Medicare Drug List Changes for 2027: What You Need to Check
If you take prescription medications, one of the most important parts of your annual Medicare review is checking your prescription drug coverage for the upcoming year.
A Medicare Advantage plan or Part D prescription drug plan that worked well for you in 2026 may not work exactly the same way in 2027.
Why? Because a plan's drug list, or formulary, can change from year to year. Your prescriptions may still be covered, but their cost, tier, pharmacy requirements, or coverage rules could change.
That doesn't automatically mean you need a different Medicare plan. It does mean your prescription medications should be reviewed before deciding to keep your current coverage for 2027.
What Is a Medicare Drug Formulary?
A Medicare drug formulary is the list of prescription medications covered by a Medicare Part D plan or a Medicare Advantage plan that includes prescription drug coverage.
Plans usually organize covered medications into different tiers. Generally, medications on lower tiers have lower cost sharing, while medications on higher tiers may have higher copays or coinsurance.
The important thing to remember is that simply seeing your medication on the drug list doesn't tell the whole story.
You also need to know how the medication is covered.
Medicare explains that drug plans may make formulary changes when drug therapies change, new drugs become available, or new medical information becomes available.
What Can Change With Your Prescriptions in 2027?
When reviewing your Medicare prescription coverage for 2027, I recommend checking these five areas:
- Is the medication still covered? Verify every prescription you currently take. Don't assume that because it was covered in 2026 it will automatically be covered the same way in 2027.
- Did the drug move to another tier? A medication might remain on the formulary but move to a tier with different cost sharing.
- Are there new coverage requirements? Look for prior authorization, step therapy, or quantity limits. These rules can affect how easily you can fill a prescription.
- Is your pharmacy still a good choice? Your cost can depend on whether you use an in-network pharmacy and whether that pharmacy offers preferred or standard cost sharing.
- What will your total prescription costs look like? Don't look only at the monthly plan premium. Consider your medications, deductible, copays, coinsurance, pharmacy, and expected annual spending.
That last point is especially important. A plan with a low premium isn't necessarily the lowest-cost option once your actual medications are included.
Medicare Part D Costs Are Changing for 2027
There are also changes to the standard Medicare Part D benefit for 2027.
For 2027, the standard Part D deductible is $700, up from $615 in 2026. Individual plans may structure their benefits differently and can have a lower deductible.
The 2027 Part D out-of-pocket threshold is $2,400, compared with $2,100 in 2026. Once an enrollee reaches the applicable out-of-pocket threshold for covered Part D drugs, the catastrophic phase provides no additional enrollee cost sharing.
These numbers are important, but they still don't tell you what your prescriptions will cost. Your actual expenses depend on your medications and the specific plan covering them.
Check Your Annual Notice of Change
If you already have a Medicare Advantage or Medicare prescription drug plan, watch for your Annual Notice of Change, often called the ANOC.
Plans send the ANOC each fall. It explains changes to your coverage and costs that will take effect in January. Medicare recommends reviewing the notice to determine whether your current plan will continue to meet your needs.
Don't toss that packet into the junk-mail pile.
Pay particular attention to sections dealing with prescription drug coverage, premiums, deductibles, copays, benefits, and other changes to your plan.
Your ANOC is a good starting point, but I still recommend running your actual prescriptions through the available 2027 plan options.
Why You Should Review Your Medications Every Year
It's easy to think:
"My medications haven't changed, so I don't need to review my plan."
But your medications don't have to change for your costs to change.
Your Medicare plan can change.
Your drug's tier can change.
Your pharmacy's status can change.
A generic or biosimilar alternative may become available.
Another plan may cover your prescriptions differently.
This is why I recommend reviewing Medicare prescription coverage every year, even when you're happy with your current plan.
Sometimes the review confirms that your existing coverage still makes sense. That's a perfectly good outcome.
The goal isn't to change plans every year. The goal is to know what you're walking into before January arrives.
When Can You Compare 2027 Medicare Plans?
Beginning October 1, 2026, Medicare beneficiaries can start comparing Medicare health and prescription drug coverage options for 2027.
Medicare's Annual Open Enrollment Period runs from October 15 through December 7. During this period, eligible beneficiaries can make changes to their Medicare Advantage or Medicare prescription drug coverage for the following year.
Changes made during Medicare Open Enrollment generally take effect January 1, 2027.
What Should You Have Ready for a Medicare Review?
Before your Medicare review, have an updated list of your prescription medications available.
Include the medication name, dosage, how often you take it, and the pharmacy you normally use.
That information allows us to compare more than plan premiums. We can look at how your actual medications are covered and identify any potential surprises before the new year.
Do I Need to Change Medicare Plans Because My Drug Costs Changed?
Not necessarily.
A prescription change is only one part of the bigger picture.
If you have Medicare Advantage, you may also want to review your doctors, hospitals, specialists, medical copays, maximum out-of-pocket amount, dental or vision benefits, and other coverage.
Sometimes staying with your current plan makes sense.
Sometimes another option deserves a closer look.
The important part is making that decision based on your medications, doctors, health needs, and coverage, rather than assuming everything will stay the same.
Schedule Your 2027 Medicare Review
If you'd like me to review your Medicare coverage for 2027, you can schedule a Medicare review beginning October 1.
I'll review your current coverage, prescriptions, doctors, and the 2027 options available in your area so you can see what has changed before making a decision.
Schedule your Medicare review: www.shawnrayinsurance.com/calendar
I'm an independent Medicare insurance broker and provide year-round support—not only during Medicare Open Enrollment.
