Medicare premiums, deductibles, and coverage rules are shifting again for 2027. The Centers for Medicare and Medicaid Services (CMS) won’t finalize all its 2027 rates and rules until the fall, but early estimates and several rule changes are already known—and they point to a much gentler year than 2026’s steep hikes.
Medicare expert Lauren Bigham Steele walked us through what’s confirmed, what’s still a projection, and what enrollees should watch for.
- Part B premiums are projected to rise to $209.50/month in 2027—a modest increase, far smaller than 2026’s jump.
- Part D’s deductible ($700) and out-of-pocket max ($2,400) are already finalized.
- CMS has finalized a 2.5% average payment increase to Medicare Advantage plans, worth over $13 billion.
- A prior authorization pilot in 6 states continues in 2027, though it’s now facing pushback in Congress.
What’s Changing with Medicare in 2027?
Many Medicare premiums and deductibles will increase in 2027, though there’s reason to hope that the price hikes won’t be as steep as last year’s.
New pharmaceuticals will be added to the Medicare Drug Price Negotiation Program in 2027—including weight-loss drugs Ozempic, Rybelsus, and Wegovy. That could theoretically lower the cost of these drugs for Medicare enrollees, though Bigham Steele believes the direct impact on beneficiaries out of pocket costs may be minimal, for reasons explored later in this article.
The star ratings that many Medicare recipients use to evaluate their Medicare Advantage and Part D plan options are being modified, and some marketing rules related to the sale of Medicare Advantage plans will change as well.
CMS recently announced a 2.48% “net average increase” in its payments to Medicare Advantage plans for 2027—a cash infusion of more than $13 billion that far exceeds earlier proposals and should allow most Advantage plans to continue offering benefits comparable to those currently provided.
Meanwhile, a controversial prior authorization pilot program—Wasteful and Inappropriate Service Reduction (WISeR)—launched in 2026, requiring pre-approval before original Medicare enrollees in six states can receive coverage for certain medical services. This pilot program will continue in 2027 and has now been in effect long enough to gauge its impact on patients.
Let’s dive into a closer look at each of these changes…
Medicare Premium Changes
The premiums charged for Medicare Part B, the Medicare component that covers doctor’s appointments and outpatient care, will almost certainly rise in 2027. CMS won’t announce the official Medicare Part B premium 2027 figures until fall, but the upward trend is clear.
- 2000: $45.50/month
- 2025: $185.00/month
- 2026: $202.90/month
- 2027 (estimated): $209.50/month
The good news: the 2027 increase is projected to be much smaller than the one enrollees endured in 2026. The annual report by the boards of trustees of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds—a federal body jointly administered by agencies including the US Department of the Treasury and CMS— estimates 2027 Part B monthly premiums at $209.50, an increase of just $6.60.
Bigham Steele cautions that this figure should be considered an educated guess, not a guarantee. “It may be around there, but those are estimates,” Bigham Steele says. “I wouldn’t take anything for fact yet.”
The Part B deductible increases most years as well, climbing from $100 in 2000 to $257 in 2025, then to $283 in 2026. The same trustees’ report forecasts a 2027 Part B deductible of $292—just $9 above the 2026 figure.
Medicare Part A, which covers in-patient hospital stays, doesn’t impose any monthly premium for most enrollees, but its deductible does increase most years— from $776 in 2000 to $1,676 in 2025 to $1,736 in 2026. The trustees’ report projects a more modest increase to $1,788 in 2027.
If these estimates hold up, Medicare Part A and B costs should not take a substantially bigger bite out of enrollees’ budgets in 2027 than they did in 2026.
Prescription Drug Coverage Changes
Premiums for Medicare Part D, the Medicare component that provides prescription drug coverage, are likely to increase in 2027, too. What a given enrollee will pay depends on the Part D plan he or she selects, but it’s estimated that the “base beneficiary premium”—a measure of the average plan premiums charged—could climb from $38.99/month in 2026 to roughly $41.33 in 2027.
Unlike the Part A and B figures above, two key Part D numbers for 2027 are already finalized:
- Part D deductible: $700, up from $615 in 2026
- Part D out-of-pocket maximum: $2,400, up from $2,100 in 2026—a $300 jump
“The out-of-pocket max right now is $2,100,” says Bigham Steele, “and it’s going up to $2,400 in 2027.”
Fifteen new drugs will also be added to the Medicare Drug Price Negotiation Program in 2027, which permits the federal government to negotiate prices for certain expensive Part D drugs—aiming to reduce the cost of these drugs for both the Medicare system and for Medicare enrollees. The newly added drugs include:
- GLP-1s: Ozempic, Rybelsus, Wegovy
- Asthma/COPD: Trelegy Ellipta, Breo Ellipta
- Cancer: Xtandi, Ibrance, Pomalyst, Calquence
- Pulmonary fibrosis: Ofev
- IBS: Linzess, Xifaxan
- Huntington’s disease / tardive dyskinesia: Austedo
- Bipolar / depression / schizophrenia: Vraylar
- Type 2 diabetes: Tradjenta, Janumet
- Behcet’s disease / plaque psoriasis / psoriatic arthritis: Otezla
That might seem like great news for Medicare enrollees who take these drugs, but Bigham Steele notes that any price reduction for these drugs is unlikely to reduce most people’s total healthcare costs.
