2027 Medicare Part D Costs: The $2,400 Cap, Rising Premiums, and What’s Really Changing

Two things are true about Medicare Part D at the same time in 2027. Your maximum drug spending is capped at a new, higher number, and your premium could jump more than it has in recent years. Both are locked into regulation, not projections, and here is exactly what each one means for your wallet.

The 2027 Out-of-Pocket Cap: $2,400

CMS finalized the core 2027 Part D numbers back on April 6, 2026. The annual out-of-pocket cap — the most you’ll ever pay for covered prescription drugs in a calendar year — rises from $2,100 in 2026 to $2,400 in 2027.

Once your out-of-pocket spending on covered drugs hits that $2,400 mark, your cost for the rest of the year drops to $0. That’s the same “catastrophic coverage eliminated” structure the Inflation Reduction Act introduced in 2024 and expanded in 2025 and 2026 — it just moves up by $300.

The standard deductible is rising too, from $615 to $700. That’s the amount you’ll typically pay before your plan’s coverage kicks in, though plenty of plans set their deductible lower or waive it for certain drug tiers.

Consider “Diane in Ohio (OH),” who takes a specialty medication for rheumatoid arthritis that lists for well over $15,000 a year. In 2026, her out-of-pocket exposure topped out at $2,100. In 2027, that ceiling moves to $2,400 — still a fraction of the list price, but $300 more than she budgeted for the year before.

If you don’t take any high-cost medications, the cap barely matters to you. If you do, this is the single number worth checking against your last twelve months of pharmacy receipts before you pick a 2027 plan.

The Real Story: Why Your Premium Might Jump More Than Usual

Here’s the part that hasn’t gotten as much attention as the cap. CMS quietly ended the Part D Premium Stabilization Demonstration, a voluntary program that had been cushioning premium swings since 2025 while insurers adjusted to the IRA’s redesigned benefit.

Without that cushion, the National Average Monthly Bid Amount — the enrollment-weighted average of what insurers say it costs them to offer Part D coverage — jumped to $296.05 for 2027, roughly a 24% increase from 2026. The base beneficiary premium, the benchmark used to calculate your plan’s premium, rises to $41.33 from $38.99.

CMS Administrator Mehmet Oz has said premiums should rise “by less than $10 for most Medicare recipients, with many even seeing lower premiums,” and a 6% annual cap on the base beneficiary premium (an IRA provision running through 2029) limits how far that benchmark itself can move. CMS’s September 28 projections back that up on average: stand-alone Part D premiums are expected to rise from about $35.09 to $36 a month, and the drug portion of Medicare Advantage plans to fall from about $11.32 to $7. Averages hide a wide spread, though, so the honest answer is still that it depends on which plan you’re in.

One thing worth clearing up directly: Part D itself is not ending in 2027. What’s ending is a temporary subsidy program insurers could opt into. Some social media chatter has conflated the two — the coverage, the cap, and the negotiated drug prices below are all still very much in place.

Bigger Drug Discounts: Ozempic Drops to $274/Month

The second round of Medicare’s drug price negotiations takes effect January 1, 2027, covering 15 additional high-cost drugs selected back in January 2025 — including the Ozempic, Wegovy, and Rybelsus semaglutide family, Trelegy Ellipta, Xtandi, Ibrance, and Janumet.

Ozempic’s negotiated Maximum Fair Price drops to $274 for a 30-day supply, down from a roughly $959 list price — about a 71% cut. Wegovy’s higher-dose version drops to $385. Across all 15 drugs, negotiated prices are down 38% to 85% off list.

Here’s the catch worth flagging before you get your hopes up: the negotiated price is what Medicare pays the manufacturer, not automatically your copay. Your Part D plan still sets its own tier placement, prior authorization rules, and cost-sharing for these drugs.

If you or a family member takes one of these 15 medications, check your plan’s 2027 Annual Notice of Change for the specific tier and copay rather than assuming you’ll see $274 at the pharmacy counter. Comparing that copay across plans during Open Enrollment is worth the extra ten minutes.

Where Part D Shoppers Get Tripped Up in 2027

I get questions about this cluster of changes every fall, and the same few points trip people up year after year.

Assuming your current plan’s premium is staying the same. With the stabilization demonstration gone, 2027 is not a “set it and forget it” year. Even a loyal, years-long PDP customer should re-run their drugs through Medicare’s Plan Finder this Open Enrollment.

Confusing the negotiated price with your copay. As covered above, $274 for Ozempic is Medicare’s negotiated price with the manufacturer — not necessarily what shows up on your receipt. Your plan’s formulary tier still drives your actual cost.

Missing a small premium increase on autopay. This isn’t hypothetical: Wellcare disenrolled roughly 140,000 Part D members in April 2026 after premiums rose from $0 to as little as $8 a month and members on autopay never noticed the new charge. Go 63+ days without creditable drug coverage and you risk a permanent late-enrollment penalty. Check that your autopay is pulling the correct, current amount — see my full rundown of the 2026 Medicare changes for what triggered that wave of disenrollments.

Not checking Extra Help eligibility. If your income and resources are limited, the $2,400 cap and $700 deductible may not even be the relevant numbers for you — Medicare’s Extra Help program can reduce or eliminate your Part D deductible, premium, and copays entirely. See my guide to Medicare Extra Help to check if you qualify.

Ignoring how IRMAA layers on top. Your Part D premium can carry an IRMAA surcharge if your income is above the threshold, calculated from your modified adjusted gross income (MAGI) — see my AGI vs. MAGI explainer if you’re not sure which number applies to you.

Your 2027 Open Enrollment Action Plan

Medicare’s Annual Enrollment Period runs October 15 through December 7, and this is the window to act on everything above — see my full breakdown of 2027 Open Enrollment dates and rules for the complete calendar.

Start by pulling your last twelve months of pharmacy costs and running every medication and dosage through Medicare’s official Plan Finder tool. Compare the total annual cost — premium plus deductible plus copays — not just the sticker premium.

Take “Robert in Nevada (NV),” who stuck with his $0-premium plan for three years because the price looked unbeatable. When he finally ran his blood pressure and cholesterol medications through Plan Finder for 2027, a $32-a-month plan came out nearly $400 a year cheaper overall, because his current plan placed both drugs on a high-copay tier.

If you’re on a high-cost specialty drug, check whether it’s one of the 15 newly negotiated medications and, if so, what tier your plan places it on for 2027. And if your household income has genuinely dropped since your last tax return — through retirement, widowhood, or a similar life event — remember that IRMAA is based on a two-year lookback, and Form SSA-44 can get your surcharge corrected without waiting it out.

For the fuller picture of how Part D fits alongside Part A, Part B, and IRMAA, see my 2026-2027 Medicare Premiums, Deductibles, and IRMAA guide. And since Part B premiums come straight out of Social Security checks, a bigger Part B increase can quietly eat into your COLA raise — my Social Security COLA tracker walks through that math for 2027.

What Still Changes Between Now and January 1

CMS released the 2027 plan landscape on September 28, so plan-by-plan premiums are now live in Medicare’s Plan Finder. The big remaining piece is the official 2027 Part B premium and IRMAA brackets, which usually come out in November.

What I’m watching for: whether individual plans stay close to CMS’s roughly $1 average increase once people start comparing, or whether the end of the stabilization program shows up as bigger jumps for specific plans. I’ll update this page as the Part B numbers land.