Part D Changes for 2027: What Utah Seniors Should Know

Let's set the stage

Part D has changed more in the last three years than in the 20 before that. The Inflation Reduction Act closed the old coverage gap, put a hard cap on what you pay for covered drugs, capped insulin, and let Medicare negotiate prices on some of the most expensive drugs. 2027 continues those changes. Here is what is different from 2026 and what it means when you pick a plan during Open Enrollment, October 15 to December 7, 2026.

2027 at a glance, with 2026 for comparison

Sources: CMS CY 2027 Rate Announcement (April 6, 2026); CMS Part D 2027 national average monthly bid amount fact sheet (July 28, 2026); Medicare.gov Part D costs; CMS Selected Drug List and Negotiated Prices file (September 21, 2026).

Change 1: the out-of-pocket cap goes to $2,400

Once what you pay for covered Part D drugs reaches $2,400 in 2027, you pay nothing more for covered drugs for the rest of the year. The cap is indexed, which is why it rose from $2,000 in 2025 to $2,100 in 2026 and now $2,400. Your deductible, copays and coinsurance count. Your monthly premium and drugs your plan does not cover do not. For a deeper walk-through, see the 2027 Part D out-of-pocket cap.

Change 2: the deductible can be up to $700

The deductible is the most a plan can make you pay before it starts sharing the cost. Plans can set it lower, and many do. In the Utah CMS CY2027 landscape, stand-alone Part D plan deductibles run from $300 to $700, and Medicare Advantage plans with drug coverage run from $0 to $700. Here's the thing: a plan with a low premium and a $700 deductible can cost more in January than a plan with a higher premium and a lower deductible. Price the whole year, not the premium.

Change 3: a second round of negotiated drug prices

Prices for a second group of 15 drugs start January 1, 2027. The biggest one by Medicare spending is Ozempic, Wegovy and Rybelsus, which CMS negotiated together as one selected drug at $274 for a 30 day supply, against a 2024 list price of $959. Six drugs from the first round stay in the program with small inflation adjustments for 2027: Eliquis ($237.25 for 30 days, up from $231 in 2026), Jardiance ($202.33, up from $197), Farxiga ($183.33, up from $178.50), Januvia ($116.06, up from $113), Enbrel and Imbruvica. Four first round drugs leave the program on December 31, 2026, because a generic or biosimilar version is now on the market: Xarelto, Entresto, Stelara and the NovoLog and Fiasp insulins. Starting in 2027 those four no longer have a Medicare negotiated price. The negotiated price is what the plan and pharmacy work from. It is not your copay. Your cost still depends on the plan's tier, deductible and copay or coinsurance. See Does Medicare cover Ozempic? and Eliquis cost with Medicare.

What stays the same

• Insulin: no more than $35 for a one month supply of each covered insulin product, and the deductible does not apply. See Is insulin capped at $35 under Medicare?
• Recommended adult vaccines covered under Part D, like shingles, at no cost to you.
• The Medicare Prescription Payment Plan. You can choose to spread your out-of-pocket drug costs into monthly payments across the year instead of paying large amounts at the pharmacy counter in January. It does not lower your total cost; it smooths it out. Ask your plan to enroll.
• Extra Help for people with limited income and resources, which lowers premiums, deductibles and copays.

Utah stand-alone Part D plans for 2027

If you have Original Medicare with a Medicare Supplement, you get drug coverage from a stand-alone Part D plan. The CMS CY2027 landscape shows:

Source: CMS CY2027 Medicare Advantage and Prescription Drug Plan Landscape, Utah rows.

One honest caveat about formularies

Which drugs each plan covers, and on which tier, comes from the plan formularies, and they change every January. A drug that was on a low tier in 2026 can move up, need prior authorization, or drop off in 2027. Do not assume last year's coverage carries over. Give us your exact drug list and pharmacy and we will check it against the 2027 plans with you, one drug at a time.

Every Utah stand-alone Part D plan for 2027

The fixed cost column is the plan premium for 12 months plus the deductible. It is not your total cost, because copays and coinsurance come on top, but it shows how differently these plans are built.

Source: CMS CY2027 Medicare Advantage and Prescription Drug Plan Landscape, Utah rows.

Here's the thing. If you take one or two inexpensive generics, a low premium plan may be all you need, and the deductible may never matter. If you take expensive brand drugs, you are likely to hit the $2,400 cap, and the premium becomes the main thing that differs between plans. The right plan depends on your drug list, which is why we price it plan by plan.

Worked example: when does the $2,400 cap kick in?

Under the 2027 standard design, you pay the first $700 of covered drug costs, then 25% until your share reaches $2,400. So you reach the cap after $7,500 in total covered drug costs: $700 deductible plus 25% of the next $6,800, which is $1,700. Someone on a specialty drug that costs about $7,500 a month could reach the cap with the first fill. Someone with $3,000 of drug costs for the whole year would pay $700 plus 25% of $2,300, or $1,275, under the standard design. Plans with copays instead of coinsurance will land differently.

Medicare Advantage drug coverage in Utah

Most Medicare Advantage plans include Part D. In Salt Lake County, 22 of the 28 Medicare Advantage plans for 2027 (not counting special needs plans) include drug coverage and 6 do not. Plans without drug coverage are usually chosen by people who get drugs another way, such as through the VA. If you join a Medicare Advantage plan with drug coverage, its drug deductible and the $2,400 cap apply the same way.

Do not forget the income adjustment

If your income is above the Part B income thresholds, you also pay a Part D income-related monthly adjustment on top of your plan premium. It is billed by Medicare, not by your plan, and it applies whether your drug coverage is a stand-alone plan or built into a Medicare Advantage plan.

What to do during Open Enrollment

1. Read your plan's Annual Notice of Change. It lists what changes for 2027.
2. Make a list of every drug, dose and how often you take it, plus your pharmacy.
3. Compare plans on total yearly cost: premium plus deductible plus copays, not premium alone.
4. Check tiers and prior authorization for your expensive drugs.
5. If your costs land early in the year, ask about the Medicare Prescription Payment Plan.
6. Make your choice by December 7, 2026. Coverage starts January 1, 2027.

Updated October 26, 2026 by the Everything Senior Insurance Data Desk.