commonly treat, and how far the negotiated price for a 30-day supply sits below the 2024 list price.

A lower drug price does not mean your copay drops by the same percentage. What you pay still depends on your plan’s deductible, copays and coinsurance. CMS estimates that people with Medicare drug coverage would save about $685 million in out-of-pocket costs in 2027 under the standard benefit. By law, every Medicare drug plan must include these drugs on its formulary.

Some first-round drugs leave the program in 2027. CMS’s selected drugs and negotiated prices page lists Stelara, Entresto, Xarelto and the NovoLog and Fiasp insulin products as removed effective January 1, 2027. CMS removes a drug when, for example, a generic or biosimilar version reaches the market. If you take one of these, check your plan’s 2027 price during Open Enrollment.

Has the 2027 Medicare Part B premium been announced?

Not yet. As of October 20, 2026, CMS has not released the 2027 Medicare Part B premium, the Part B deductible, or the Part A deductible and premiums. We will update this page when it does. Until then, the current 2026 amounts from Medicare.gov’s Medicare costs page apply:

• Part B standard premium: $202.90 a month. People with higher incomes pay more, an extra charge called IRMAA.
• Part B deductible: $283 a year.
• Part A hospital deductible: $1,736 for each benefit period.
• Part A premium: $0 for most people. People without enough work history can buy Part A for $311 or $565 a month in 2026, depending on how long they worked.

You may see 2027 Part B numbers on news sites already. Those are projections, not official amounts, so don’t budget on them as if they were final. If you are about to sign up, our Medicare enrollment calculator shows your sign-up window. Missing that window can mean a lifelong surcharge, which we explain in our guide to the Part B late enrollment penalty.

What CMS has said about Medicare Advantage and drug plans for 2027

Three CMS releases shape the plans you will see this fall.

The Rate Announcement (final). On April 6, 2026, CMS finalized how it will pay Medicare Advantage and Part D plans in 2027. Its fact sheet on the CY 2027 Rate Announcement projects that payments to Medicare Advantage plans will rise 2.48%, or over $13 billion. That is the payment to plans, not a change in what you pay. Each plan sets its own premiums and benefits within those payments.

The 2027 plan outlook (CMS projections). In its September 28, 2026 press release, CMS said:

• The number of Medicare Advantage plans nationwide goes from 5,553 in 2026 to about 5,532 in 2027.
• The average monthly Medicare Advantage premium is projected to fall from $14.37 to $12.00.
• The average stand-alone drug plan premium is projected to rise from $35.09 to $36.

These are national averages. Your own premium depends on the plan and where you live. For Massachusetts, see our county-by-county plan counts.

Star Ratings (final). CMS posted the 2027 Star Ratings on Medicare Plan Finder on October 8, 2026, per its 2027 Star Ratings fact sheet. Plans are rated from one to five stars.

One more Part D number is final. The national base beneficiary premium for 2027 is $41.33, according to CMS’s July 28, 2026 Part D bid memo. It isn’t a premium anyone pays directly. It is the number used to figure the Part D late enrollment penalty. Medicare.gov’s Part D costs page explains the formula: 1% of that premium for each full month you went without creditable drug coverage, rounded to the nearest $0.10.

Hypothetical example. Joan went 20 months without drug coverage after she first became eligible. Her 2027 penalty would be 20% × $41.33 = $8.27, rounded to $8.30 a month, added to her drug plan premium for as long as she has Part D. The base premium can change each year, so her penalty can change too.

Social Security’s 2027 cost-of-living increase

Social Security benefits and SSI payments will rise 3.6% for 2027, as stated in SSA’s 2027 cost-of-living adjustment update.

If your Part B premium comes out of your Social Security check, your net increase also depends on the 2027 Part B premium. Because CMS hasn’t announced that premium yet, you can’t work out your exact 2027 deposit until it does.

Medicare changes 2027 for some noncitizens

One of the bigger Medicare changes for 2027 affects eligibility. A 2025 law, Public Law 119-21, limits Medicare to four groups:

• U.S. citizens and U.S. nationals;
• lawful permanent residents (green card holders);
• Cuban and Haitian entrants; and
• people living in the U.S. lawfully under a Compact of Free Association.

CMS lists these groups in its fact sheet on the CY 2027 Physician Fee Schedule proposed rule.

What is final: the law itself. People who had Medicare on July 4, 2025, but don’t fit one of those groups lose eligibility 18 months after that date.

What is proposed: the process. In the CY 2027 Physician Fee Schedule proposed rule, 91 Fed. Reg. 43842 (July 16, 2026), CMS notes that green card holders who meet the existing 5-year residency rule keep their Medicare. It also proposes that Social Security send termination notices toward the end of December 2026, with enrollment ending effective February 1, 2027. The notices would explain appeal rights. CMS has not yet issued a final rule, so these dates could change.

If you or a family member has Medicare and an immigration status other than citizen or green card holder, contact Social Security now and keep any letter it sends. Our Medicare eligibility guide covers the general rules.

