Written and medically reviewed by Dorcas Morak, Pharm.D
Medicare Open Enrollment gives beneficiaries an important opportunity each fall to review their coverage and prepare for the year ahead. While premiums are often a major consideration, prescription drug costs can also change significantly from one year to the next.
For 2027, Medicare Part D includes changes to key cost limits, including a higher standard deductible and annual out-of-pocket threshold. Reviewing your medications, plan formulary, pharmacy network, and estimated annual costs during Open Enrollment can help you choose coverage that better fits your needs and avoid unexpected prescription expenses.
When Is Medicare Open Enrollment for 2027 Coverage?
Medicare Open Enrollment, also called the Annual Enrollment Period, runs from October 15 through December 7, 2026, for coverage beginning January 1, 2027.
During Open Enrollment, you can switch Medicare Advantage plans, change Medicare drug plans, move from Original Medicare to Medicare Advantage, or return from Medicare Advantage to Original Medicare. If you return to Original Medicare, you can also join a standalone Part D prescription drug plan.
Medicare beneficiaries were able to start comparing their current coverage with available 2027 plan options on October 1.
Why Should You Review Your Medicare Part D Plan Every Year?
Medicare Part D plans can change their premiums, deductibles, formularies, drug tiers, pharmacy networks, and coverage requirements from one year to the next. Even if you're satisfied with your current coverage, the same plan may cost more or cover your medications differently in 2027.
Before automatically renewing, make a list of the medications you currently take, including the drug name, dosage, and quantity, and compare how available plans will cover them in the coming year.
What Is a Medicare Annual Notice of Change?
If you're enrolled in a Medicare Advantage or Part D plan, you should have received an Annual Notice of Change (ANOC) in September. This document explains changes to your plan's costs, coverage, and other important details that will take effect in January.
Review the ANOC carefully for changes involving prescription drug premiums, deductibles, formularies, drug tiers, pharmacy networks, and coverage requirements. Even one change involving a medication you take regularly could affect your annual prescription costs.
How Can Part D Formulary Changes Affect Prescription Costs?
A formulary is the list of medications covered by a Medicare drug plan. Plans may make changes from year to year, so a medication covered favorably under your current plan may have different coverage in 2027.
For example, medications such as atorvastatin for high cholesterol, metformin for type 2 diabetes, or apixaban (Eliquis®) for preventing blood clots may be placed on different tiers or have different coverage requirements depending on the plan.
Plans may also require prior authorization, step therapy, or quantity limits for certain medications. Checking each medication against a plan's 2027 formulary can help you understand what you may pay and whether additional coverage requirements apply.
What Is the Medicare Part D Out-of-Pocket Cap for 2027?
The Medicare Part D annual out-of-pocket threshold increases from $2,100 in 2026 to $2,400 in 2027. Once you reach the $2,400 threshold through qualifying out-of-pocket spending on covered Part D medications, you enter catastrophic coverage and pay $0 for covered Part D drugs for the remainder of the calendar year.
Monthly Part D premiums do not count toward the $2,400 threshold. Prescription purchases made outside your Part D benefit, such as those made using a prescription discount program instead of Medicare, generally do not count toward the threshold either.
What Is the Medicare Part D Deductible for 2027?
The standard Medicare Part D deductible increases from $615 in 2026 to $700 in 2027. This is the maximum deductible under the standard Part D benefit, although individual plans may charge a lower deductible or apply the deductible differently depending on the plan and medication.
Because plan costs can vary, it's important to consider the deductible along with premiums, copays, coinsurance, and drug tiers when comparing your 2027 options.
Should You Compare Medicare Advantage and Standalone Part D Plans?
Medicare Advantage plans may include prescription drug coverage along with medical benefits, while standalone Part D plans provide prescription coverage for people with Original Medicare.
When comparing options, look beyond the monthly premium. Review whether your medications are covered, what tiers they're assigned to, applicable deductibles and copays or coinsurance, coverage requirements, and which pharmacies participate in the plan's network.
