KFF says millions of Medicare beneficiaries in stand-alone Part D plans face a 50% average premium increase in 2027 — from $34 to $51 a month — after CMS ended its premium subsidy effort early, a change with direct implications for medication affordability, adherence, and open-enrollment counseling. CMS, by contrast, projected only a $1 increase, sharpening a politically charged split over what clinicians should expect patients to face next year.

The Move

• KFF’s new analysis found that nearly 25 million people in stand-alone Medicare prescription drug plans could see average monthly premiums rise 50% in 2027.

• KFF estimates 10.4 million enrollees who do not receive low-income subsidies — 76% of that group — will pay more if they stay in their current plan.

• That includes 4.1 million people now in zero-premium plans; KFF says no zero-premium stand-alone plans will be available in 2027.

• CMS has offered a far more modest outlook, projecting the national average premium will rise from $35 to $36 based on September 2026 enrollment.

Why it Matters for Care

• Higher premiums, rising deductibles, and more coinsurance could make drug costs less predictable and increase the risk that patients delay fills, skip doses, or abandon treatment.

• For 2027, KFF found average deductibles would rise to $643 in stand-alone plans, up from $540 in 2026; Medicare Advantage drug deductibles would rise to $489 from $360.

• Patients in traditional Medicare with stand-alone Part D coverage may need especially proactive medication-cost counseling during open enrollment, which runs through Dec. 7.

• At the bedside and in clinic, clinicians may need to flag high-cost prescriptions, refer patients to plan-selection help, and anticipate formulary or pharmacy changes when patients switch plans.

Between the Lines

• KFF points to CMS’ July decision to end early a three-year subsidy effort that had helped hold down stand-alone Part D premiums in 2025 and 2026.

• CMS Administrator Mehmet Oz has described that subsidy as an insurance industry bailout, underscoring the administration’s political interest in reframing federal support for insurers.

• The KFF-CMS gap may partly reflect different assumptions: KFF emphasizes what current enrollees will pay if they stay put, while CMS may be assuming beneficiaries switch to cheaper plans.

• That distinction matters clinically because many older adults do not comparison-shop, meaning the realized burden could be closer to KFF’s patient-level warning than to CMS’ aggregate estimate.

What to Watch

• Whether CMS explains its premium methodology or updates its estimate in response to KFF’s findings.

• Open-enrollment behavior through Dec. 7, especially how many beneficiaries move out of sharply higher-premium stand-alone plans.

• Whether plan switching offsets premium shock but introduces new access issues through different formularies, utilization management, or pharmacy networks.

• How drug affordability plays in the November midterm elections, as the Trump administration argues it has lowered drug prices even as some Medicare beneficiaries face higher coverage costs.

Source: KFF Health News