If you’re like a lot of Medicare consumers, you may not pay much attention to the annual open enrollment period that opened Oct. 15 and runs through Dec. 7. But things are a little different this year, and it’s worth your time to study your options.
That’s because a new KFF analysis finds that the average monthly premium for Medicare Part D coverage in stand-alone prescription drug plans (PDPs) will increase to $51 in 2027, up 50% from $34 in 2026, if current enrollees don’t switch into lower-premium plans during open enrollment.
KFF notes that’s more than more than five times higher than the drug coverage premium in Medicare Advantage plans that offer Part D coverage (MA-PDs), which is projected to average $9 per month next year. The estimated $17 increase in the average monthly PDP contrasts with an expected increase of less than $2 in monthly premiums for drug coverage through MA-PDs.
“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,” said Juliette Cubanski, a vice president and director of the Program on Medicare Policy at KFF. “There are relatively low-premium PDP options, but people facing large premium increases need to take action if they want to avoid paying significantly more.”
Most PDP enrollees who are not receiving extra financial subsidies provided to low-income enrollees will pay higher premiums in 2027 if they don’t switch to cheaper plans, including more than 4 million enrollees who are currently enrolled in PDPs that charge zero premium. This is because there are no zero premium PDPs available in 2027.
How to find the right plan
Let’s face it, this is pretty complicated and your average senior who’s not a retired actuary may have trouble staying focused.
So without going into all the reasoning behind it, here is a step-by-step procedure to evaluate competing plans:
Go to Medicare’s Plan Compare tool. Enter all the drugs you take. This will give you an idea of your monthly drug costs.
Compare yearly cost. You can’t just multiply monthly times 12 because of the tier setup.
Check which drugs are covered. Not all plans cover all drugs.
Check your preferred pharmacy. The same plan will pay differently at different pharmacies. Why? Good question. Look up PBMs.
Confirm your doctors, hospitals and specialists are in the plan if you’re using Medicare Advantage.
Read the Annual Notice of Change. This will help you pick out, what else, changes.
If this is just too complicated and hard to navigate, you can contact your State Health Insurance Assistance Program (SHIP) for free, independent counseling not sponsored by any insurance company.
Confused? You’re not alone
Quite honestly, the Outraged Consumer has always thought — and still does — that Medicare and most other government programs are way too baffling for the average person and even for many above-average people. It’s partly bureaucratic thinking with a very large measure of industry lobbying that creates all the exceptions, exemptions, extensions and other extremely obtuse provisions.
Surveys bear this out. For example, 88 percent of people polled in a recent survey didn’t know that what we might call Original Medicare — not Medicare Advantage — has no yearly limit on out-of-pocket costs.
Elder Law Answers is a good place to start if you’re still confused, baffled or simply bored after reading the Medicare site and the SHIP program. Besides basic information in fairly simple language, the site has a nationwide directory of attorneys who practice elder law. They may be the best option if you have thorny questions after looking elsewhere. Many offer a free first consultation.
If you’re too young to be in Medicare, congratulations. But you ought to read this anyway because your older relatives probably could use some help.