Medicare Part D 2027: Deductible, Out-of-Pocket Cap and Premium
For 2027 the Part D standard benefit deductible is $700 and the annual out-of-pocket cap is $2,400, from the CMS CY 2027 Rate Announcement. The base beneficiary premium is $41.33 a month. Part D IRMAA for 2027 is computed here from that base premium because CMS has not published it yet.
Maintained by Archie Chang · Figures checked against CMS October 24, 2026 · Methodology & sources
2027 drug cost calculator
Uses the defined standard benefit: $700.00 deductible, 25% coinsurance, $2,400.00 cap. Your plan's tiers and copays, its own deductible (plans may charge less) and any pharmacy network differences will change the result.
Your 2027 estimate
- Deductible phase (100%)
- $700.00
- 25% coinsurance phase
- $1,625.00
- Covered insulin (up to $35 a month per product)
- $0.00
- Annual out-of-pocket drug costs
- $2,325.00
- Month you reach the $2,400.00 cap
- Not reached in 2027
- Plan premiums for the year
- $0.00
- Part D IRMAA for the year (computed, not yet published by CMS)
- $0.00
- Total with premium and IRMAA
- $2,325.00
| Month | You pay | Total so far |
|---|---|---|
| January | $600.00 | $600.00 |
| February | $225.00 | $825.00 |
| March | $150.00 | $975.00 |
| April | $150.00 | $1,125.00 |
| May | $150.00 | $1,275.00 |
| June | $150.00 | $1,425.00 |
| July | $150.00 | $1,575.00 |
| August | $150.00 | $1,725.00 |
| September | $150.00 | $1,875.00 |
| October | $150.00 | $2,025.00 |
| November | $150.00 | $2,175.00 |
| December | $150.00 | $2,325.00 |
2027 Part D parameters compared with 2026
| Parameter | 2027 | 2026 | Source |
|---|---|---|---|
| Standard benefit deductible | $700 | $615 | CMS Rate Announcement |
| Annual out-of-pocket threshold (cap) | $2,400 | $2,100 | CMS Rate Announcement |
| Coinsurance between deductible and cap | 25% | 25% | 42 U.S.C. 1395w-102 |
| Cost sharing after the cap | $0 | $0 | 42 U.S.C. 1395w-102 |
| Covered insulin, per month (no deductible) | Lesser of $35 or 25% of the price | Lesser of $35 or 25% of the price | 42 U.S.C. 1395w-102 |
| ACIP-recommended adult vaccines | $0 | $0 | 42 U.S.C. 1395w-102 |
| Base beneficiary premium (monthly) | $41.33 | $38.99 | CMS 2027 bid release |
| National average monthly bid amount | $296.05 | Not compared here | CMS 2027 bid release |
| Extra Help maximum copay, generic or preferred multi-source / other drug: full-benefit dual eligibles (with Medicaid), not institutionalized, income up to 100% of poverty | $1.65 / $5.00 | $1.60 / $4.90 | CMS Rate Announcement |
| Extra Help maximum copay, generic or preferred multi-source / other drug: all other full-subsidy enrollees (income up to 150% of poverty) | $5.80 / $14.40 | $5.10 / $12.65 | CMS Rate Announcement |
The 2027 deductible and cap are the 2026 amounts times the 13.65% annual percentage increase (a 9.37% trend and a 3.92% prior-year revision), with the deductible rounded to the nearest $5 and the cap to the nearest $50. After the cap you pay $0 for covered Part D drugs for the rest of the year. The deductible does not apply to covered insulin or ACIP-recommended adult vaccines.
Extra Help (low-income subsidy) 2027 maximum copays up to the cap, by CMS category (Rate Announcement Table V-2). Full-benefit dual eligibles (with Medicaid), not institutionalized, with income at or below 100% of poverty: $1.65 for generic or preferred multi-source drugs and $5.00 for other drugs. All other full-subsidy enrollees, up to 150% of poverty (duals above 100%, and people with Extra Help but not full Medicaid): $5.80 and $14.40. Full-benefit duals who are institutionalized, or who would be without home and community-based services, pay $0. The 2027 resource limits are not in the Rate Announcement, so they are not shown.
