Medicare 2026

Cancer Drugs and Medicare in 2027: How Part B, Part D and the New Negotiated Prices Fit Together

Cancer treatment can involve several kinds of medicines, and Medicare pays for them in different ways. Knowing which part of Medicare covers which drug — and how the new negotiated prices work — can help you plan ahead for 2027.

Part B vs. Part D for cancer drugs

Medicare Part B generally covers cancer drugs that a provider gives you by infusion or injection in a doctor's office or hospital outpatient department. It also covers some oral cancer drugs that have an injectable form. Under Part B, after you meet the yearly Part B deductible, you typically pay 20 percent of the Medicare-approved amount for the drug. A Medigap (Medicare Supplement) policy can cover all or part of that 20 percent coinsurance. The 2027 Part B standard premium and deductible had not been announced at the time of writing; CMS usually announces them in the fall. The same is true of the 2027 IRMAA income-related surcharges.

Medicare Part D covers most cancer drugs you take at home — pills, capsules and certain self-administered injectables. Cancer drugs (antineoplastics) are one of Part D's "protected classes," meaning plans must cover all or substantially all of them. Your share of the cost under Part D depends on your plan's deductible, the tier the drug falls on, and the plan's cost sharing. In 2027, no Part D plan may charge a deductible higher than $700, and once your own spending on covered drugs reaches $2,400, you pay nothing more for covered Part D drugs for the rest of the year. The Part D base beneficiary premium for 2027 is $41.33 — a national figure used to calculate the late-enrollment penalty; actual plan premiums are set plan by plan.

The negotiated prices: what's changing in 2027

Under Medicare's drug price negotiation program, drug companies must make certain drugs available to people with Medicare and to pharmacies at a negotiated price (the law calls it the "maximum fair price"). Imbruvica, used for several blood cancers, has had a negotiated price of $9,319 for a 30-day supply since January 1, 2026 (its 2023 list price was $14,934).

On January 1, 2027, four more cancer drugs get negotiated prices, each for a 30-day supply and compared to the 2024 list price:

• Xtandi (prostate cancer): $7,004, down from a list price of $13,480.
• Ibrance (breast cancer): $7,871, down from $15,741.
• Calquence (chronic lymphocytic leukemia, mantle cell lymphoma): $8,600, down from $14,228.
• Pomalyst (multiple myeloma, Kaposi sarcoma): $8,650, down from $21,744.

CMS has also selected 15 more drugs — payable under Part B and/or covered under Part D — for a third round of negotiation, with prices taking effect beginning in 2028. It's the first round to include Part B drugs.

What a negotiated price does — and doesn't — mean for you

A negotiated price is the price the manufacturer must offer; it is not your copay. What you actually pay for a Part D cancer drug still depends on your plan's deductible, the tier the drug sits on, and the plan's cost sharing — and the $2,400 Part D out-of-pocket cap still applies in 2027. For people taking high-cost cancer medicines, that cap is often the figure that matters most, because once you hit it, your covered Part D drug costs stop for the year.

Enrollment windows to know

Annual Enrollment runs October 15 – December 7, 2026, with changes taking effect January 1, 2027. This is the main time to compare Part D plans or Medicare Advantage plans for the coming year.

If you have Medicaid or qualify for Extra Help, you have a monthly Special Enrollment Period to move to Original Medicare with a stand-alone Part D plan, or to switch stand-alone Part D plans. People who are full-benefit dual-eligible can join an integrated D-SNP in any month.

The Social Security Administration announced a 3.6 percent cost-of-living adjustment for benefits payable beginning January 2027, which can affect your monthly check even if your drug costs change too.

Original Medicare + Medigap, or Medicare Advantage?

Both paths cover cancer care, with trade-offs:

• Original Medicare with a stand-alone Part D plan, often paired with Medigap, generally lets you see any provider who accepts Medicare and uses Medigap to help cover Part B's 20 percent coinsurance for infused drugs. You pay separate premiums for Part B, Part D and Medigap.
• Medicare Advantage bundles medical and (usually) drug coverage with an annual out-of-pocket maximum on medical services, but typically uses provider networks and may require prior authorization for certain cancer drugs or treatments.

Neither is "better" in the abstract — the right fit depends on your providers, your prescriptions and your budget. If you take a drug on the negotiated-price list, check how each plan you're considering covers it.

Where to go next

For plan comparisons, drug coverage checks and official rules, visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227), available 24 hours a day, 7 days a week. These are the authoritative sources for current Part D rules and plan details.

This article is for educational purposes only and is not affiliated with any government agency.