In short
- The 2027 Part D out-of-pocket cap is $2,400, up from $2,100. After you reach it, you pay nothing more for covered drugs that year.
- Drug plans can charge a deductible of up to $700 in 2027, up from $615.
- The Part D Premium Stabilization Demonstration ends after 2026, so premium increases are no longer held down by that program.
- Nebraska drops from 11 standalone drug plans to 9 for 2027. SilverScript Choice (PDP) and HealthSpring Extra Rx (PDP) are not offered in the state.
- Plans, premiums and drug lists vary by county and change every year, so compare your own medications on Medicare.gov.
CMS released 2027 premium estimates and the plan landscape on September 28. Put together with the Part D rules CMS set in April and July, you now have most of the 2027 drug coverage picture. The short version: the cap and deductible both go up, a program that cushioned premiums is gone, and Nebraskans will have fewer standalone drug plans to choose from.
How much will Part D cost you in 2027?
The two biggest numbers both rise. The out-of-pocket cap goes to $2,400 and the maximum deductible to $700.
| Part D item | 2026 | 2027 |
|---|---|---|
| Maximum deductible | $615 | $700 |
| Your share after the deductible (standard benefit) | 25% | 25% |
| Out-of-pocket cap | $2,100 | $2,400 |
| After you reach the cap | Nothing for covered drugs | Nothing for covered drugs |
| Extra Help maximum, generic | $5.10 | $5.80 |
| Extra Help maximum, other drugs | $12.65 | $14.40 |
| National base beneficiary premium | $38.99 | $41.33 |
The cap counts what you pay for covered Part D drugs, plus certain payments made for you, like Extra Help. A quick way to read it: if your share of your medications averages more than $200 a month, you will reach the 2027 cap before the year is out. Many plans use flat copays by tier instead of the 25% standard share, so your actual costs depend on the plan's drug list. Our guide to the Part D out-of-pocket cap covers what counts and what doesn't.
Why are drug plan premiums under pressure?
The main change is that the Part D Premium Stabilization Demonstration ends. In 2026, it lowered the base premium by $10 and capped yearly premium increases at $50 for plans in the demonstration. CMS said on July 28 that it will end the demonstration after 2026 "to return the program to operating under traditional market conditions in CY 2027."
Plan costs are also climbing. The national average monthly bid rose from $239.27 in 2026 to $296.05 for 2027. Nationally, CMS projects the average standalone drug plan premium will go from $35.09 to about $36 a month, while the average drug premium inside Medicare Advantage plans falls from $11.32 to about $7. National averages hide a lot. Your own plan could move much more than the average in either direction.
What's changing for Nebraska drug plans?
According to CMS, Nebraska will have 9 standalone drug plans (PDPs) from 5 companies in 2027, down from 11 plans from 6 companies in 2026. Nebraska shares a drug plan region with Iowa, Minnesota, Montana, North Dakota, South Dakota and Wyoming.
- Two plans are leaving. SilverScript Choice (PDP) from CVS Health and HealthSpring Extra Rx (PDP) from HCSC are not offered in Nebraska for 2027. If you have one, you need to choose a new plan, or you will start 2027 with no drug coverage.
- A lower premium exists for everyone. CMS says 100% of Nebraska standalone plan enrollees have access to a plan with a lower premium than they paid in 2026. The lowest 2027 standalone premium in the state is $5.30 a month. A low premium does not mean low total cost if the plan covers your medications poorly.
- Extra Help is common. CMS says 16.70% of Nebraskans in standalone drug plans get Extra Help.
Plan availability, premiums, drug lists and pharmacy networks vary by county and change every year.
What else changes for prescriptions on January 1, 2027?
- Fifteen more negotiated drug prices take effect, including Ozempic, Rybelsus and Wegovy. See our negotiated drug price update for the full list.
- The GLP-1 Bridge continues through December 31, 2027, for people who qualify.