Virtually all Medicare enrollees who regularly take expensive drugs such as these will still reach their $2,400 Part D out-of-pocket max in 2027 even if the prices of these drugs are significantly reduced, she explains—so the total they’ll pay out of pocket for covered prescription drugs is likely to land at $2,400 either way.
This drug price negotiation program had greater potential to save Medicare enrollees money before new legislation took effect in 2025 that dramatically lowered Part D’s out-of-pocket maximums. “Once they introduced the Inflation reduction act, it changed where the savings are being felt,” says Bigham Steele. “The out-of-pocket maximum is what really helps protect enrollees from high drug costs, while the negotiated prices can help lower costs for the Medicare program as a whole.”
Helpful: The Medicare Prescription Payment Plan, first introduced in 2025, will continue in 2027. This voluntary plan lets Medicare enrollees spread the cost of pricey prescription drugs out across the year rather than face the full $2,400 out-of-pocket figure in the first few months.
Medicare Advantage Changes
Most Medicare Advantage plans will no doubt continue charging $0 premiums in 2027, but the rules governing these privately offered alternatives to original Medicare won’t be identical to 2026’s. Here’s what’s changing:
The elimination of certain marketing restrictions
Agents selling Advantage plans will no longer have to wait at least 48 hours after a consumer signs a “Scope of Appointment” form before enrolling that customer in a plan, for example.
These marketing changes will be implemented beginning in October 2026, so the new rules will be in effect when enrollees select their Advantage plans for the 2027 coverage year.
No more unused-benefits warnings
Currently, Advantage plans must send enrollees mid-year notifications about any supplemental benefits that they haven’t yet used. Starting in 2027, those warnings will no longer be required.
A shift in the stars
The star ratings that many consumers use to evaluate Medicare Advantage and Part D plans will change in 2027.
The rating criteria are being streamlined to deemphasize administrative issues and focus on matters that tend to be of greater importance to enrollees, such as medical outcomes and patient experience.
A bump in government funding
The federal government’s payments to Medicare Advantage plan providers will rise by 2.48% on average in 2027—significantly higher than some earlier proposals. This influx of funds should help offset rising healthcare costs and allow most Medicare Advantage plans to avoid cutting back substantially on their benefits.
These are only the Medicare Advantage changes that apply sector-wide. The specific Advantage plan that someone is currently enrolled in could change in important ways, too.
“If you’re on a Medicare Advantage plan, you want to make sure that your copay is still affordable, that your drugs are still well covered, and that your doctor is still in network with that plan,” says Bigham Steele. “If you want to change plans, you can do that between October 15 and December 7th.”
Those already enrolled in a Medicare Advantage plan can also change plans during the Medicare Advantage Open Enrollment period from January 1st to March 31st—or during Special Enrollment Periods, which are triggered by certain qualifying life events.
Original Medicare and Prior Authorization Changes
Under the pilot program WISeR introduced in 2026, CMS began requiring medical providers in six states—Arizona, New Jersey, Ohio, Oklahoma, Texas, and Washington—to obtain authorization before providing original Medicare enrollees with certain medical services. The services affected were selected because they’re often prescribed unnecessarily or even fraudulently, and this pilot program will continue in 2027.
The rollout caused considerable anxiety, since one advantage of choosing original Medicare over a Medicare Advantage plan has historically been the absence of prior authorization requirements.
So far, though, feedback from enrollees suggests the program hasn’t caused major problems. “We have a big Facebook group, and people do get concerned about it,” says Bigham Steele. “But we haven’t seen people run into the kind of complicated prior authorization issues we thought they might, because it’s really only for those specific services.”
The pilot’s future isn’t entirely settled, though. The House Appropriations Committee voted in mid-2026 to block funding for the program in its fiscal 2027 spending bill, and the Senate separately rejected a resolution that would have ended it outright. Neither move has changed the program yet, but it means the prior authorization pilot remains a live political fight enrollees in the affected states should keep an eye on heading into 2027.
What Medicare Beneficiaries Should Do Now
The Medicare Annual Enrollment Period for 2027 begins October 15. Before it arrives, enrollees should:
- Review their “Annual Notice of Change,” which current Medicare Advantage or Part D plans must send by the end of September, to confirm the plan still makes sense based on drug coverage, costs, and provider networks.
- Watch the mail carefully in late September and early October—“It looks like every other Medicare solicitation that they’re going to get in the mail during that time,” warns Bigham Steele, “so it’s really important to check carefully and not accidentally throw it away.”
- Switch plans well before December 7 if a needed drug won’t be covered in 2027, a provider is leaving the network, or another plan is simply a better fit.
