Medicare 2026

Philadelphia Medicare in 2027: the Part D numbers CMS has locked, and what's still coming

Philadelphia — It is fall 2026, which means Medicare's Annual Enrollment Period is here: October 15 through December 7, 2026. Any change you make in that window takes effect January 1, 2027. CMS has already published some of the key 2027 numbers for Part D, but a few of the figures Philadelphia retirees care most about — the Part B premium and the IRMAA income brackets — are not out yet. Here is what is confirmed, what is pending, and what to look for in the mail before you decide anything.

What CMS has confirmed for 2027

Two Part D numbers are already locked for next year, and both matter if you take prescription drugs:

• Part D out-of-pocket cap: $2,400 in 2027, up from $2,100 in 2026. Once your out-of-pocket spending on covered drugs hits that cap, you pay $0 for the rest of the calendar year.
• Part D maximum deductible: $700 in 2027, up from $615 in 2026. That is the ceiling a plan can set — individual plans can choose a lower deductible.

CMS has also set the Part D national base beneficiary premium at $41.33 for 2027. This is a formula input used behind the scenes (it helps calculate things like the late-enrollment penalty and the Part D IRMAA surcharge). It is not what any specific plan charges.

One structural reminder that is easy to miss: the old coverage gap — the "donut hole" — was eliminated starting in 2025. Part D now has three phases (deductible, initial coverage, catastrophic), and the $2,400 cap in 2027 is the hard ceiling.

What CMS has not announced yet

Two of the biggest numbers for a Philadelphia household budget are still pending:

• The 2027 Part B standard premium and deductible.
• The 2027 IRMAA income brackets and surcharges (the extra amounts higher-income beneficiaries pay on Part B and Part D).

CMS normally releases these in the fall, usually in November. We are not going to estimate them, and we would steer clear of any article that does. For reference, IRMAA in 2026 begins above $109,000 in income for a single filer; the 2027 thresholds will be published alongside the Part B figures.

Once CMS posts the official numbers, they will appear on medicare.gov and in the Social Security notice you receive before January.

Your Annual Notice of Change is the document to read

If you are already in a Medicare Advantage plan or a stand‑alone Part D plan, your insurer mailed (or will mail) you an Annual Notice of Change in late September. It lists, in plain language, exactly what is changing about your plan for 2027 compared with 2026: the premium, the drug formulary, the provider network, the copays, the extras.

Nothing happens if you do nothing — your current plan simply renews with those changes, as long as it is still offered next year. That is why the ANOC matters more than any article: it is specific to your plan, your drugs, and your doctors.

Three things worth checking on your ANOC:

1. Is your plan still being offered in Philadelphia County in 2027? (Some plans are not returning.) 2. Are your prescriptions still on the formulary at the same tier? 3. Are your doctors and the Philadelphia-area hospital systems you use still in network?

How plan availability is moving locally

Philadelphia is in Philadelphia County, where Medicare plan availability is set. For plan year 2026, the county has 97 Medicare Advantage plans from 17 carriers, and all of them include drug coverage. There are 0 stand-alone Part D plans listed in the county data for 2026. The table on this page lists every plan by carrier.

For 2027, the county landscape shifts a bit: 12 plans are not returning, 13 are new, and 9 have been renamed. We cannot tell you from here which specific plan belongs in which bucket — your ANOC (or a non-renewal letter, if your plan is leaving) is the source of truth for your situation.

Carriers offering MA‑PD in Philadelphia County in 2026 include Aetna (CVS Health), Blue Cross Blue Shield (HCSC), Centene (WellCare), Clover Health, Devoted Health, Geisinger Gold, Highmark, Highmark Wholecare Medicare Assured, Humana, Independence Blue Cross, Jefferson Health Plans, Perennial Advantage, Provider Partners Health Plans, UnitedHealthcare, UPMC for Life, UPMC for Life Complete Care, and VISTA Health Plan Inc. The full list, with plan types, is in the table below.

Of the 97 plans, 31 are Special Needs Plans (SNPs) — designed for people who are dually eligible for Medicare and Medicaid, who live in an institution, or who have certain chronic conditions. If one of those situations applies to you, the SNP route is worth asking about.

What a Philadelphia resident can actually do between now and December 7

A practical order of operations for this fall:

1. Open the ANOC. If you are happy and nothing meaningful changes, you can let the plan renew. 2. Check your drug list for 2027. Use the Medicare Plan Finder at medicare.gov to see how your prescriptions line up with plans offered in your ZIP code. 3. Confirm your providers. Call your doctor's office and the hospital system you use (Penn Medicine, Jefferson, Temple, and others in Philadelphia all contract with multiple plans) to confirm which 2027 plans they will accept. 4. Wait on the Part B and IRMAA numbers if those matter for your budget — they will be published before January 1. 5. Decide by December 7, 2026. That is the deadline for an AEP change to take effect January 1, 2027.

If you are in a Medicare Advantage plan on January 1 and want to switch, you still have the Medicare Advantage Open Enrollment Period (January 1 – March 31) for a one-time change.

Where to get Philadelphia-specific help

• medicare.gov — official plan comparison and the 2027 figures as CMS releases them.
• 1-800-MEDICARE — 24/7 help from Medicare itself.
• PA MEDI (Pennsylvania's SHIP program) — free, unbiased, one-on-one counseling for Pennsylvania Medicare beneficiaries. Philadelphia residents can reach a local counselor through the Philadelphia Corporation for Aging.