Medicare 2026

Trelegy and Breo Get Medicare Negotiated Prices Starting January 1, 2027 — What People With Part D Should Know

If you or someone you care for uses an inhaler for asthma or COPD, there's news worth understanding. Starting January 1, 2027, two widely used inhalers — Trelegy Ellipta and Breo Ellipta — will have Medicare negotiated prices under the drug price negotiation program created by the Inflation Reduction Act. These prices apply to the drug manufacturers and pharmacies, and they come alongside other 2027 Part D changes that affect what you pay at the pharmacy counter.

Here's a plain-English walk-through of what's changing, what isn't, and how to think about it before the Annual Enrollment Period that runs October 15 through December 7, 2026.

What's actually changing on January 1, 2027

Trelegy Ellipta and Breo Ellipta are both inhalers used for asthma and COPD. In 2024, about 1,269,000 people with Part D used Trelegy and about 626,000 used Breo. Their 2024 list prices were $654 and $397 for a 30-day supply, respectively.

Beginning January 1, 2027, Medicare's negotiated prices (the law calls these "maximum fair prices") take effect:

• Trelegy Ellipta: $175 for a 30-day supply
• Breo Ellipta: $67 for a 30-day supply

A negotiated price is the price the manufacturer must make the drug available at to people with Medicare and to pharmacies that dispense it. It is not automatically your out-of-pocket cost. Your share depends on your specific plan.

Why the negotiated price isn't the same as your copay

Part D plans are run by private insurers, and each plan sets its own deductible, drug tiers and cost sharing within rules set by Medicare. So for 2027, what you pay for Trelegy or Breo depends on:

• Whether your plan has a deductible, and whether these drugs are subject to it. The maximum deductible any Part D plan may charge in 2027 is $700, but many plans charge less.
• What tier your plan places the drug on, and whether cost sharing is a copay (flat dollar amount) or coinsurance (a percentage).
• Where you are in the plan year relative to the Part D out-of-pocket cap.

One important protection applies to everyone with Part D: in 2027, once your own 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, the cap is $2,100 in 2026.)

By law, both stand-alone Part D plans and Medicare Advantage plans that include drug coverage must list the negotiated-price drugs on their formularies, so coverage access shouldn't be a barrier.

How to think about your 2027 coverage

Annual Enrollment runs October 15 through December 7, 2026, and the choices you make take effect January 1, 2027. This is the window most people use to review their drug plan or Medicare Advantage plan.

As you compare, two general paths exist, and neither is "better" — they involve different trade-offs:

• Original Medicare with a stand-alone Part D plan (often paired with a Medigap policy). This typically offers broad provider access nationwide and more predictable cost sharing with Medigap, but you pay separate premiums for Part D and Medigap, and Medigap doesn't cover drugs.
• Medicare Advantage with drug coverage included. These plans often bundle medical and drug coverage with extra benefits and network rules, which can mean lower premiums but more plan-specific utilization management and network restrictions.

The right fit depends on your medications, providers, budget and preferences. Medicare.gov's Plan Finder lets you enter your drug list to see estimated annual costs under different plans.

If you have Medicaid or Extra Help

If you qualify for Medicaid or the Extra Help program (also called the Low-Income Subsidy), you have additional flexibility year-round. Since 2025:

• 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.
• If you're a full-benefit dual-eligible (enrolled in both Medicare and full Medicaid), you can join an integrated Dual Eligible Special Needs Plan (D-SNP) in any month.

This means you aren't limited to Annual Enrollment to adjust your drug coverage.

Other 2027 Part D figures to know

• Out-of-pocket cap: $2,400
• Maximum allowable Part D deductible: $700
• Part D base beneficiary premium: $41.33 (a national figure used to calculate the late-enrollment penalty; actual plan premiums vary and are set plan by plan)

CMS typically announces the 2027 Part B standard premium, Part B deductible, and the IRMAA income-related surcharges in the fall (usually November). Until those are released, no one should quote or estimate them.

Also for context: the Social Security Administration announced on October 14, 2026 a 3.6 percent cost-of-living adjustment (COLA) for benefits payable beginning January 2027.

What should you do next?

1. Make a current list of your medications, including Trelegy or Breo if you take them. 2. During Annual Enrollment (October 15 – December 7, 2026), use Medicare.gov's Plan Finder to compare how different plans would cover your drugs in 2027. 3. Pay attention to each plan's deductible, the tier your inhaler falls on, and the full-year estimated cost — not just the monthly premium. 4. If you have Medicaid or Extra Help, remember you have monthly flexibility to change stand-alone Part D plans or move between Original Medicare and Medicare Advantage under the rules above.

For official, personalized information, visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227), available 24/7. This article is educational and independent; it is not from Medicare or any government agency.