Medicare 2026

How to Compare Medicare Part D Plans for 2027: What to Check Beyond the Premium

If you take even one prescription, the monthly premium is only part of the story on a Part D drug plan. Two plans with similar premiums can leave you paying very different amounts over the year, depending on how each one covers your specific medications. Here is a plain-English guide to what to check when you line up Part D plans for 2027 — during Annual Enrollment, which runs October 15 through December 7, 2026, with your choice taking effect January 1, 2027.

Start with the drugs you actually take

Before you look at any plan, make a list of your prescriptions: name, dose, how often you take it, and the pharmacy you prefer. Every Part D plan has its own formulary — the list of drugs it covers — and places each covered drug on a tier that determines your share of the cost. A drug can be on one plan's formulary and off another's, or on a low tier in one plan and a high tier in another.

Also check for utilization management: prior authorization (your prescriber must get the plan's approval first), step therapy (you must try a lower-cost drug before the plan covers another one), and quantity limits (a cap on how much you can get at a time). These rules can affect whether you actually get the medication you expect.

Look at the deductible and cost sharing

Each plan sets its own deductible — the amount you pay before the plan starts sharing costs. For 2027, no Part D plan may charge a deductible higher than $700, but many plans charge less, and some charge none on certain tiers. After the deductible, you pay a copay or coinsurance that varies by tier.

Here's an important 2027 program fact: once your own out-of-pocket spending on covered Part D drugs reaches $2,400, you pay nothing more for covered Part D drugs for the rest of the year. (For comparison, that cap is $2,100 in 2026.) This cap applies in every Part D plan.

Check the pharmacy network

Plans usually have preferred pharmacies (lower cost sharing) and standard pharmacies (higher cost sharing). The same drug at the same plan can cost noticeably different amounts depending on where you fill it. If you're attached to a particular pharmacy, confirm whether it's preferred, standard or out of network. Many plans also offer mail order for maintenance medications, often with a 90-day supply that can be more convenient and sometimes less expensive.

Don't skip the star rating

Medicare publishes a star rating (1 to 5 stars) for each plan, reflecting things like customer service, member complaints, and how well the plan handles drug pricing and safety. It's one more signal of what dealing with the plan may feel like day to day.

Let the Plan Finder do the math

The easiest way to compare apples to apples is the Plan Finder on Medicare.gov. Enter your drugs, doses and pharmacies, and it will estimate your total yearly drug costs in each plan — premium, deductible and expected cost sharing combined. That total, not the premium alone, is the number that matters.

For 2027, there are 323 stand-alone Part D plans nationwide offered by 15 insurers, though stand-alone plans are offered region by region, so what's available where you live will be a subset.

If paying at the pharmacy counter is hard

Ask the plan about the Medicare Prescription Payment Plan. It lets you spread your out-of-pocket drug costs across the calendar year in monthly amounts rather than paying large sums at the pharmacy. It does not lower what you owe — the total is the same — but it can smooth cash flow, especially early in the year when a deductible or a high-tier drug can hit hard.

A note on the late-enrollment penalty

If you went without creditable drug coverage after you were first eligible, you may owe a Part D late-enrollment penalty. The penalty is calculated using the national base beneficiary premium, which for 2027 is $41.33. It gets added to whatever plan premium you pay, for as long as you have Part D.

Medicare Advantage vs. Original Medicare + Medigap

Many people get drug coverage bundled into a Medicare Advantage plan; others pair Original Medicare with a Medigap policy and a stand-alone Part D plan. Neither path is universally better. Medicare Advantage can bundle benefits and often has a lower premium, but typically uses provider networks and plan rules. Original Medicare with Medigap generally offers broader provider choice and more predictable cost sharing, but Medigap premiums are an added monthly cost and you still need a separate Part D plan. The right fit depends on your doctors, your medications, your travel patterns and your budget.

If you have Medicaid or Extra Help

Since 2025, people with Medicaid or Extra Help 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. Full-benefit dual-eligible individuals can also join an integrated D-SNP in any month. You are not limited to Annual Enrollment.

A couple of 2027 figures aren't out yet

The 2027 Part B standard premium and deductible, and the IRMAA income-related surcharge brackets, had not been announced at the time of writing. CMS typically announces them in the fall. Check Medicare.gov for the current figures before you finalize decisions tied to them.

Where to go next

For official plan details, formulary lookups and the Plan Finder, visit Medicare.gov. To speak with someone directly, call 1-800-MEDICARE (1-800-633-4227), available 24 hours a day, 7 days a week.