Some Medicare Drug Premiums Are Jumping $117 a Month in 2027. Here’s What to Check Now

Medicare beneficiaries reviewing their 2027 coverage could be in for a surprise. While the government projects that the average stand-alone Part D premium will increase by less than $1 a month, some individual plans are moving dramatically in the opposite direction. One AARP Medicare Rx Preferred plan from UnitedHealthcare in the Kansas region is increasing from $147 a month in 2026 to $264.50 in 2027, a jump of $117.50 every month.

That example illustrates why Medicare averages can be misleading. Some beneficiaries will see little change or even lower premiums, while others could pay hundreds or more over the course of the year if they automatically renew their existing coverage. The premium is only one part of the story because deductibles, drug tiers, pharmacy networks and formulary rules are also changing for 2027.

1. Some Part D Premium Increases Are Enormous

CMS projects that the average monthly premium for stand-alone Part D plans will rise only slightly, from about $35 in 2026 to $36 in 2027. At first glance, that makes the coming year appear relatively uneventful. But that average combines plans with falling premiums, relatively stable premiums and some extremely large increases.

KFF found that beneficiaries in some national plans will face increases of $50 or more per month if they remain in their current coverage. The increases vary significantly by state because the same insurer can charge different premiums in different regions. That means a neighbor’s experience with the same brand may provide very little information about what your own premium will be.

The $117.50 increase in the Kansas-region AARP Medicare Rx Preferred plan is an extreme example, but it shows how large the difference can become. Paying an additional $117.50 each month amounts to another $1,410 over a full year before filling a single prescription. A beneficiary who simply allows the plan to renew could therefore absorb a significant new expense without changing medications at all.

2. There Will Be Fewer Stand-Alone Drug Plans to Choose From

The stand-alone Part D market is also shrinking. The total number of plans nationwide is falling from 360 in 2026 to 316 in 2027, while the number available to the average beneficiary falls from 11 to nine. KFF says this will be the fourth consecutive year in which the average number of stand-alone Part D choices declines.

Some of that reduction comes from insurers pulling specific products from regions rather than leaving Medicare entirely. Health Care Service Corporation is withdrawing its HealthSpring Extra Rx plan from 22 regions, while CVS Health is scaling back SilverScript Choice in 13 regions. Beneficiaries affected by those changes will need to select replacement coverage rather than assuming their existing plan will simply continue unchanged.

Fewer choices do not automatically mean worse coverage because a market can have dozens of plans that are poorly suited to a particular person’s medications. The concern is that reduced competition can leave some beneficiaries with fewer affordable alternatives when their existing plan becomes expensive. This makes the annual comparison process more important, not less.

3. The Standard Part D Deductible Is Rising to $700

The standard Part D deductible will increase from $615 in 2026 to $700 in 2027. That represents an $85 increase before the plan begins providing the standard level of coverage for drugs subject to the deductible. Some plans will continue offering lower deductibles or exempt certain drug tiers from the deductible entirely, so $700 is a maximum standard amount rather than what every enrollee will necessarily pay.

This is another reason premiums should never be compared in isolation. A plan charging $10 less each month but imposing a much larger deductible could ultimately cost more for someone taking expensive medications. Conversely, a higher-premium plan might produce a lower total annual cost if it offers more favorable coverage for the beneficiary’s specific prescriptions.

Beneficiaries should therefore compare estimated annual spending rather than simply sorting plans by premium. Medicare’s Plan Finder allows users to enter medications, dosages and preferred pharmacies to estimate what different plans could cost over the full year. The cheapest premium is not necessarily the cheapest Medicare drug plan.

4. The Part D Out-of-Pocket Cap Is Also Increasing

The annual Part D out-of-pocket threshold rises from $2,100 in 2026 to $2,400 in 2027. This limit applies to covered Part D prescription-drug costs counted toward the cap and represents one of the most important protections created by the redesigned Part D benefit. Beneficiaries who take very expensive medications will therefore have $300 more potential exposure before reaching the 2027 limit.

The cap does not mean total Medicare spending is limited to $2,400. Premiums generally do not count toward the Part D out-of-pocket threshold, and expenses for drugs that are not covered by the plan can fall outside the protection. Medical costs under Original Medicare or Medicare Advantage also operate under separate rules.

Someone paying substantially more in premiums can therefore experience higher overall costs even if prescription spending eventually reaches the Part D cap. The relevant number is the combination of premiums and expected drug costs, not either one by itself.

5. A Drug Can Stay Covered and Still Become Much More Expensive

A medication does not have to disappear from the formulary to create a major cost increase. Plans can move drugs between tiers, change a fixed copayment into percentage-based coinsurance or impose different utilization rules. A prescription that cost relatively little in 2026 could therefore remain covered in 2027 while costing substantially more.

Coinsurance deserves particular attention because the beneficiary pays a percentage of the drug’s negotiated cost rather than a fixed dollar amount. A $40 copay provides a relatively predictable expense, while 20% or 30% coinsurance on an expensive brand-name medication can create a much larger bill. Changes like these can easily matter more than a modest difference in monthly premium.

Beneficiaries should compare each medication individually rather than simply checking whether it appears on the formulary. The Annual Notice of Change and the plan’s 2027 formulary can reveal whether a drug changed tiers, acquired new restrictions or moved from a copay to coinsurance structure.

