MedicarePrescription Drugs2027 Changes
Big Medicare Changes for 2027: Is Your Prescription One of the 15 Drugs Getting Lower Prices?
Starting Jan. 1, 2027, Medicare’s negotiated prices take effect for 15 widely used drugs, including Ozempic, Wegovy, Trelegy Ellipta and Xtandi, with cuts of 38% to 85% from 2024 list prices. Part D’s out-of-pocket cap also rises to $2,400. Open enrollment ends Dec. 7.
By the Medicare & Money DeskFact-checked against CMS figures, SSA, Medicare Trustees projections and trade coverageUpdated November 9, 2026Scope Medicare Part D and Parts A and B, 2027
If you take a GLP-1 for diabetes, an inhaler for COPD or a targeted cancer pill, check your pharmacy receipts from this year and keep them for comparison. On Jan. 1, 2027, Medicare will start paying sharply lower negotiated prices for 15 brand-name drugs used by about 5.3 million Part D enrollees. For many people that means smaller coinsurance bills at the counter.
It is the second round of drug price negotiation created by the Inflation Reduction Act, and it arrives alongside other 2027 changes: a higher Part D out-of-pocket cap and deductible, the end of a temporary premium subsidy, and Part A and B costs still awaiting final announcement. With Medicare open enrollment running only until Dec. 7, the next four weeks are when your choices for 2027 lock in.
What We Know
- CMS finalized negotiated prices for 15 drugs in November 2025; they take effect Jan. 1, 2027.
- The 2027 Part D out-of-pocket cap is $2,400, the maximum deductible $700 and the base beneficiary premium $41.33.
- Social Security benefits rise 3.6% in January 2027, about $75 a month on average, per SSA.
- Core Medicare telehealth flexibilities are extended through Dec. 31, 2027.
What Is Still Unclear
- Official 2027 Part B premium and Part A and B deductibles had not been announced as of this update; trustees project $209.50 a month for Part B.
- How much individual enrollees save depends on each plan’s copays, coinsurance and formulary.
- Plan-by-plan Part D premium changes after the end of the premium stabilization demonstration vary.
- Coverage rules for GLP-1 drugs used only for weight loss are separate from the negotiated price and differ by plan.
Change 1The 15 Drugs Getting Medicare’s Negotiated Prices
CMS selected these drugs because they account for some of Medicare’s highest Part D spending. In 2024 they cost the program $42.5 billion, about 15% of total Part D gross drug costs, and enrollees paid $1.7 billion out of pocket for them. The new “maximum fair prices” are what Medicare plans will pay for each drug starting in 2027, though they are not necessarily what you will pay at the pharmacy.
How Medicare Negotiation Works
The Inflation Reduction Act of 2022 gave Medicare authority to negotiate prices directly with manufacturers for a limited number of high-spending drugs that have been on the market for years without generic or biosimilar competition. CMS selects the drugs, makes an initial offer, and manufacturers can counter before a final price is set. The resulting “maximum fair price” applies across all Part D plans, so the discount follows the drug no matter which plan you choose. Pharmacies are reimbursed so that the lower price can be passed through to the plan and, depending on cost-sharing, to you.
| Drug | Used for | 2024 list, 30 days | 2027 negotiated, 30 days | Cut |
|---|---|---|---|---|
| Ozempic, Rybelsus, Wegovy | Type 2 diabetes, heart risk, obesity | $959 | $274 | 71% |
| Trelegy Ellipta | Asthma, COPD | $654 | $175 | 73% |
| Xtandi | Prostate cancer | Not listed | $7,004 | 48% |
| Pomalyst | Multiple myeloma | Not listed | $8,650 | 60% |
| Ibrance | Breast cancer | Not listed | $7,871 | 50% |
| Ofev | Idiopathic pulmonary fibrosis | Not listed | $6,350 | 50% |
| Linzess | Chronic constipation, IBS-C | $539 | $136 | 75% |
| Calquence | Leukemia, lymphoma | Not listed | $8,600 | 40% |
| Austedo, Austedo XR | Huntington’s chorea, tardive dyskinesia | Not listed | $4,093 | 38% |
| Breo Ellipta | Asthma, COPD | $397 | $67 | 83% |
| Tradjenta | Type 2 diabetes | $488 | $78 | 84% |
| Xifaxan | Hepatic encephalopathy, IBS-D | Not listed | $1,000 | 63% |
| Vraylar | Bipolar disorder, depression, schizophrenia | Not listed | $770 | 44% |
| Janumet, Janumet XR | Type 2 diabetes | $526 | $80 | 85% |
| Otezla, Otezla XR | Psoriasis, psoriatic arthritis | Not listed | $1,650 | 65% |
Sources for prices: CMS figures as reported by Kiplinger, Pharmaphorum and Doctronic. CMS counts Ozempic, Rybelsus and Wegovy as one drug because all contain semaglutide.
