Medicare Drug Plan Premiums Could Rise 50% for Those Who Stay Put

The headline numbers don't agree

With the midterm vote days away, President Trump says his administration has made American drug prices the cheapest in the world. Millions of seniors who buy their own drug coverage are getting a different message in the mail.

A KFF analysis published Oct. 30 projects that the average monthly premium for stand-alone Medicare Part D drug plans will reach $51 in 2027, up 50% from $34 in 2026, if current enrollees keep the plans they have.4 The same analysis puts the drug portion of Medicare Advantage premiums at about $9 a month, an increase of less than $2.4 KFF says about 10.4 million people will pay more next year if they stay in their current plan. That is 76% of stand-alone plan enrollees who don't get low-income subsidies.8

The Centers for Medicare & Medicaid Services tells a calmer story. The agency says the average stand-alone premium will rise by less than $1, from $35.09 to $36. It also says the Part D portion of Medicare Advantage premiums will fall 38%, from $11.32 to $7.3 CMS dismissed predictions of a premium spike as "speculation and misleading reports" and said the Part D market is returning to normal.3

Both figures can be accurate. They answer different questions. The CMS number describes the plans for sale. The KFF number describes what people will pay if they don't shop around. KFF's own early-October review agreed that many enrollees face modest increases or even reductions, while others face jumps of $50 or more a month.2 Still, the KFF projection is closer to what most households will actually pay. Many seniors renew without comparing plans, so the cost of staying put is the figure that matters for them.

Who gets hit

The increases are concentrated. In 2027 there will be no zero-premium stand-alone plans for people without low-income subsidies. That means all of the roughly 4 million people who paid nothing this year will owe something next year, whether they switch or not.2 UnitedHealthcare's AARP-branded plans show the sharpest increases. Every state and the District of Columbia will see monthly jumps of at least $50 for AARP Medicare Rx Preferred, and four states will see increases above $100.2 One Virginia enrollee was told his AARP-UnitedHealthcare premium would rise from $39.60 to $121.90 a month. He found a Humana plan with similar benefits for $19.30.8

The choices are also shrinking. The average beneficiary will have 9 stand-alone plans to pick from, down from 11, the fourth straight year of decline.2 Deductibles are rising too. KFF projects an average Part D deductible of $643 for stand-alone enrollees, up from $540, and $489 for Medicare Advantage drug plan enrollees, up from $360.4 The legal out-of-pocket cap goes from $2,100 to $2,400, and the maximum standard deductible goes from $615 to $700.10

A subsidy that ended a year early

Policy is a big part of the cause. In July, CMS ended a three-year pilot early. The program had paid extra subsidies to stand-alone plans in 2025 and 2026.8 It cut premiums by $10 a month per enrollee and capped each plan's yearly increase at $50.10 KFF says the program was worth about $9.8 billion.10 Ending it did not raise premiums across the board, but it probably explains why zero-premium plans disappeared and why some increases now exceed $50.2

CMS Administrator Mehmet Oz says insurers have adjusted their bids and no longer need the support.9 The agency describes its cuts as reducing "handouts to big insurance companies."3 The underlying costs have not gone away, though. Analysts expected strong upward pressure on stand-alone premiums from rising drug prices, the richer benefit created by the 2022 drug law, and growing use of expensive GLP-1 drugs.1 KFF also warns that plans holding premiums down may be making coverage worse in other ways, such as covering fewer drugs, raising cost-sharing, or adding more prior-approval hurdles.2

Medicare Advantage: steady prices, fewer benefits

CMS also says Medicare Advantage is stable. It cites a weighted average premium falling more than 16%, from $14.37 to $12.22 That average includes lower-premium special needs plans, which makes the change look better than it is for the general Medicare Advantage population.22 Leerink Partners puts the industry-weighted average premium up about 1%. It also finds average out-of-pocket maximums up 10% and Part D deductibles up 30%.22 J.P. Morgan found that premiums for Medicare Advantage plans with drug coverage are rising by several dollars on average, partly because insurers are offering fewer $0 plans.22