Base beneficiary premium 2027: $41.33
CMS announced on July 28, 2026 that the national average monthly bid amount is $296.05 and the base beneficiary premium is $41.33. The bid-based calculation would have produced $94.06, but the IRA limits the yearly increase to 6%, so the premium is $38.99 x 1.06. Your plan's premium differs from the base premium, and the base premium is also what the Part D late enrollment penalty uses (1% per uncovered month).
Part D IRMAA 2027: computed, not yet published by CMS
| Bracket | Applicable percentage | 2026 (official CMS) | 2027 (computed) |
|---|---|---|---|
| 1 | 35% | $14.50 | $15.40 |
| 2 | 50% | $37.50 | $39.70 |
| 3 | 65% | $60.40 | $64.00 |
| 4 | 80% | $83.30 | $88.30 |
| 5 | 85% | $91.00 | $96.40 |
CMS has not published the 2027 Part D income-related amounts. These are computed from the statute: the base premium times (applicable percentage minus 25.5%) divided by 25.5%, rounded to 10 cents. The identical computation reproduces every CMS amount for 2022 to 2026, but treat the 2027 column as computed until CMS publishes it. The 2027 brackets use your 2025 income; see IRMAA brackets 2027 for the income thresholds and Medicare Part B premium 2027 for Part B.
Medicare Prescription Payment Plan: how the monthly cap works
The payment plan spreads your out-of-pocket costs over the rest of the year instead of charging them at the pharmacy. It does not reduce what you owe and does not change how you move through the benefit. First month: (out-of-pocket threshold minus true out-of-pocket costs before you opted in) divided by the months left in the year, counting the current month. Later months: (what you still owe plus new costs) divided by the months left. The plan bills the lesser of the cap and what you owe.
CMS's December 20, 2024 technical memo works this through with the 2025 threshold of $2,000: a January election gives a first-month cap of ($2,000 - $0) / 12 = $166.67; with a $620 first fill and $30 refills, February is ($620.00 - $166.67 + $30.00) / 11 = $43.94. For 2027 the same formulas use the $2,400 threshold, so a January election with no earlier costs starts at $200.00. CMS has not issued separate 2027 payment plan guidance; the CY 2026 Medicare Advantage and Part D final rule carries the program forward. The December bill is billed and paid in the following year.
What this calculator does not model
- Plan-specific tiers, copays and deductibles. Plans may charge less than $700 or exempt some tiers, and flat copays differ from 25% coinsurance.
- Extra Help, employer or union coverage, state assistance programs and manufacturer payments that count toward the cap.
- Prices vary by pharmacy and drug; enter the plan-negotiated price, not the retail cash price.
- Insulin is modeled per product as the lesser of $35 or 25% of the price you enter; the lower maximum-fair-price limit is not modeled. Insulin payments count toward the deductible, as CMS instructs.
- Monthly costs are the same each month, or an annual total spread evenly. Real fills are lumpy, which changes the cap month.
- The payment plan uses your own costs as the TrOOP; supplemental coverage that counts toward the cap (Example 2 to 4 of the CMS memo) is not modeled.
Frequently asked questions
What is the Medicare Part D deductible in 2027?
The defined standard benefit deductible is $700 in 2027, up from $615 in 2026 (CMS CY 2027 Rate Announcement, April 6, 2026). It is the 2026 amount times the 13.65% annual percentage increase, rounded to the nearest $5. Plans may charge less, and some plans have no deductible or exempt certain drug tiers. Covered insulin and ACIP-recommended adult vaccines are not subject to the deductible, although what you pay for insulin counts toward meeting it.
What is the Medicare Part D out-of-pocket maximum in 2027?
The annual out-of-pocket threshold is $2,400 in 2027, up from $2,100 in 2026 (CMS Rate Announcement, Table V-2). It is the 2026 amount times 13.65%, rounded to the nearest $50. Once your true out-of-pocket costs reach it, you pay $0 for covered Part D drugs for the rest of the year. It counts what you pay plus certain help such as Extra Help and state pharmaceutical assistance programs; it does not include your monthly premium.
