Reviewing 2027 Health and Drug Plan Options for Best Coverage

Every year people with Medicare are advised to review their Medicare health plans (also called Part C or Medicare Advantage) and prescription drug plans (Part D) to compare the cost, coverage and convenience of their current plans with other plans available in their area. This is especially true for anyone with a costly chronic illness, like kidney disease.

Medical Coverage for Established Dialysis & Transplant Patients

In 2023 data there were 830,910 individuals with ESRD on dialysis or with transplants. Below are the percentages of patients with Medicare who could be impacted by changes to Medicare health and/or drug plans¹:

Patients not listed in this table have other coverage without Medicare.

Medicare Part D changes every year, but this year there will be significant changes. In 2022, the Inflation Reduction Act (IRA) required both standalone and Medicare Advantage Part D plans to cover insulin for $35/month and set a $2,000 cap on out-of-pocket costs for drugs on a Part D plan’s formulary. Both helped people with kidney disease, especially those who were taking costly drugs. In August 2023, CMS published a fact sheet listing 10 Part B or D drugs on which drug makers had negotiated prices. This year people paid less for these drugs, including Jardiance and Januvia for people with diabetes, and Farxiga for those with diabetes and CKD. In November 2025, CMS published a fact sheet for 15 negotiated Part B or D drugs and costs that will take effect in 2027. In January 2026, CMS published a fact sheet for 2028 that included another 15 Part B or D drugs and their costs.

Part D Changes for 2027

Annual Notice of Change (ANOC)

People who have a Medicare health or drug plan will get an ANOC from their plan by September 30. They should not ignore this document. It will state what their premiums, co-pays, deductibles, out-of-pocket limits, prescription drug coverage, and provider or pharmacy networks will be in 2027. Medicare’s Plan Compare site has data for 2026 plans now. Starting October 1 the Medicare Plan Compare site will have 2027 health and drug plan information available so people can review and compare their options. People can log into their Medicare account using Medicare.gov, Login.gov, ID.me, or Clear. Patients can compare their plan’s premium, deductible, covered drugs, and pharmacy network to other plans. Anyone wanting to make a change can do so at the start of the Annual Enrollment Period (AEP).

What to Review During Medicare’s Annual Enrollment Period (AEP)

From October 15 through December 7, individuals with Medicare Part A and/or B, including those with kidney failure, can review and keep their current plan or change from their current Medicare health (Medicare Advantage or MA) plan and/or standalone drug plan to another plan if a different one provides better coverage at a lower cost. The Medicare Plan Compare site will have a link to the current plan and all other plans available in their area starting October 1.

Patients need to decide if they want to look only at standalone Part D plans or look at Medicare health (MA) plans and/or Medigap plans too. Patients may want to:

• Check the premium and deductible for their plan for 2027 and other plans to compare (maximum of three at one time).

• List the drugs they take to see if they’re all covered. They may want to ask their doctor if they may need other drugs if their treatment changes, like switching from dialysis to transplant or vice versa.

• Check the plan’s site (Part D Compare will link to it) for the plan’s drug formulary to verify:

  • What drug(s) they take

  • The dosage for each drug

  • The quantity of each drug they take per month

  • Check whether any drugs require prior authorization, have quantity limits, or require taking a lower cost drug first to see if it works (step therapy)

The Medicare site asks for you to:

• Enter your ZIP code

• Choose whether you want to compare Medicare Advantage, Part D, or Medigap options

• Indicate whether you receive help paying health or drug costs

• Choose whether you want drug costs included in the comparison

  • If searching for a standalone Part D plan, the patient can filter by insurance carrier or star (quality) rating. The default sort order is lowest drug + premium cost. The other option is lowest premium. For example, in my area, there are 12 standalone Part D plans to choose from in 2026.

  • If searching for a Medicare Advantage plan, the patient can filter by health plan type, plan benefits, insurance carriers, drug coverage and star ratings. Medicare Advantage plans can be costly for those with a chronic condition like dialysis, if copays are per treatment. MA plans have a maximum out of pocket cap of $9,850 for in-network services and $14,800 combined for both in-network and out-of-network care on PPO plans. They may have a limited provider network, especially in rural areas, and they have a history of delaying approval of prior authorizations and denying claims.² Multiple physician organizations signed a letter to congressional leadership advocating for MA prior authorization reform because delays in prior authorization have caused patients harm. In my area, there are 36 MA plans to choose from this year (2026). Soon we’ll see how many are offered in 2027.

  • If searching for a Medigap plan, it asks age, sex, if tobacco is used, and the patient can check to only see plans for those 65 or younger. There’s an option to choose if eligible for a household discount for a spouse or roommate. Medigap plans are designated with letters: A-D, F, G, and K-N. Plans with the same letter have the same coverage no matter what company sells them. Cost is the only difference. NOTE: Premiums and availability depend on how these questions are answered.

Possible Effects of 2027 Changes in Part D Plans

Premium and out of pocket costs in standalone Part D plans may cause some people to consider switching to a Medicare Advantage plan. If considering switching from Traditional Medicare to a Medicare Advantage plan, be aware that changes may be greater in 2027 than in the past, including changes to provider networks, higher copays, and fewer extra benefits. Plans may have fewer providers in their network. Some MA plans are being eliminated. If that happens, the patient will have these options:

• Choose another MA plan. The patient should check on amounts of copays, the cap on out-of-pocket costs, and changes to extra benefits currently used;

• Return to Traditional Medicare and add a standalone Part D plan, knowing that Medicare has out-of-pocket costs that the patient will owe; or

• Return to Traditional Medicare, a standalone Part D plan, and sign up for a Medigap (Medicare supplement) plan during the guaranteed issue time (usually 63 days or less) when there’s no underwriting based on the patient’s health. More than half of those with Traditional Medicare also have a Medigap plan. A Medicare booklet explains these plans and the Medicare site allows people to compare Medigap plans. In 2025Plan G was the most popular plan (39%), followed by Plan F (36%), which was sold until 2020, then Plan N (10%), and Plan C (2.5%).³

Medicare Prescription Payment Plan

The Medicare Prescription Payment Plan lets people with Medicare drug coverage spread their out-of-pocket prescription costs across the calendar year instead of paying those costs at the pharmacy. Participants receive a monthly bill from their health or drug plan. Monthly payments may change during the year as new prescription costs are added. The program does not reduce total Part D-covered drug costs which are capped at $2,400 in 2027, but it may make higher costs earlier in the year easier to manage.

Helpful Resources

Here are some contacts for help and advice:

• If computer savvy, visit Medicare Plan Compare

• Call Medicare at 1-800-633-4227 or 1-877-486-2048 (TTY).

• Your State Health Insurance Assistance Program can provide free unbiased help to choose a plan.

• An independent broker who works with multiple companies can advise you about changes and how to prepare for them. Watch this 13-minute video from Abt Insurance Agency, which is free to clients and is paid for by insurers.

Conclusion

This can be a stressful time of the year and some people assume that their Part D or Medicare Advantage plan will be the same in 2027 as it was in 2026. This can be a costly mistake. If you’re choosing a plan or helping someone else do so, fight the urge to do nothing. Use one or more of the resources provided in this blog. Taking the time to compare your options now may help you avoid higher costs or unexpected coverage changes in 2027.