KFF projects a 50% rise in the average stand-alone Medicare drug plan premium for 2027 unless enrollees switch

People with stand-alone Medicare prescription drug plans (PDPs) face much higher premiums in 2027 unless they change plans, according to a KFF analysis published on 30 October. KFF projects that the average monthly PDP premium will rise by $17, or 50%, from $34 this year to $51 next year. The projection assumes that enrollees stay in their current plan and excludes people who receive low-income subsidies.

A main cause is that no zero-premium PDP will be available in 2027. More than 4 million people are in zero-premium plans now. KFF Health News reported that about 10.4 million enrollees, or 76% of stand-alone enrollees without low-income subsidies, would pay more if they do not move. Across the eight national PDPs, 2027 premiums range from $6.50 a month for Centene's Wellcare Value Script Rx to $204.50 for UnitedHealth's AARP Medicare Rx Preferred, which costs $126 this year.

Drug cover inside Medicare Advantage changes much less: KFF projects an average premium of $9 a month, an increase of less than $2. Deductibles rise in both markets. The average PDP deductible goes to $643 from $540, and the average for Medicare Advantage drug plans goes to $489 from $360. KFF also says most Part D enrollees will face coinsurance rather than copayments for both preferred brands and non-preferred drugs, which can make out-of-pocket costs less predictable.

The increase follows the decision by the Centers for Medicare & Medicaid Services (CMS) to end its temporary subsidy pilot for stand-alone plans early, in July, after it had paid subsidies for 2025 and 2026. CMS projected a rise of only about $1 in the national average PDP premium, to $36. KFF said the agency did not explain its method and may have assumed that people would move to cheaper plans.

Nearly 25 million people have stand-alone Part D cover. Open enrollment runs until 7 December. KFF's Juliette Cubanski said that low-premium options exist, but that people facing large increases "need to take action".