What is the 2027 Part D base beneficiary premium?
$41.33 a month, announced by CMS on July 28, 2026. By law it cannot rise more than 6% a year from 2024 to 2029, and $38.99 x 1.06 is $41.33. The national average monthly bid amount is $296.05. Your own plan premium differs: it starts from the base premium and adjusts for your plan's bid and any supplemental coverage.
What is the Part D IRMAA for 2027?
CMS has not yet published the 2027 Part D income-related monthly adjustment amounts, so the figures here are computed: the base beneficiary premium ($41.33) times (applicable percentage minus 25.5%) divided by 25.5%, rounded to 10 cents. That gives $15.40, $39.70, $64.00, $88.30, $96.40 for brackets 1 to 5. The same computation reproduces every official CMS amount for 2022 to 2026. They are added to your plan premium and paid to Social Security. Treat them as computed, not official, until CMS publishes the table.
How does the Medicare Prescription Payment Plan monthly cap work?
If you opt in, you pay $0 at the pharmacy and your plan bills you monthly. In your first month the cap is (out-of-pocket threshold minus the true out-of-pocket costs you had before opting in) divided by the months left in the year, including the current one. In later months it is (what you still owe plus new costs this month) divided by the months left. You are billed the lesser of the cap and what you owe. With the 2027 threshold of $2,400, opting in for January with no earlier costs gives a first-month cap of $200.00. The plan does not lower your total costs; it spreads them out. CMS's worked examples use the 2025 threshold of $2,000.
How much does insulin cost under Part D in 2027?
For each covered insulin product, your cost for a month's supply is at most $35: the law says it may not exceed the lesser of $35, 25% of the maximum fair price, or 25% of the plan's negotiated price (42 U.S.C. 1395w-102(b)(9)), so it can be lower. The limit is per product per month's supply, so two insulin products can cost up to $70 a month. The deductible does not apply to covered insulin, but what you pay for it counts toward the $2,400 cap and toward satisfying the deductible for your other drugs (CMS Program Instructions, section 40). ACIP-recommended adult vaccines cost $0.
What is the 2027 Medicare Advantage and Part D Advance Notice?
CMS publishes an Advance Notice for comment, then a final Rate Announcement. For 2027 the Advance Notice came out on January 26, 2026 and the final Rate Announcement on April 6, 2026. The Rate Announcement's Attachment V sets the final Part D benefit parameters: $700 deductible and $2,400 out-of-pocket threshold. Where the Rate Announcement differs from the Advance Notice, the Rate Announcement controls.
What are the 2027 Extra Help (low-income subsidy) copays?
CMS's Rate Announcement (Table V-2) lists maximum 2027 copays up to the out-of-pocket threshold. Full-benefit dual eligibles (people who also have full Medicaid) who are not institutionalized and have income at or below 100% of the federal poverty level pay $1.65 for generic or preferred multi-source drugs and $5.00 for other drugs. Other full-subsidy enrollees pay $5.80 and $14.40: dual eligibles with income above 100% up to 150% of the poverty level, and people who get full Extra Help without being full-benefit duals (for example through QMB, SLMB, QI or SSI, or an Extra Help application) with income at or below 150% of the poverty level. Full-benefit duals who are institutionalized, or who would be institutionalized without home and community-based services, pay $0. The 2027 resource limits were not in the Rate Announcement.
Sources: CMS CY 2027 Rate Announcement (Attachment V) · CMS 2027 Part D national average bid and base premium · CMS July 28, 2026 Parts C & D announcement · 42 U.S.C. 1395w-102 (benefit structure) · 42 U.S.C. 1395w-113 (premium and IRMAA) · CMS Medicare Prescription Payment Plan · MPPP final part one guidance · MPPP technical memo (Dec 20, 2024)
Medicare Part D 2027. Estimate only; your plan and Medicare notices are authoritative.