Medicare 2026

Medicare's GLOBE Model Will Lower Part B Drug Coinsurance for Some Patients Starting in 2027

On September 30, 2026, the Centers for Medicare & Medicaid Services (CMS) finalized a new initiative called the Global Benchmark for Efficient Drug Pricing Model, or GLOBE. It's a mandatory program that assesses rebates on certain Original Medicare Part B drugs whose U.S. prices are higher than prices paid in economically comparable countries. Participation is mandatory for the manufacturers of drugs that meet the model's criteria.

What is the GLOBE Model?

The model launches January 1, 2027 and runs through March 31, 2032. The reduced coinsurance patients may notice at the point of care takes effect a few months later — from April 1, 2027 through March 31, 2032.

Which drugs are included?

GLOBE focuses on drugs administered in a clinical setting — the kind a doctor or nurse gives you in an infusion suite or office visit, which fall under Part B rather than Part D. Think cancer therapies and medications for autoimmune conditions and arthritis.

CMS selected drugs from five therapeutic classes — oncology, rheumatology, immunology, ophthalmology and endocrinology — where annual Original Medicare spending exceeds $100 million.

Several categories are excluded:

• Biosimilars and their reference biologicals once a biosimilar enters the U.S. market
• Orphan-only drugs
• Plasma-derived products
• Certain cell and gene therapies

Who sees the lower coinsurance?

This is the part that catches most people by surprise. The reduced coinsurance does not apply to every Medicare beneficiary. It applies only to a randomly selected model cohort — about 25 percent of Part B beneficiaries — who meet two conditions:

1. Original Medicare is their primary payer, and 2. Their address of record is in a selected ZIP Code Tabulation Area.

Nobody has to apply or enroll. You can't opt in, and you don't need to do anything to be included. CMS will publish the GLOBE Model ZIP Codes List by January 16, 2027. If you're in the cohort and later move, you stay in the model as long as Original Medicare remains your primary payer.

People whose primary coverage is a Medicare Advantage plan are not in the cohort. CMS does note, however, that all people with Medicare may see Part B premium savings from the model over time, since Part B premiums reflect overall program spending.

What the savings can look like

CMS offered a simple example. Suppose the Part B allowed amount for a GLOBE drug is $100. Normally a patient pays 20 percent coinsurance — $20 — and Medicare pays the provider $80. If the GLOBE coinsurance percentage for that drug is 10 percent, the patient pays $10 and Medicare pays the provider $90.

How much any individual actually saves depends on which drug is being administered and personal circumstances — notably whether you have supplemental insurance (such as a Medigap policy or retiree coverage) that already picks up some or all of your Part B coinsurance.

How this fits with the rest of Medicare in 2027

GLOBE is one piece of a bigger picture. A few other 2027 program-level facts to keep in mind:

• The Part D out-of-pocket cap is $2,400 in 2027 (up from $2,100 in 2026). Once your out-of-pocket drug costs under Part D reach that cap, you pay nothing more for covered Part D drugs the rest of the year.
• The highest deductible any Part D plan may charge in 2027 is $700.
• The Part D base beneficiary premium for 2027 is $41.33. This national figure is used to calculate the late-enrollment penalty; actual plan premiums are set plan by plan.
• The Social Security Administration announced a 3.6 percent cost-of-living adjustment (COLA) for benefits payable beginning January 2027.

The 2027 Part B standard premium and deductible, and the 2027 IRMAA income-related surcharge brackets, have not been announced yet. CMS typically announces them in the fall. Check Medicare.gov for official figures when they're published.

Enrollment windows worth marking

• Annual Enrollment (Open Enrollment): October 15 – December 7, 2026. Choices made in this window take effect January 1, 2027. This is when most people review Part D and Medicare Advantage options.
• Dual-eligible and Extra Help enrollees: Since 2025, there's 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 people can also join an integrated Dual Eligible Special Needs Plan (D-SNP) in any month.

Original Medicare vs. Medicare Advantage: a neutral note

Because GLOBE's reduced coinsurance applies only when Original Medicare is the primary payer, some people will wonder how their coverage choice fits in. Both paths have trade-offs.

With Original Medicare, you generally have broad provider access nationwide, and many people pair it with a Medigap policy and a stand-alone Part D plan. There are typically additional premiums for these.

With Medicare Advantage, plans often bundle drug coverage and may include extras, but networks and prior-authorization rules vary. GLOBE's reduced Part B coinsurance would not apply, though CMS notes everyone with Medicare may see Part B premium savings over time.

Neither path is universally better. The right choice depends on your health, your prescriptions, your providers and your budget.

Where to get official information

For the most current, personalized information, visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227), available 24 hours a day, seven days a week.