Many $0 Drug Plans Disappear in 2027. Here's What to Check Before Dec. 7

Medicare Part D covers prescription drugs for people with Medicare. Many people with Original Medicare purchase a separate, standalone Part D plan.

For 2027, those plans are changing significantly:

• No more $0 premiums: Standalone Part D plans with no monthly premium will no longer be available to people who do not receive Extra Help.
• 4.1 million affected: That's KFF's estimate of the number of current $0-premium plan enrollees without Extra Help who will face a premium if they stay in their plans.
• A higher projected average: KFF estimates the average monthly premium will rise from $34 to $51 if current enrollees do not switch.
• Large increases for some: KFF estimates that 3.9 million people could pay at least $100 per month if they keep their current plans.

These are estimates based on existing enrollment and current plan choices. Your actual premium will depend on the plan available in your area and the coverage you select.

There isn't just one reason.

One factor is the end of the federal Part D Premium Stabilization Demonstration, which provided temporary financial support to participating standalone drug plans.

The demonstration began in 2025 with a monthly subsidy of up to $15 and a limit of $35 on how much a participating plan's total monthly premium could increase from the previous year.

For 2026, the subsidy was reduced to $10 and the premium-increase limit was raised to $50.

CMS announced in July 2026 that it would discontinue the demonstration after 2026, returning standalone plans to more traditional market conditions in 2027.

The loss of the additional subsidy and premium-increase protection matters, particularly for plans that benefited from the program.

But it isn't the whole story. Other pressures include rising prescription drug costs and the richer Part D coverage introduced by the Inflation Reduction Act of 2022. The redesigned benefit changed how costs are shared among beneficiaries, insurers, drug manufacturers, and the federal government.

The combined effect is contributing to significant differences in premiums among plans.

You may see two different numbers for the projected 2027 average.

KFF estimates an average monthly premium of $51 for standalone Part D plans if current enrollees stay in their existing plans.

CMS projects a national average of approximately $36, compared with $35.09 in 2026.

There are two important differences behind these estimates.

First, they use different enrollment snapshots. KFF's estimate uses June 2026 enrollment, while CMS's September estimate uses a later enrollment snapshot.

Second, the two organizations use different approaches to estimating the average. CMS has not explained the precise method behind its projection, so we should not assume exactly how it accounts for people changing plans.

KFF expects the actual average to be lower than $51 as people compare coverage and move to less expensive plans.

The takeaway: The $51 figure illustrates what could happen if people stay in their current plans. It is not a prediction that everyone's premium will increase by 50%.

Premiums are only one part of prescription drug costs.

The annual out-of-pocket limit for covered Part D medications will increase from $2,100 in 2026 to $2,400 in 2027.

Once you reach the applicable limit on out-of-pocket spending for covered Part D drugs, you enter catastrophic coverage and generally pay nothing for covered Part D medications for the rest of the year.

This limit does not include your monthly premiums. It also does not mean every prescription expense counts toward the limit; only qualifying spending on covered Part D drugs counts.

The higher cap means some people who take expensive medications could have more out-of-pocket exposure in 2027 than they did in 2026.

This change is especially important if you:

• Have Original Medicare and a separate Part D prescription drug plan.
• Currently pay $0 per month for your drug coverage.
• Have received a notice that your current plan's premium is increasing.
• Take several prescription medications or expensive brand-name drugs.
• Have been keeping the same Part D plan for several years without comparing alternatives.

People receiving Extra Help have different protections. They may still qualify for plans with no monthly premium, depending on their eligibility and available plan options.

If you have a Medicare Advantage plan that includes prescription drug coverage, the standalone Part D premium figures in this article do not apply to your plan in the same way.

Medicare Open Enrollment runs from October 15 through December 7, 2026. Changes generally take effect January 1, 2027.

Don't simply allow your current plan to renew without checking the new costs.

Here are six things to compare:

1. Your new monthly premium

Check the amount your current plan will charge in 2027. If you currently pay nothing, confirm whether a monthly premium is being introduced.

2. Your medications

Make sure every prescription you take is covered. Check whether any medication has moved to a different coverage tier or has new restrictions.

3. Your deductible

The maximum standard Part D deductible rises from $615 in 2026 to $700 in 2027. Individual plans may charge less or have no deductible.

4. Your copayments and coinsurance

A low-premium plan may charge more when you fill prescriptions. Compare what you will actually pay for your medications.

5. Your pharmacy

Check whether your preferred pharmacy is in the plan's network and whether it qualifies as a preferred pharmacy. The same prescription can cost different amounts at different pharmacies.

6. Your estimated annual cost

Compare premiums, deductibles, and prescription costs together. The plan with the lowest monthly premium isn't necessarily the least expensive over the entire year.

You can compare available Medicare drug plans using the government's official Medicare Plan Finder.

Enter your prescriptions and preferred pharmacies to see how different plans compare in your area.

Official resources:

Medicare Plan Finder — Compare 2027 plans
https://www.medicare.gov/plan-compare/

Medicare — Understanding Part D costs
https://www.medicare.gov/health-drug-plans/part-d/basics/costs

You can also call Medicare at 1-800-MEDICARE (1-800-633-4227).

For free, unbiased help comparing Medicare coverage, contact your State Health Insurance Assistance Program (SHIP).

Find free Medicare counseling through SHIP
https://www.shiphelp.org/

STRONG: CMS confirms the 2027 plan changes, the end of the Premium Stabilization Demonstration after 2026, the $700 standard deductible, and the $2,400 annual out-of-pocket limit.

MODERATE: KFF's analysis estimates that the average standalone Part D premium will rise from $34 to $51 if current enrollees stay in their existing plans. This is a projection, not a guaranteed average increase.

STRONG: KFF's analysis of 2027 plan availability finds no $0-premium standalone Part D plans for beneficiaries who do not receive Extra Help, affecting an estimated 4.1 million current enrollees if they remain in their plans.