Your healthcare needs beyond prescription coverage should also be considered when deciding between Original Medicare and Medicare Advantage.
How Do Medicare Part D Premiums, Deductibles, and Drug Tiers Affect Costs?
A lower monthly premium doesn't necessarily mean you'll spend less overall. Depending on the plan, you may also have a deductible and different copays or coinsurance based on the tier assigned to each medication.
For example, lower-cost generic medications such as lisinopril or atorvastatin are often placed on lower tiers, while brand-name and specialty medications may be placed on higher tiers with greater cost sharing.
Estimating your total annual costs—including premiums and what you expect to spend on your medications—provides a more complete comparison than looking at premiums alone.
Why Should You Compare Pharmacy Networks During Medicare Open Enrollment?
Where you fill your prescriptions can affect what you pay. Medicare drug plans have pharmacy networks, and some plans may offer lower cost sharing at certain preferred pharmacies.
Before choosing a plan, check whether your preferred pharmacy participates in the network and compare estimated prescription costs at other participating pharmacies. A plan that looks affordable based on premiums alone may not be the lowest-cost option if your usual pharmacy has higher cost sharing.
Can You Use the RxLess® Assurance Plan Instead of Medicare Part D?
Medicare beneficiaries cannot combine Part D coverage with a prescription discount program for the same prescription purchase. However, the RxLess® Assurance Plan price may be lower than the price available through your Part D plan, particularly for certain generic medications.
You can compare both prices and decide which payment option makes sense for a particular prescription. If you use the RxLess® Assurance Plan instead of Part D, the prescription is purchased outside your Medicare drug benefit. The amount you pay generally does not count toward your Part D deductible or $2,400 annual out-of-pocket threshold.
For that reason, consider both the immediate prescription price and the impact of paying outside your Part D plan on your overall annual drug costs.
Could You Qualify for Medicare Extra Help?
People with limited income and resources may qualify for Medicare's Extra Help program, which helps reduce Part D prescription drug costs. Depending on eligibility, Extra Help can reduce premiums, deductibles, and the amount you pay for covered prescriptions.
If prescription costs are difficult to manage, checking whether you qualify for Extra Help can be an important part of reviewing your Medicare coverage.
What Is the Medicare Prescription Payment Plan?
The Medicare Prescription Payment Plan allows people with Medicare Part D to spread their out-of-pocket costs for covered prescription drugs across the calendar year rather than paying the full amount at the pharmacy when a prescription is filled.
The program does not lower the price of your medications or reduce your total Part D costs. Instead, it may make higher prescription expenses easier to manage by spreading payments over time.
What Happens If You Miss Medicare Open Enrollment?
If you don't make changes by December 7, your current Medicare coverage generally continues into 2027 if the plan remains available. In many cases, you'll need to wait until another applicable enrollment period to change coverage unless you qualify for a Special Enrollment Period.
People already enrolled in Medicare Advantage also have the Medicare Advantage Open Enrollment Period from January 1 through March 31. During that period, they can switch to another Medicare Advantage plan or return to Original Medicare and, if applicable, join a standalone Part D plan.
Compare Prescription Prices with the RxLess® Assurance Plan
Choosing the right Medicare coverage can help manage prescription expenses, but it can still be worthwhile comparing prices throughout the year. The RxLess® Assurance Plan lets you compare prescription prices at more than 70,000 participating pharmacies nationwide.
Even if you have Medicare Part D, you should compare your plan's price with the RxLess® Assurance Plan price before filling a prescription. If the RxLess® Assurance Plan price is lower, you can choose to pay that price instead of using Part D, keeping in mind that the purchase generally will not count toward your Part D deductible or $2,400 annual out-of-pocket threshold.
Download the free RxLess® app to compare prices on your medications and start saving whenever you fill a prescription at a participating pharmacy.
