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A KFF analysis projects that average monthly premiums for stand-alone Medicare prescription drug plans will rise from $34 in 2026 to $51 in 2027. The increase is not universal: beneficiaries can compare coverage during open enrollment, and Medicare Advantage enrollees face a much smaller projected increase in the drug portion of their premiums. President Donald Trump has claimed his administration lowered drug prices, but those claims do not address the plan-premium projections.
Millions of Medicare beneficiaries enrolled in stand-alone prescription drug plans are projected to face a sharp premium increase in 2027, with the average monthly cost rising from $34 to $51, according to a new KFF analysis. People can avoid the average increase by switching to a lower-cost plan during open enrollment, which runs through Dec. 7; the projections come as President Donald Trump claims his administration has secured lower medicine prices.
KFF found that about 10.4 million people — 76% of enrollees in stand-alone drug plans who do not receive low-income subsidies — would pay higher monthly premiums in 2027 if they remain in their current plan. The group includes 4.1 million people now enrolled in zero-premium plans; KFF says no zero-premium stand-alone plans will be available next year.
The projections vary by coverage type. The roughly 31 million Medicare beneficiaries with drug coverage through Medicare Advantage plans are projected to pay an average of $9 a month for the drug portion of their overall premium in 2027, an increase of less than $2. Nearly 25 million people are enrolled in stand-alone plans, according to KFF.
Premiums are only one part of projected costs. KFF estimates average drug deductibles in 2027 of $643 for stand-alone plans, up from $540 in 2026, and $489 for Medicare Advantage drug coverage, up from $360. The analysis also found that most enrollees will face coinsurance rather than fixed copayments for drugs, making their out-of-pocket costs dependent on a percentage of each medicine’s price.
The projected increase could affect household budgets even before beneficiaries pay for prescriptions. For people who stay in the same stand-alone plan, higher monthly premiums may be combined with higher deductibles and coinsurance, though actual costs depend on each person’s medicines and coverage. KFF’s figures are averages, not a forecast of what every enrollee will pay.
Shopping could change the outcome. Robert Travis Scott of Abingdon, Virginia, said his current plan’s monthly premium was set to rise from $39.60 in 2026 to $121.90 in 2027. After comparing options, he selected a Humana plan costing $19.30 a month with what he described as similar benefits. He estimated the change would save him about $1,000 next year. His experience illustrates the potential value of comparing plans, but it does not establish that another plan will offer the same savings or cover a beneficiary’s medicines on comparable terms.
The figures also enter a political debate over affordability. Trump told a campaign rally in Ohio on Oct. 28 that his administration had obtained lower pharmaceutical prices. KFF’s analysis concerns insurance premiums and cost-sharing for Medicare drug coverage, which are related to—but distinct from—the prices manufacturers charge for medicines.
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Why 2027 Plan Costs May Rise
KFF said one possible contributor to the projected stand-alone premium increase is the Centers for Medicare & Medicaid Services’ decision in July to end early a three-year pilot intended to limit premiums. The program provided subsidies to stand-alone plans in 2025 and 2026. CMS Administrator Mehmet Oz has described it as an insurance industry bailout; KFF said ending the support after two years could contribute to higher premiums in 2027.
KFF’s projection differs from a CMS estimate of a $1 rise in the national average premium, from $35 to $36, based on September 2026 enrollment. KFF said CMS did not explain its calculation methods and suggested the agency may have assumed that beneficiaries would move to lower-cost plans. The two estimates therefore should not be treated as directly comparable without more information on their methods and assumptions.
Scott’s plan change shows how an individual’s costs can differ from a national average: he reported finding a lower-priced option after receiving notice of a steep increase. His case does not by itself explain why premiums are rising across the market or predict what other enrollees will find.
“With some plans increasing premiums substantially, the stakes are higher this year for people with Medicare stand-alone drug coverage if they sit on the sidelines during open enrollment.”
— Juliette Cubanski, KFF vice president and director of the Program on Medicare Policy
The KFF figures are projections, and the analysis does not mean every stand-alone plan will raise its premium by 50%. Individual costs depend on the plan selected, medicines used and coverage terms. It is also unclear from the available information how CMS calculated its lower average-increase estimate or whether its assumptions account for beneficiaries switching plans.
CMS had not immediately responded to KFF’s request for comment on the analysis, according to the report. The precise effect of ending the subsidy pilot on premiums is also not established: KFF identifies it as a possible cause, rather than proving it accounts for the projected increase. Trump’s statements about negotiated medicine prices do not, on their own, confirm what beneficiaries will pay in premiums or at the pharmacy counter.
Compare Plans Before Dec. 7
Medicare’s open enrollment period runs through Dec. 7. Beneficiaries can compare available plans and review premiums, deductibles, medicines covered and cost-sharing before deciding whether to keep or change coverage. A low monthly premium alone does not show whether a plan will cover a person’s prescriptions on favorable terms, so the relevant plan details may differ from one enrollee to another.
The next clearer picture of costs will come as 2027 coverage takes effect and beneficiaries see their actual premiums and prescription expenses. Further explanation from CMS about the difference between its estimate and KFF’s analysis could also clarify how the projections were calculated.
Key Questions
KFF projects that the average monthly premium will increase from $34 in 2026 to $51 in 2027. That is an average; individual plan premiums may be different.
Can beneficiaries avoid the projected average increase?
KFF says beneficiaries can avoid the average increase by switching to a lower-cost plan during open enrollment, which runs through Dec. 7. Whether a different plan is suitable depends on its coverage, medicines, deductible and other costs.
Will Medicare Advantage drug coverage rise by the same amount?
No. KFF projects an average of $9 per month for the drug portion of Medicare Advantage enrollees’ overall premiums in 2027, an increase of less than $2. This is a separate estimate from the stand-alone plan average.
Why might stand-alone plan premiums increase?
KFF says one possible factor is CMS ending early a pilot that subsidized stand-alone plans in 2025 and 2026. The analysis does not establish that this is the sole cause of the projected increase.
How does CMS’s estimate differ from KFF’s?
CMS projected a $1 increase in the national average premium, from $35 to $36, based on September 2026 enrollment. KFF said CMS did not explain its calculation methods and that the estimates may use different assumptions.
Source: kffhealthnews.org