The cuts to extra benefits are easy to miss. Leerink's review of Medicare Plan Finder data found reduced dental benefits for almost 70% of UnitedHealthcare members, 45% of Centene members, and 36% of CVS/Aetna members. Insurers' press releases, meanwhile, said core benefits were being preserved.21 Humana reduced or eliminated the Part B premium giveback for 62% of its members.29

Plans are also disappearing in some places. In 193 counties, beneficiaries will have no general-enrollment Medicare Advantage drug plan in 2027, up from 123 counties. About 638,000 people live in those counties.23 Humana says its plan discontinuations affect about 600,000 members, and UnitedHealth says about 390,000.23 Insurers expect Medicare Advantage enrollment to fall to about 34 million, a drop of roughly 2 million. CMS says that projection overstates the decline.22

The drug-price claims

Trump calls his drug pricing deals an election-winning issue. He says the U.S. has gone from the highest drug prices in the world to the lowest.11 The record is more complicated. KFF compared 32 brand-name drugs and found the TrumpRx price was below the average foreign price for 17 and above it for 15. Only five were the cheapest anywhere, and 13 were the most expensive.11 The rheumatoid arthritis drug Enbrel costs $3,354 a month on TrumpRx, more than five times the $641 average abroad.11

The bigger issue is who the deals reach. The most-favored-nation agreements mainly lower prices for Medicaid programs and people paying cash. Prices under Medicare and private insurance stay largely the same.1215 KFF's Juliette Cubanski points out that most Medicaid enrollees already pay little or nothing for their medicines, so any savings mostly go to state budgets.19 TrumpRx purchases also did not count toward insurance deductibles at launch.17 Drugmakers, meanwhile, are doing well: Eli Lilly, Merck, and Bristol Myers Squibb each reported record quarterly revenue and raised their full-year forecasts.14

Some changes do help Medicare enrollees directly. One is a GLP-1 program with a $50 monthly copay that the White House says began in July.17 Another is the drug price negotiation process created under the Biden administration. On Jan. 1, negotiated prices take effect for 15 more drugs.10 CMS estimates they will cut beneficiaries' out-of-pocket costs by about $685 million in 2027.30 The administration's own MFN deals reach Medicare only partially.

Medicaid cuts and hospital bills

The Medicare changes come alongside larger coverage losses elsewhere. Starting Jan. 1, about 20 million adults who gained Medicaid through expansion must document 80 hours a month of work, school, or volunteering. They must also re-verify eligibility every six months instead of once a year.41 The Congressional Budget Office projects about 7.5 million people will lose coverage by 2034 under the new eligibility rules, including at least 2.6 million who are eligible but won't get through the paperwork.

Hospitals expect to absorb much of the cost. The Urban Institute estimates the law will produce $278 billion in uncompensated care by 2034.41 Kaufman Hall data show hospitals' bad debt and charity care per day rose 18% in March 2026 compared with a year earlier.42 Washington state hospitals project nearly $6 billion in lost revenue through 2033.46 Analysts in New Hampshire warn that unpaid bills could be passed on to privately insured patients through higher premiums.48

Private insurance premiums are already rising fast. Insurers in the ACA marketplaces proposed a median increase of 15% for 2027, after a 20% median increase in 2026.40 Employer plan costs are projected to rise 8% to 10%, the largest increase in more than 20 years.38 STAT's reporting found that high prices, especially at hospitals, drive spending more than how often people use care.31 Hospitals argue that patients are sicker and that higher volume is the main driver.31

The takeaway

The administration's drug pricing deals are real, but they are narrow. They lower prices for cash buyers and Medicaid programs. Elderly and middle-class voters mostly see their costs through insurance premiums, deductibles, and plan changes. On those measures, 2027 looks worse for many people, not better.

The CMS figures are accurate but leave a lot out. A flat average premium can coexist with the loss of every zero-premium plan, $80-a-month increases for some enrollees, higher deductibles, and smaller dental benefits. Seniors have until Dec. 7 to compare plans.6 Those who renew automatically will pay the most for the gap between the official averages and their own bills.