How Deep the Cuts Go
Change 2Part D’s New Numbers: Cap, Deductible and Premiums
The 2027 Part D figures were set by CMS earlier this year. The annual out-of-pocket cap rises to $2,400 from $2,100, the maximum deductible rises to $700 from $615, and the base beneficiary premium, a benchmark used to calculate premiums and penalties, rises to $41.33 a month from $38.99. After the deductible, enrollees in the standard benefit pay 25% of drug costs until they hit the cap; after that, covered drugs cost nothing for the rest of the year.
Part D Costs, 2026 vs 2027
Out-of-pocket cap
Maximum deductible
Base beneficiary premium, per month
The Premium Subsidy That Disappears
A federal Part D premium stabilization demonstration lowered stand-alone drug plan premiums by about $16 per person per month in 2026, according to Kiplinger. It will not be extended into 2027, so some enrollees may see higher premiums. Choice is also narrower: the average number of stand-alone drug plans available fell from 30 five years ago to 11 in 2026, Kiplinger reports. Insulin remains capped at $35 a month for a covered insulin under Part D, and the Medicare Prescription Payment Plan still lets enrollees spread out-of-pocket costs into monthly payments.
The Fine Print on GLP-1 Drugs
Semaglutide’s 71% price cut is the headline of this round, and Medicare spent $15.1 billion on it in 2024. But the price applies only when the drug is covered. Medicare law has long excluded drugs used solely for weight loss, so Part D plans cover Ozempic and Rybelsus for type 2 diabetes and Wegovy for approved uses such as reducing cardiovascular risk. Coverage rules for weight management alone have been the subject of separate policy debates and can vary, so confirm with your plan whether your specific use is covered before counting on the lower price.
Change 3Parts A and B: What Is Projected and What Is Confirmed
CMS typically announces Part A and B costs in mid-November, so the official 2027 figures may arrive any day. For now, the Medicare Trustees’ June 2026 report projects the standard Part B premium at about $209.50 a month, up $6.60 from $202.90, and the Part B deductible at about $292, up from $283. The Part A hospital deductible is projected at about $1,788, up from $1,736.
Projected 2027 Part A and B Costs vs 2026
Social Security’s 3.6% cost-of-living adjustment for 2027, announced Oct. 14, raises the average retirement benefit by about $75 a month for nearly 72 million beneficiaries. If the Part B premium lands near the projection, the $6.60 increase would absorb a modest slice of that raise for people who have Part B deducted from their checks. SSA says each person’s 2027 Medicare premium amount will appear in the my Social Security Message Center starting in late November.
Medicare Advantage Enrollees: The Notice That Matters
About half of Medicare beneficiaries are in Medicare Advantage plans, which bundle hospital, medical and usually drug coverage. The negotiated prices apply to their drug coverage too, but each plan sets its own copays, networks and extra benefits for 2027. Every enrollee should have received an Annual Notice of Change by the end of September. If your plan changed its pharmacy network, dropped a doctor or moved one of your drugs to a higher tier, open enrollment is the time to act, and enrollees can make one switch between Medicare Advantage plans or back to Original Medicare from Jan. 1 to March 31.
Telehealth Gets Another Year
Core Medicare telehealth flexibilities, including the ability to have many visits from home, are extended through Dec. 31, 2027, under the Consolidated Appropriations Act of 2026, according to Kiplinger. That gives rural and homebound enrollees another year of predictable access.
DecideWill the Lower Prices Actually Reach You?
A lower negotiated price helps you most when your cost-sharing is a percentage of the drug’s price. If your plan charges coinsurance, typically 25% in the standard benefit, a lower price means a lower bill. If your plan charges a flat dollar copay for the drug, the negotiated price may not change what you pay at the counter, though it can still help you reach the out-of-pocket cap more slowly and lowers what Medicare spends.
| Your situation | Likely effect in 2027 | Why | What to check |
|---|---|---|---|
| Take a listed drug, pay coinsurance | Lower costs likely | 25% of a smaller price | Plan’s coinsurance on that drug |
| Take a listed drug, pay a flat copay | May stay similar | Copay not tied to price | Whether the copay changes in 2027 |
| Already hit the cap every year | Cap rises to $2,400 | You may reach the cap later or not at all | Total yearly cost on Medicare Plan Finder |
| In the deductible phase | Lower costs likely | Deductible is paid against the drug’s price | Plan deductible, up to $700 |
| Medicare Advantage with drug coverage | Depends on plan | Same negotiated price; plan sets cost-sharing | Annual Notice of Change |
| Extra Help enrollee | Already low costs | Fixed low copays continue | Eligibility and plan premium |
| Not on any listed drug | Indirect effect | Program-wide savings; your drugs unaffected | Premiums and formulary changes |
TimelineKey Dates Between Now and 2028
- Nov. 2025CMS finalizes prices for 15 drugs.
