The season’s news
Medicare in 2027: the drug cap rises, Ozempic gets negotiated, and one subsidy quietly ends
Short answer: 2027 is a bigger-than-usual year of change on the drug side, and most of it is already final. The out-of-pocket cap rises to $2,400, the standard deductible jumps to $700, negotiated prices for 15 more drugs (led by Ozempic, Wegovy, and Rybelsus at $274 a month) take effect January 1, and the federal subsidy that held down standalone drug plan premiums ends December 31, 2026, which makes this fall’s open enrollment the most consequential re-shop in years. Part B’s premium lands in late October. Here’s everything, sorted by whether it’s confirmed and what to do about it.
Key takeaways
- Final: the Part D out-of-pocket cap rises to $2,400 (from $2,100), the standard deductible to $700 (from $615), the base premium to $41.33.
- Final: negotiated prices on 15 more drugs start January 1, including the semaglutide family (Ozempic, Wegovy, Rybelsus) at $274 for 30 days, 71% off list.
- Final: the premium-stabilization subsidy for standalone drug plans ends December 31, 2026; standalone premiums may jump more than usual.
- Pending: the 2027 Part B premium and Part A/B deductibles, announced late October or early November.
- Unchanged: $35 insulin, $0 vaccines, monthly payment smoothing, the GLP-1 Bridge (through 2027), and Part D’s overall structure.
The drug numbers, all final
| Part D parameter | 2026 | 2027 | Change |
|---|---|---|---|
| Out-of-pocket cap on covered drugs | $2,100 | $2,400 | +$300 |
| Standard deductible (maximum) | $615 | $700 | +$85 |
| National base premium | $38.99 | $41.33 | +$2.34 (the 6% legal maximum) |
| Insulin, per month’s supply | $35 | $35 | none |
| ACIP-recommended vaccines | $0 | $0 | none |
Per the CMS CY2027 Rate Announcement (April 2026) and the July 2026 Part D bid announcement. Individual plan premiums and deductibles vary beneath these ceilings.
Read the first two rows together and the shape of 2027 emerges: the ceiling protecting heavy prescription users rises $300, while the floor everyone crosses first rises $85. Light-prescription households mostly feel the deductible; heavy-prescription households trade a slightly later cap for the negotiated prices below, which for many will more than repay it. The base premium’s $2.34 rise hit the Inflation Reduction Act’s 6% annual cap exactly, and that number matters beyond premiums: it’s the base for the Part D late penalty and the Part D IRMAA surcharges.
The negotiated 15, led by semaglutide
January 1 activates round two of Medicare’s drug price negotiation: 15 more drugs that together accounted for $42.5 billion of Part D spending in 2024, used by 5.3 million beneficiaries. The headline is the semaglutide family: Ozempic, Rybelsus, and Wegovy drop to $274 for a 30-day supply, 71% below the $959 list price. The list also includes Trelegy Ellipta (COPD/asthma), Xtandi (prostate cancer), Pomalyst, Ibrance (breast cancer), Ofev, Austedo, and Janumet, with negotiated discounts running 38% to 85% off list. What you’ll actually pay still flows through your plan’s tiers and phases, but lower negotiated prices mean you cross the deductible and reach the $2,400 cap on genuinely lower totals, and plans’ costs for these drugs fall too. One planning note: diabetes-prescribed GLP-1s live in normal Part D where these prices apply; weight-loss prescriptions continue through the separate $50 Bridge program for all of 2027.
The subsidy ending, which is the re-shop siren
Since 2025, a federal demonstration program has quietly subsidized standalone Part D plans (a $10 monthly premium reduction and a cap on year-over-year increases in 2026). CMS is ending it December 31, 2026, calling the market ready for normal conditions. Translation for the roughly 25 million people in standalone plans: 2027 premiums lose their training wheels, and some plans will jump noticeably while others reprice modestly. Advantage plans’ built-in drug coverage isn’t affected the same way. None of this is a reason for alarm; all of it is a reason to spend 15 minutes in the Plan Finder once 2027 prices post on October 15, because the spread between plans will likely be wider than any recent year.
Still pending: the Part B side
The 2027 Part B premium (2026: $202.90) and the Part A and B deductibles arrive in CMS’s customary late-October/early-November announcement, typically alongside the Social Security COLA news cycle. Trustees’ projections have pointed to a more modest increase than 2026’s near-10% jump, but projections aren’t premiums; we’ll publish the real numbers within days of the release, in the 2027 premiums tracker. IRMAA brackets for 2027 (based on 2025 returns) land in the same announcement.
What isn’t changing
The redesigned Part D structure itself is now codified regulation: no donut hole returning, catastrophic coverage still $0 after the cap, monthly smoothing still mandatory for every plan. Insulin stays $35, vaccines stay $0, the GLP-1 Bridge runs through December 31, 2027, and the annual calendar (ANOC in September, enrollment October 15–December 7, changes live January 1) runs exactly as always. Open enrollment mechanics live on our season page.
Who should re-shop hardest this fall
- Anyone in a standalone Part D plan: the subsidy’s end makes premium changes plan-specific and unpredictable; sort by total annual cost, not by loyalty.
- People taking any of the negotiated 15: plans may reshuffle tiers around the new prices; the same drug can land very differently across plans.
- Anyone whose ANOC shows a deductible jumping toward the new $700 maximum, or tier moves on their specific drugs.
- Everyone else: the standard 30-minute check. Auto-renewal into a repriced plan is the most expensive form of doing nothing that Medicare offers.
Questions people also ask
What is the Medicare Part D out-of-pocket cap for 2027?
What will Ozempic cost on Medicare in 2027?
Why might my drug plan premium jump for 2027?
Has the 2027 Part B premium been announced?
What Medicare benefits stay the same in 2027?
Sources for this article
- CMS.gov2027 Part D bid announcement: the $41.33 base premium and the stabilization program’s end.
- Medicare.govPart D costs: the deductible, cap, and smoothing rules.
- CMS.gov2026 premiums and deductibles: the 2026 baselines compared throughout.
Figures checked against these sources in September 2026. We update within weeks when CMS publishes new amounts.
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