In 60 seconds: If your Medicare Part D plan costs you $0 a month, enjoy it while it lasts. KFF's analysis of 2027 plan data finds that not one stand-alone Part D plan will offer a $0 premium next year to enrollees who don't receive the low-income subsidy — and the roughly 4 million people who paid nothing in 2026 will all face a premium in 2027. Open enrollment ends Dec. 7, so the time to compare total costs is now.
- There will be no $0-premium stand-alone Part D plans in 2027 for enrollees without Extra Help, according to KFF.
- 28% of those enrollees — about 4 million people — paid $0 in 2026, and every one of them faces a premium in 2027 whether they keep their plan or switch.
- The cheapest option in many states is Wellcare Value Script at $5.30 a month.
- Compare the TOTAL yearly cost — premium plus deductible plus drug costs — in Medicare's Plan Finder before Dec. 7, not the premium alone.
Mary Johnson, an independent Social Security and Medicare policy analyst, recently shared something that should make you check your own paperwork. Her Part D plan is going from a $0 premium in 2026 to more than $19 a month in 2027. She's not alone — she's just one of the few who read the letter.
What happened
KFF went through the federal plan data for 2027, and the headline is blunt: for Part D enrollees who don't receive low-income subsidies, there will be no $0-premium stand-alone drug plans at all next year. In 2026, 28% of those enrollees — about 4 million people — paid no monthly premium. Every one of them will pay more in 2027, whether they keep their current plan or switch to a new one.
Why now? A temporary federal program — the Part D Premium Stabilization Demonstration — spent the last few years cushioning premiums while insurers adjusted to the redesigned Part D benefit. It ends after 2026, and plans are now pricing on their own. The market is shrinking at the same time: the number of stand-alone drug plans falls from 360 in 2026 to 312 in 2027.
CMS pushes back on the alarm, pointing out that the average stand-alone premium barely moves, from $35.09 to about $36 a month. But an average is exactly the wrong lens here, as KFF's Juliette Cubanski has noted — the cushion was applied plan by plan, and it is ending plan by plan. What matters is the number printed on your own plan's notice.
Latest verified facts
- The cheapest seats left: Centene's Wellcare Value Script will cost $5.30 a month in 45 states, and Wellcare Classic $7.30 in 33 states — the lowest stand-alone premiums KFF found for 2027.
- What staying put can cost: Humana Basic Rx enrollees in 28 states face increases of $6.30 to $30.60 a month if they keep their plan; AARP Medicare Rx Saver enrollees in 3 states face a $10.30 increase (KFF).
- The other numbers are rising too: the standard Part D deductible goes from $615 in 2026 to $700 in 2027, and the annual out-of-pocket cap on drug spending rises from $2,100 to $2,400.
- Extra Help is the exception: enrollees who qualify for the low-income subsidy keep $0-premium benchmark plans and a $0 deductible in 2027. The end of $0 applies to people without the subsidy.
Why it matters
Medicare open enrollment runs Oct. 15 to Dec. 7. Whatever plan you hold on Dec. 7 is, with narrow exceptions, the plan you're stuck with starting Jan. 1. If you do nothing, your plan renews — with whatever new premium, deductible and drug list comes with it.
And the premium is only the visible part of the bill. Insurers can also move your drugs to a costlier tier, swap a copay for coinsurance, or drop your pharmacy from the preferred network. A plan that looks $10 cheaper can quietly cost you hundreds more at the counter. That's why counselors repeat the same advice every fall: compare the total yearly cost for your actual medications at your actual pharmacy, not the headline premium.
Impact on the USA and the world
About 25 million Americans rely on stand-alone Part D plans, so even single-digit monthly increases add up to real household money — especially for retirees on fixed incomes who take several brand-name or specialty drugs. Expect busier phone lines at 1-800-MEDICARE and heavier loads on the free state SHIP counseling programs as the Dec. 7 deadline approaches.
Internationally, the ripple is small but real: the US is the world's largest drug market, and when Washington squeezes or cushions drug-plan economics, it feeds the pricing debates every other health system is having with the same manufacturers.
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What happens next
Here's the checklist to work through before Dec. 7:
- Find your Annual Notice of Change. Your plan mailed it in the fall. Look for the new premium and deductible, and any of your drugs that moved to a different cost tier.
- Re-run your plan in Medicare's Plan Finder. Enter your exact medications and your actual pharmacy. A plan that looks cheap can turn expensive if your pharmacy isn't preferred.
- Compare the total yearly cost, not just the premium. Premium plus deductible plus what you'll pay at the counter. A $0-premium plan with a high deductible could cost more than a $19 plan that covers your pills well — and in 2027, the $0 option is gone anyway.
- Check Extra Help. If your income and savings are limited, you may qualify for the Low-Income Subsidy. You can apply through the Social Security Administration.
- Don't wait for the last week. Phone lines and comparison tools get slammed in early December.
Who should worry most? People who take several brand-name or specialty drugs, anyone whose plan sent a notice with a bigger premium, and anyone who hasn't compared plans in a few years. Plans change every fall, even when your health doesn't.
This article is general information about Medicare plan changes, not personal advice. For help with your own situation, call 1-800-MEDICARE or contact your state's SHIP program, which offers free Medicare guidance.
Frequently asked questions
Will any Part D plan cost $0 in 2027?
No stand-alone Part D plan will offer a $0 premium in 2027 to enrollees who don't receive the low-income subsidy, according to KFF. People with Extra Help keep $0-premium benchmark plans. The cheapest stand-alone option in many states is Wellcare Value Script at $5.30 a month.
What should I check before Dec. 7?
Read your Annual Notice of Change, then compare plans in Medicare's Plan Finder using your exact medications and pharmacy. Judge plans by total yearly cost — premium plus deductible plus drug costs — and check whether you qualify for Extra Help.
What happens if I do nothing?
Your current plan renews for 2027 at its new premium, with its updated deductible and drug list. In most cases you can't change again until the next open enrollment unless you qualify for a special enrollment period.
Why did $0-premium plans disappear?
A temporary federal premium stabilization program that held Part D premiums down ends after 2026, while plans carry more financial risk under the redesigned benefit. Insurers priced 2027 plans without the cushion.