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Costs & IRMAA

Nearly All Medicare Stand-Alone Drug Plan Members Will Face a Deductible in 2027, With Averages Up Sharply

A KFF analysis of 2027 Part D plan designs finds average deductibles rising to 643 dollars for stand-alone plan enrollees and 489 dollars for Medicare Advantage drug plan members, while the share of enrollees subject to any deductible expanded in both plan types.

By the Goodsurance editorial teamOctober 30, 2026

A KFF analysis published during the 2027 Medicare open enrollment season documents how Part D drug coverage deductibles have shifted across both stand-alone and Medicare Advantage plans, finding that virtually all stand-alone drug plan enrollees will face a deductible before coverage begins.

The statutory maximum deductible for 2027 is 700 dollars, up from 615 dollars in 2026. Because plans may charge less than the maximum, average deductibles vary widely. KFF calculates that the weighted average deductible for enrollees in stand-alone prescription drug plans will reach 643 dollars in 2027, up from 540 dollars in 2026. For people whose drug coverage is bundled inside a Medicare Advantage plan, the average deductible will be 489 dollars in 2027, up from 360 dollars in 2026.

Nearly every Medicare stand-alone drug plan now includes a deductible in 2027, with the average rising to 643 dollars.

The share of plan enrollees subject to any deductible also grew. For stand-alone drug plans, 99.8 percent of members will face a deductible in 2027, compared with 96 percent in 2026. For Medicare Advantage drug plans, 85 percent of members will face one, up from 80 percent.

Beyond the deductible, cost-sharing structures differ by drug type. For preferred brand-name drugs, stand-alone plan enrollees typically face median coinsurance of 25 percent; Medicare Advantage drug plan enrollees face 20 percent. For non-preferred drugs, which can include both brands and some generics, median coinsurance reaches 35 percent for stand-alone plans and 29 percent for Medicare Advantage drug plans. Generic drug tiers more often carry fixed copayments.

An annual out-of-pocket spending cap of 2,400 dollars applies to all Part D coverage in 2027. Beneficiaries choosing or switching plans have until December 7 during the current open enrollment period.

In plain words

Medicare drug plans for 2027 come with a deductible. A deductible is the amount you pay out of your own pocket before the plan starts covering drugs. Almost everyone with a stand-alone Medicare drug plan will have a deductible in 2027. The average amount is 643 dollars for those plans. For people in Medicare Advantage drug plans, the average deductible is 489 dollars. Both amounts are higher than last year. After you meet the deductible, you still share costs with your plan. For brand-name drugs, plans often charge between 20 and 25 percent of the cost. There is a limit on how much you can spend out of pocket on drugs in 2027: 2,400 dollars total. If you want to pick or change plans, you have until December 7.

Understand the basics first

Source: KFF
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