On 30 October 2026 KFF published its analysis of Medicare Part D premiums and cost sharing in 2027, and its headline figure has since driven the open enrollment conversation: the average monthly premium for stand-alone prescription drug plans is projected at $51 in 2027, up 50% from $34 in 2026. The figure comes with a condition that matters as much as the number itself. It assumes current enrollees keep the plan they have now, weighted by June 2026 enrollment. Healthcare Dive reported the analysis on 2 November 2026, as open enrollment for 2027 was getting underway.
Who Faces Higher Bills
The pressure is not spread evenly. KFF finds that 10.4 million stand-alone plan enrollees who do not receive low-income subsidies, 76% of that group, would pay a higher monthly premium in 2027 if they make no change. That includes 4.1 million people enrolled in zero-premium plans in 2026, who will face higher premiums next year because no zero-premium stand-alone plans are available in 2027. Of those facing an increase, 2.4 million would see their monthly premium rise by more than $50 if they stay in the same plan. A year earlier, only 38,000 enrollees faced an increase that large. The end of the Part D Premium Stabilization Demonstration after 2026 removed both the extra premium subsidies paid to plan sponsors and the $50 cap on premium increases that applied in 2026. National premiums range widely: Centene's Wellcare Value Script Rx averages $6.50 a month in 2027, while United's AARP Medicare Rx Preferred averages $204.50, up from $126.00 in 2026.
Why the CMS Figure Differs
Readers who saw a very different number in September are not misremembering. When CMS released 2027 plan data in September, it projected that the average monthly stand-alone premium would rise by less than $1, from $35 to $36. KFF notes that CMS did not explain the method behind that calculation, and suggests CMS may have assumed people would switch to lower-cost plans, which would produce a lower enrollment-weighted average. KFF also expects its own $51 figure to fall once switching is counted. The pattern is familiar: at the start of open enrollment in October 2025, KFF projected the average stand-alone premium would rise from $37 in 2025 to $44 for 2026, but the actual weighted average in 2026 came in at $34 after enrollees switched to cheaper plans and new enrollees joined lower-premium ones. The $51 figure is best read as the cost of standing still, not as a forecast of what the average enrollee will actually pay.
Deductibles and Cost Sharing Rise Too
Premiums are only part of the 2027 picture. The standard Part D deductible rises from $615 in 2026 to $700 in 2027. The average deductible for stand-alone plan enrollees rises from $540 to $643, while for Medicare Advantage enrollees with drug coverage it rises from $360 to $489. Virtually all stand-alone plan enrollees, 99.8%, will be in a plan that charges a deductible in 2027, up from 96% in 2026. Most enrollees will also face coinsurance, a percentage of a drug's cost, rather than a fixed copayment for preferred brands and non-preferred drugs. For stand-alone plans, median coinsurance is 25% for preferred brands and 35% for non-preferred drugs. Drug coverage inside Medicare Advantage plans averages about $9 a month in 2027, though Healthcare Dive notes those plans can bring narrower networks and wider use of prior authorization.
Why This Matters for Healthcare Organizations
Clinics and hospitals do not set Part D premiums, but they feel the consequences in the exam room. When a patient's drug costs jump, prescriptions go unfilled and refills get delayed. The practical window is now: open enrollment runs through 7 December 2026, and changes made by then take effect on 1 January 2027. Staff who talk to Medicare patients can point them to a full plan comparison, not just the monthly premium, because a low premium paired with a high deductible and coinsurance can cost more over the year. Practices that run benefits checks before visits should expect more plan changes than usual this season.
Analysis: A Projection About Standing Still
The argument over $51 versus $36 is really an argument about behaviour. KFF's number measures what happens if nobody moves. CMS's number, on KFF's reading, measures something closer to what happens if people shop around, as they usually do. Both can be honestly calculated and still point in different directions, which is why the method note matters more than the headline. The figure that should worry clinics most is not the average at all. It is the distribution: 2.4 million people facing a rise of more than $50 a month if they stay put, against 38,000 a year earlier, and the disappearance of zero-premium stand-alone plans. Averages smooth that shock away. What to watch next is how much switching actually happens by 7 December, and whether the final weighted average lands closer to the CMS figure, as KFF itself expects, or stays high because the cheapest options are gone in some regions.
Clinics reviewing how intake, benefits checks and patient communication work can explore MedClinicX's AI patient portal, see how after-hours calls are handled on our AI medical receptionist page, or explore the demos and request a quote for their own practice. For related coverage, see our earlier article on CMS proposing public accuracy scores for Medicare Advantage directories.
Sources and References
- KFF — Medicare Part D Premiums and Cost Sharing in 2027, 30 October 2026: https://www.kff.org/medicare/medicare-part-d-premiums-and-cost-sharing-in-2027/
- KFF — The Average Monthly Premium for Medicare Part D Stand-Alone Plans Is Projected to Increase by 50% From $34 to $51 in 2027 Unless Enrollees Switch to Lower-Cost Plans, 30 October 2026: https://www.kff.org/medicare/the-average-monthly-premium-for-medicare-part-d-stand-alone-plans-is-projected-to-increase-by-50-from-34-to-51-in-2027-unless-enrollees-switch-to-lower-cost-plans/
- Healthcare Dive — Medicare Part D premiums are spiking 50% on average next year, KFF finds, 2 November 2026: https://www.healthcaredive.com/news/medicare-part-d-premiums-skyrocket-2027-kff/873421/
- USA Today — Why your Medicare drug plan costs will be higher in 2027, 1 November 2026: https://www.usatoday.com/story/money/personal-finance/healthcare/2026/11/01/medicare-part-d-drug-plan-prices-will-rise-in-2027/92501695007/
Reporting based on the sources above, accessed 3 November 2026. The KFF analysis was read directly in full, and the Healthcare Dive and USA Today reports were read directly and cross-checked against it. MedClinicX did not conduct original reporting or interviews for this article. This article is for information only and is not medical, insurance or financial advice. Corrections: contact us via https://medclinicx.com/contact