6. Pharmacy Networks Can Change the Price Too

The pharmacy someone uses can materially affect what a prescription costs under Part D. Plans often distinguish between preferred and standard pharmacies, offering lower negotiated prices or cost sharing when prescriptions are filled through preferred locations. A pharmacy that was preferred in 2026 may not necessarily occupy the same position in 2027.

That can create an unexpected increase even when the plan and medication remain unchanged. A beneficiary who has used the same neighborhood pharmacy for years may discover that another chain or mail-order option produces substantially lower costs under the new benefit structure. Checking pharmacy status should therefore be part of the annual review.

Convenience still matters, particularly for someone managing several medications or relying on a trusted local pharmacist. The goal is not automatically switching to the cheapest pharmacy, but understanding what the convenience costs. The difference may be trivial for one medication and hundreds of dollars over a year for another.

7. Prior Authorization and Step Therapy Matter More Than the Premium

Drug plans can also change the rules governing how medications are accessed. Prior authorization may require the prescriber to obtain approval before the plan covers a drug, while step therapy can require a beneficiary to try another medication first. Quantity limits may restrict how much of a prescription is covered during a given period.

These restrictions do not necessarily mean a medication cannot be obtained. They can, however, add delays, paperwork and uncertainty for beneficiaries already stabilized on a particular treatment. UnitedHealthcare’s own 2027 Part D guidance warns that medications may move tiers, leave formularies or acquire new prior authorization and quantity-limit requirements.

Someone taking several important medications should therefore review restrictions alongside price. A plan that looks inexpensive can become frustrating if every major prescription requires additional authorization. Coverage quality includes the ability to access the medication, not simply whether its name appears somewhere on the drug list.

8. Zero-Premium Stand-Alone Part D Plans Are Disappearing for Many Enrollees

Another notable change is the disappearance of $0-premium stand-alone Part D options for beneficiaries who do not receive the Low-Income Subsidy, also known as Extra Help. KFF estimates that roughly 4 million people without the subsidy were enrolled in zero-premium stand-alone plans in 2026. Every one of those beneficiaries will face a premium in 2027 if they remain in stand-alone Part D coverage.

The increases will not all be dramatic. Some beneficiaries may move from $0 to a relatively inexpensive plan costing only several dollars each month, while others could face a much larger change depending on their insurer and state. The important point is that last year’s $0 premium should not be assumed to continue.

Beneficiaries receiving Extra Help operate under different premium and cost-sharing rules. Anyone with limited income and resources should determine whether they qualify before assuming the full advertised premium is unavoidable. That assistance can materially change the economics of Part D coverage.

Medicare Advantage Is Changing Too, but Not in the Same Way

The premium story should not be generalized to every Medicare Advantage enrollee. CMS projects average Medicare Advantage premiums to decline in 2027, and the majority of people enrolled in Medicare Advantage drug plans do not pay a separate premium for their prescription coverage. Medicare Advantage plans can use federal rebate dollars to offset some prescription-drug premiums, an option that stand-alone Part D plans do not have in the same way.

Medicare Advantage beneficiaries can still face meaningful changes elsewhere. KFF found that the average Medicare beneficiary will have 35 Medicare Advantage plans available in 2027, down from 39 in 2026, and many states will see fewer Medicare Advantage prescription-drug options. Provider networks, medical copays, supplemental benefits and drug coverage can all change from one year to the next.

That means a $0 premium Medicare Advantage plan should not automatically be viewed as unchanged or free. The premium represents only one component of the plan’s financial exposure. Hospital copays, specialist visits, prescription costs and the annual medical out-of-pocket maximum can ultimately matter much more.

Read the Annual Notice of Change Before Dec. 7

Every Medicare Advantage and Part D enrollee should receive an Annual Notice of Change explaining what will be different in the coming year. This document deserves more attention in 2027 because a familiar plan name can conceal substantial changes to premiums, deductibles, formularies and cost sharing. Assuming the plan is basically the same because the insurance card looks familiar can become an expensive mistake.

Start with the new premium, but then move immediately to prescriptions. Check whether every medication remains covered, which tier it occupies, whether the cost is a copay or coinsurance and whether new restrictions apply. After that, compare pharmacies and estimate the full year’s expected cost.

Medicare Open Enrollment runs from Oct. 15 through Dec. 7, with coverage choices taking effect Jan. 1, 2027. Beneficiaries who discover that an existing plan no longer fits can use that period to move to another Part D or Medicare Advantage option, subject to Medicare’s enrollment rules.

The Average Premium Increase Could Hide Your Real Increase

The headline Medicare statistics for 2027 do not look particularly alarming. CMS expects the average stand-alone Part D premium to rise by less than $1 a month, and many beneficiaries will indeed experience only modest changes. Those averages provide almost no protection, however, to someone whose individual plan rises by $50, $60 or even $117.50 per month.

This is why Medicare beneficiaries should resist the temptation to renew automatically. The plan that was cheapest or most convenient in 2026 may no longer hold that position once premiums, deductibles, formularies and pharmacy arrangements are updated. Even people whose premium barely changes may discover that their actual medications have become more expensive.

The most important Medicare number for 2027 is therefore not the national average. It is the cost of your plan, your prescriptions and your pharmacy after all of the changes take effect.

A $117 monthly increase is large enough to get anyone’s attention. The bigger risk is paying it for an entire year simply because the renewal notice was never opened.