What stays the same in 2027

Not every rule moves with the calendar. Alongside the Medicare changes 2027 brings, several drug-cost protections are written into law and carry over:

• Insulin: you pay no more than $35 for a one-month supply of each insulin product covered by Part D, or by Part B when you use a covered insulin pump. Other costs may apply.
• Vaccines: Part D covers adult vaccines recommended by the Advisory Committee on Immunization Practices, such as the shingles and RSV shots, with no deductible or copayment.
• Spreading drug costs: the Medicare Prescription Payment Plan still lets you pay your Part D out-of-pocket costs in monthly amounts across the calendar year instead of all at once at the pharmacy. It changes when you pay, not how much you owe.

Sources: Medicare.gov, “Insulin,” “Shingles vaccines,” and “How much does Medicare drug coverage cost?”

What to do during Open Enrollment for 2027 coverage

Open Enrollment runs from October 15 to December 7, 2026. Changes you make take effect January 1, 2027, and the plan must get your request by December 7, according to Medicare.gov’s Open Enrollment page. During this window you can join, switch or drop a Medicare Advantage plan or a drug plan, or move between Original Medicare and Medicare Advantage.

A short checklist:

1. Read your plan’s notices. Your current plan tells you about its cost and benefit changes for 2027.
2. Check your drugs. Enter every prescription and your pharmacy in Medicare Plan Finder, including any of the 15 negotiated-price drugs.
3. Check your doctors and hospitals. Plan Finder lets you check whether your providers are in a plan’s network.
4. Look at total yearly cost, not just the premium. Plan Finder estimates your out-of-pocket costs. Include deductibles, copays and the $2,400 drug cap.
5. Do nothing only on purpose. If you keep your current coverage, you don’t need to do anything. It continues automatically, per Medicare’s Remember Key Medicare Dates fact sheet.

If you are already in a Medicare Advantage plan, you get one more chance from January 1 to March 31. Medicare.gov’s joining a plan page says you can switch to another Medicare Advantage plan or return to Original Medicare then. The change starts the first of the month after the plan gets your request.

Medicare changes 2027: frequently asked questions

What is the 2027 Part D out-of-pocket cap?

$2,400 for covered Part D drugs, up from $2,100 in 2026. It is final.

What is the 2027 Medicare Part B premium?

CMS hasn’t announced it yet. The 2026 standard premium is $202.90 a month and the deductible is $283.

When do the new negotiated drug prices start?

January 1, 2027, for 15 drugs. Your cost still depends on your plan.

Do I have to do anything for 2027?

Not always. Your coverage usually renews on its own. But plans change premiums, drug lists and networks every year, so it’s worth comparing between October 15 and December 7.

Is Medicare Part D ending in 2027?

No. As of October 2026, Medicare Part D is not ending or being eliminated. Medicare has set 2027 Part D amounts, including a $2,400 out-of-pocket cap and a $700 maximum deductible, and new negotiated drug prices start January 1, 2027. CMS has pushed back on ‘misleading reports’ tied to the planned end of a temporary premium demonstration after 2026 and projects stable pricing, according to CMS (Sept. 28, 2026). Open Enrollment runs October 15 to December 7.

What Part D subsidy is ending in 2027?

The temporary Part D Premium Stabilization Demonstration ends after 2026. CMS started it in 2025 as a voluntary program for stand-alone drug plans; in 2025 it cut participating plans’ base premium by $15 and capped premium increases. On July 28, 2026, CMS said plans now have enough experience with the redesigned benefit. CMS projects the average stand-alone plan premium will rise from $35.09 to about $36 in 2027, per CMS.

Is Medicare Advantage going away?

No. As of October 2026, Medicare Advantage is not going away. Some insurers are leaving certain counties for 2027, but CMS projects about 5,532 plans in 2027 versus 5,553 in 2026, and more than 99% of people with Medicare can choose at least one plan (CMS, September 28, 2026). CMS also finalized a 2.48% increase in 2027 payments to plans. If your plan is leaving, your notice explains your options.

What Medicare changes and cost increases are coming in 2027?

As of October 2026, CMS has announced some 2027 changes, but not the Part A or Part B amounts. The Part D out-of-pocket cap rises to $2,400 from $2,100, and the highest allowed Part D deductible rises to $700 from $615. Negotiated prices for 15 drugs, including Ozempic, start January 1, 2027. CMS projects the average Medicare Advantage premium will fall from $14.37 to about $12. A 2025 law also ends Medicare eligibility for some lawfully present noncitizens. CMS 2027 outlook

Get help with your 2027 Medicare choices

Octans Insurance is a licensed, independent agency in Massachusetts. Our agents can walk you through the Medicare changes for 2027 and compare the plans we offer in your area. We do not offer every plan available in your area. You can also get information about all of your options at Medicare.gov, by calling 1-800-MEDICARE (1-800-633-4227; TTY 1-877-486-2048), 24 hours a day, 7 days a week, or, in Massachusetts, through the state’s SHINE program at 1-800-243-4636.

Keep Reading: Related Guides

• Medicare IRMAA
• Medicare Extra Help
• Medicare enrollment calculator
• Medicare Advantage plans in Massachusetts by county

We do not offer every plan available in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

This article is for general information and is not tax, legal, or medical advice.

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