Medicare Part D in 2027: the new deductible, cap and premiums

Medicare drug coverage changes a little every January, and 2027 is no exception. The deductible goes up, the yearly cap on what you pay out of pocket goes up, and the national figure used for premiums and penalties rises too. If you take regular prescriptions, these numbers decide what you will spend next year, and Open Enrollment, from October 15 to December 7, is when you can act on them.

This guide walks through the 2027 Part D figures from the CMS announcement for calendar year 2027 and its Part D fact sheet, what they mean for a typical year of prescriptions, the help available to people with lower incomes, and the extra amount higher earners pay.

The 2027 Part D numbers at a glance

CMS, Announcement of Calendar Year 2027 Medicare Advantage Capitation Rates and Part C and Part D Payment Policies (Table V-6), and the CMS Part D 2027 bid fact sheet.
	2026	2027
Deductible in the defined standard benefit	$615	$700
Your share after the deductible	25%	25%
Out-of-pocket cap, then $0 for covered drugs	$2,100	$2,400
National base beneficiary premium	$38.99	$41.33

The deductible: up to $700

Under the standard Part D benefit, you pay 100% of your drug costs until you meet the deductible. CMS sets the 2027 standard deductible at $700, up from $615. It explains the arithmetic: the 2026 amount is multiplied by the yearly percentage increase in Part D drug spending and rounded to the nearest $5. Medicare.gov notes that actual deductibles, copayments and coinsurance vary by plan and pharmacy, so compare plans rather than assuming the standard figures.

After the deductible: 25%

Once the deductible is met, the defined standard benefit has you pay 25% of the cost of covered drugs in what CMS calls the initial coverage phase. Your own plan's copays and coinsurance may look different, since they vary by plan and pharmacy.

The out-of-pocket cap: $2,400

This is the number that matters most if you take expensive drugs. Once what you pay out of pocket for covered drugs reaches the threshold, you pay nothing more for covered drugs for the rest of the year. For 2027 the threshold is $2,400, up from $2,100. CMS updates it the same way as the deductible, rounding to the nearest $50.

Medicare.gov says the limit includes your deductible. So the most someone pays out of pocket for covered drugs in 2027, apart from premiums, is $2,400. That is $300 more than the most they could have paid in 2026.

Premiums

Each plan sets its own premium, so there is no single Part D premium. What CMS publishes is the national base beneficiary premium, the starting point for plan premiums and the figure used for the late enrollment penalty. For 2027 it is $41.33, up from $38.99. CMS notes that from 2024 to 2029 the yearly increase in the base premium is capped at 6% under the Inflation Reduction Act.

CMS also announced that the Part D Premium Stabilization Demonstration, a voluntary program for standalone drug plans that began in 2025, ends after 2026. It said plans now have enough experience with the redesigned benefit, and that 2027 returns to normal market conditions. Plan-by-plan premiums come out with the Medicare Advantage and Part D landscape each September.

If you sign up late: the penalty uses the 2027 base premium

The Part D late enrollment penalty is 1% of the national base beneficiary premium for each full month you went without Part D or other creditable drug coverage. With the 2027 base premium, 12 months without coverage means a penalty of about $5.00 a month, and 24 months about $9.90, rounded to the nearest 10 cents as Medicare does. The guide to late penalties explains what counts as creditable coverage and how to challenge a penalty.

Extra Help for people with limited income

Extra Help is the Medicare program that lowers drug costs for people with limited income and resources. Medicare.gov lists what people with Extra Help pay in 2027:

$0 plan premium and $0 deductible.
Up to $5.80 for each generic drug and up to $14.40 for each brand-name drug at a participating pharmacy.
$0 once total drug costs reach $2,400.

The 2026 limits to qualify are $23,940 of income and $18,090 of resources for an individual, and $32,460 and $36,100 for a married couple. People with full Medicaid, a Medicare Savings Program or SSI get it automatically. The Extra Help page covers how to apply.

Higher incomes pay an extra amount

People whose modified adjusted gross income is above the Medicare thresholds pay an income-related amount on top of their plan premium. For 2026 it ranges from $14.50 to $91.00 a month and starts above $109,000 on an individual return or $218,000 on a joint return. The 2027 amounts had not been published when this guide was checked. The IRMAA guide explains which year's income counts and how to appeal.

What to do during Open Enrollment

List every drug you take, with the dose and how often.
Compare plans in your area with those drugs entered. Medicare.gov's plan finder estimates each plan's yearly cost, including premiums.
Check that your pharmacies are in the plan's network, and whether mail order is cheaper.
Look at the deductible and the cap: a plan with a low premium but the full $700 deductible can cost more in a year of regular prescriptions.
Make the change between October 15 and December 7. It takes effect January 1, and the plan must get your request by December 7.

The enrollment periods guide lists every window, and the Part D costs page keeps the 2026 and 2027 figures side by side.