- Jan. 1, 2026First-round prices for 10 drugs take effect.
- Oct. 15, 2026Open enrollment for 2027 coverage begins.
- Dec. 7, 2026Open enrollment ends; choices lock in.
- Jan. 1, 2027New prices, $2,400 cap and 3.6% COLA start.
- 2028Prices for another 15 drugs, selected in early 2026, take effect.
The first round of negotiation covered 10 drugs, including Eliquis, Jardiance and Xarelto, with discounts from 38% to 79% off list and estimated savings of about $6 billion, according to Managed Healthcare Executive. The second round’s 15 drugs bring the total to 25 negotiated medicines, and CMS has already selected 15 more for prices taking effect in 2028.
ActYour Medicare Checklist Before Dec. 7
- Read your Annual Notice of ChangeIt lists 2027 premiums, deductibles, copays and formulary changes for your current plan.
- List every prescription and doseInclude strength and frequency for accurate Plan Finder estimates.
- Compare total yearly costPremium plus estimated drug costs, not premium alone.
- Check your pharmacyPreferred pharmacies can mean lower copays.
- Ask about Extra HelpLow-income enrollees may qualify for reduced costs.
- Get free counselingYour State Health Insurance Assistance Program offers unbiased help.
- Open enrollment Oct. 15 to Dec. 7Changes take effect Jan. 1.
- Part D cap $2,400Maximum out of pocket for covered drugs in 2027.
- Deductible up to $700Some plans charge less or none.
- Insulin $35 a monthFor covered insulins under Part D.
- Payment plan availableSpread drug costs monthly.
- Advantage change windowJan. 1 to March 31 for one switch.
Frequently Asked Questions
What drugs will be cheaper on Medicare in 2027?
Ozempic, Rybelsus and Wegovy, Trelegy Ellipta, Xtandi, Pomalyst, Ibrance, Ofev, Linzess, Calquence, Austedo, Breo Ellipta, Tradjenta, Xifaxan, Vraylar, Janumet and Otezla have negotiated prices starting Jan. 1, 2027.
How much will Ozempic cost on Medicare in 2027?
The negotiated price is $274 for a 30-day supply, down from a 2024 list price of $959. What you pay depends on your plan’s deductible, coinsurance or copay and whether your use is covered.
What is the Medicare Part D out-of-pocket maximum for 2027?
$2,400, up from $2,100 in 2026. Once you reach it, you pay nothing more for covered Part D drugs for the rest of the year.
What is the 2027 Part D deductible?
The maximum standard deductible is $700, up from $615. Plans can charge less or no deductible.
What is the Medicare Part B premium for 2027?
As of Nov. 9, 2026, CMS had not announced it. The Medicare Trustees project about $209.50 a month, up from $202.90 in 2026.
Will my copay go down if my drug was negotiated?
If you pay coinsurance or are in your deductible, your cost should fall. If your plan charges a flat copay, it may not change. Check your plan’s 2027 Annual Notice of Change.
When is Medicare open enrollment for 2027?
Oct. 15 through Dec. 7, 2026. Changes take effect Jan. 1, 2027. Medicare Advantage enrollees can make one change from Jan. 1 to March 31.
How much is the Social Security COLA for 2027?
3.6%, or about $75 a month for the average retirement benefit, starting January 2027, according to the Social Security Administration.
The Short Version
On Jan. 1, 2027, Medicare’s negotiated prices take effect for 15 drugs, including Ozempic, Wegovy, Trelegy Ellipta and Xtandi, with cuts of 38% to 85% from 2024 list prices. Part D’s out-of-pocket cap rises to $2,400, the deductible to as much as $700, and a temporary premium subsidy ends. Part B costs are projected to rise modestly, while Social Security grows 3.6%. Whether you save depends on your plan’s cost-sharing, so compare total yearly costs on Medicare Plan Finder before open enrollment closes Dec. 7.
Omisha is a health writer passionate about turning complex medical research into clear, actionable content readers can trust. She covers everything from nutrition and mental wellness to chronic disease management, always grounding her work in credible science and real-world relevance. When she's not writing, she's usually reading up on the latest health studies or exploring new wellness trends to write about next.
