What changes in Medicare on January 1, 2027
Most 2027 Medicare changes take effect January 1, 2027, and you choose your coverage for the year during Open Enrollment, October 15, 2026 through December 7, 2026. Some numbers are final. Others are estimates or projections until CMS publishes them. Here is where each one stands:
Medicare changes for 2027 at a glance
| What | 2026 | 2027 |
|---|---|---|
| Part D out-of-pocket cap, per year | $2,100 | $2,400 (final) |
| Part D maximum deductible | $615 | $700 (final) |
| Standard Part B premium, per month | $202.90 | $209.50 (projected) |
| Average Medicare Advantage premium, per month | $14.37 | $12.00 (CMS estimate) |
| Drugs with Medicare-negotiated prices | First round in effect | 15 more drugs (final) |
The rest of this page walks through each change and what it means when you compare plans. For the enrollment dates in detail, see when Medicare Open Enrollment for 2027 is.
Part D: a higher cap and a higher deductible
See the numbers
| Item | 2026 | 2027 | Status |
|---|---|---|---|
| Out-of-pocket cap | $2,100 | $2,400 | final |
| Maximum deductible | $615 | $700 | final |
The Part D out-of-pocket cap rises from $2,100 in 2026 to $2,400 in 2027, and the most a plan can charge as a deductible rises from $615 to $700.
Source: Medicare.gov — How much does Medicare drug coverage cost?
The out-of-pocket cap is the most you pay for covered Part D drugs in a year. Once your spending on covered drugs reaches $2,400 in 2027, you pay $0 for covered drugs for the rest of the year. Your monthly premium does not count toward it.
The deductible is the most a plan is allowed to charge before it starts sharing the cost. Many plans charge less, and some charge nothing, so the deductible is one of the first lines to compare. Insulin is still capped at $35 for a one-month supply of each covered insulin, with no deductible.
Higher limits don't mean you will pay more. If you take a few low-cost generics, you may never come near the cap. If you take an expensive brand-name drug, the cap is the number that protects your budget. See the 2027 Part D out-of-pocket max for how it works month by month.
Lower negotiated prices for 15 more drugs
Starting January 1, 2027, Medicare's negotiated prices apply to 15 more Part D drugs. The list includes Ozempic, Wegovy and Rybelsus, along with drugs for asthma, COPD, diabetes and several cancers. CMS says about 5.3 million people with Part D used these drugs in 2024.
The negotiated price is what your plan pays for the drug, not your copay. What you pay still depends on your plan's cost sharing, its deductible and whether the drug stays on its formulary. See which drugs get lower Medicare prices in 2027 for the full list.
Part B premium: projected, not final yet
The standard Part B premium is $209.50 (projected by the Medicare Trustees; CMS confirms the final figure in November). In 2026 it is $202.90. Most people have the Part B premium taken out of their Social Security payment, so a change shows up there in January.
CMS posts the final 2027 Part B premium, deductible and income-related surcharges in mid-November. This page will be updated when they are released. For the details, see the 2027 Part B premium.
Medicare Advantage: a lower average premium, fewer choices
CMS estimates the average Medicare Advantage premium will be $12.00 a month in 2027 (CMS estimate), down from $14.37 in 2026. CMS expects about 5,532 plans nationally, close to 5,553 last year, but the average person has 35 plans to pick from instead of 39.
In North Carolina, CMS counts 179 Medicare Advantage plans for 2027, with an average premium of $6.19 (CMS estimate) a month.
A lower average premium doesn't mean every plan got better. Plans can change their networks, drug lists, copays and out-of-pocket maximums each year. Your plan's Annual Notice of Change lists every change for 2027, and it is worth reading line by line before December 7.
GLP-1 drugs for weight loss: the Medicare GLP-1 Bridge
Part D plans generally don't cover drugs used only for weight loss. The Medicare GLP-1 Bridge, a CMS program that runs July 1, 2026 through December 31, 2027, lets eligible people with Part D get certain GLP-1 drugs for a $50 copay with prior authorization.
That copay does not count toward your Part D deductible or the $2,400 cap. For the details and who qualifies, see does Medicare cover Ozempic and Wegovy.
Quick questions
Is the 2027 Part B premium final?
Not yet. The Medicare Trustees project $209.50 a month, and CMS publishes the final figure in mid-November. Treat it as a planning number until then.
Does my Part D premium count toward the 2027 out-of-pocket cap?
No. The cap counts what you pay for covered drugs, such as your deductible, copays and coinsurance. Monthly premiums are separate.
Do I have to do anything for the 2027 changes to apply?
No. They apply to everyone with that coverage. What you can do is compare plans during Open Enrollment so the plan you have in 2027 fits your drugs, doctors and budget.
How The Jordan Insurance Agency helps
The Jordan Insurance Agency is an independent agency based in Charlotte, North Carolina. We compare Medicare Advantage and Part D plans across the carriers in your county, run your prescriptions through each plan's 2027 drug list, and show you what each option would cost you for the year.
There is no fee for our help. Carriers pay the agent, so your premium is the same whether you enroll with us or on your own.
Next steps: check when Medicare Open Enrollment for 2027 is and the 2027 Part D out-of-pocket max.
2027 Medicare figures checked October 16, 2026. Sources: Medicare.gov — How much does Medicare drug coverage cost?, CMS — Negotiated prices for initial price applicability year 2027 (fact sheet), CMS — 2027 Medicare Advantage and Part D landscape, CMS — 2027 MA and Part D state-by-state fact sheets, CMS — Medicare GLP-1 Bridge, Medicare.gov — Insulin, AMAC — Medicare costs 2027 (cites 2026 Medicare Trustees Report).
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