- The Medicare Prescription Payment Plan renews automatically if you stay in the same plan. If you switch plans, you have to opt in again with the new one. Learn how the payment plan spreads costs.
- Insulin stays capped at $35 for a one-month supply.
What should you do before December 7?
- Read your plan's Annual Notice of Change for its 2027 premium, deductible and drug list.
- Make a list of every medication, with dose, quantity and the pharmacy you use.
- Starting October 1, compare 2027 plans on Medicare.gov by total yearly cost: premium, deductible and copays together.
- Decide whether a standalone plan or Medicare Advantage drug coverage fits you better. Our comparison explains the trade-offs.
- If your income is limited, check whether you qualify for Extra Help.
Open enrollment runs October 15 to December 7, 2026. For unbiased help, call 1-800-MEDICARE (1-800-633-4227), 24 hours a day, 7 days a week (TTY 1-877-486-2048), or Nebraska SHIP (formerly SHIIP) at 1-800-234-7119. For how Bill reviews drug coverage, see our Part D page.
Frequently asked questions
The cap is $2,400 for 2027, up from $2,100 in 2026. It counts what you spend on covered Part D drugs, plus certain payments made for you, such as through Extra Help. Once you reach it, you pay nothing more for covered Part D drugs for the rest of 2027. The cap applies whether you have a standalone drug plan or a Medicare Advantage plan with drug coverage.
No Part D plan can charge a deductible above $700 in 2027, up from $615 in 2026. Some plans charge less or apply the deductible only to certain tiers. Insulin is not subject to the deductible and costs no more than $35 for a one-month supply. Recommended adult vaccines covered by Part D, such as shingles and RSV shots, have no deductible or copay.
Several reasons. The Part D Premium Stabilization Demonstration, which in 2026 lowered premiums and capped yearly increases at $50 for plans that took part, ends after 2026. The national average monthly bid, a measure of plan costs, rose from $239.27 to $296.05. Your own plan's 2027 premium is listed in its Annual Notice of Change. Compare it with other plans before December 7.
You need to pick a new plan. You can switch during open enrollment, October 15 to December 7, 2026, for coverage starting January 1. Medicare also gives a Special Enrollment Period from December 8 through the last day of February when a plan is not renewed. If you don't choose a new plan, you will have no drug coverage, and a gap of 63 days or more can lead to a late penalty.
The penalty is 1% of the national base beneficiary premium for each full month you went without drug coverage. The base premium is $41.33 for 2027, up from $38.99. Someone who went 20 months without coverage would pay about $8.30 a month extra in 2027 (1% of $41.33, times 20, rounded to the nearest 10 cents). The penalty lasts as long as you have Part D.
Yes, slightly. With Extra Help, the most you pay in 2027 is $5.80 for a generic or preferred multi-source drug and $14.40 for other drugs, up from $5.10 and $12.65 in 2026. After you reach the $2,400 cap, you have no copays. The 2027 income and asset limits have not been announced. For 2026, the income limit is $23,940 for an individual and $32,460 for a couple.
Sources
- CMS: CY 2027 Medicare Advantage and Part D Rate Announcement (April 6, 2026) (opens in a new tab)
- CMS: Medicare Part D 2027 national average monthly bid amount fact sheet (July 28, 2026) (opens in a new tab)
- CMS: 2027 Medicare Advantage and Part D premiums press release (September 28, 2026) (opens in a new tab)
- CMS: 2027 Medicare Advantage and Part D state-by-state fact sheets (opens in a new tab)
- Medicare.gov: Part D costs, deductible and out-of-pocket limit (opens in a new tab)
- Medicare.gov: Special Enrollment Periods (opens in a new tab)
- Medicare.gov: What's the Medicare Prescription Payment Plan? (CMS Product No. 12211) (opens in a new tab)
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. 1-800-MEDICARE (1-800-633-4227) is available 24 hours a day, 7 days a week. TTY users can call 1-877-486-2048.
