By Patricia Prewitt 

My Personal Rx Advisor

By the time you are reading this edition of The South Shore Senior News, radio and television ads will be in full force for annual Medicare open enrollment that starts October 15 and runs through December 7. It’s important to check those notices in the mail to be sure you aren’t surprised about rate or coverage changes for 2027.

The Center for Medicare and Medicaid Services reminds beneficiaries that Medicare plans can change their costs, coverage, provider networks, and pharmacy networks each year. CMS also notes that the lowest monthly premium product may not correlate with the overall lowest costs. Tier structure, pricing, and copays determine total annual prescription costs.

What are the estimated prescription costs for 2027 for Medicare enrollees?

• Increased base Rx premium: The monthly base premium for a standard drug plan is estimated to increase to $41.33. Your plan may be lower or higher.

• Increased deductibles: The maximum annual deductible for Part D Medicare prescription drugs plans is expected to rise from $615 to $700.

• Increased out-of-pocket limits: The out-of-pocket maximum for covered medications increases to $2,400 annually. It remains that if your medication is not covered-or not on the Prescription Drug Plan Formulary, your costs may be higher and not be applied to this cap.

• Increased copays/new tier structures: Watch for changes in tier position and copay/coinsurance pricing. What was $10 in 2026 for a Tier Two drug may jump to $15 in 2027. My own plan added a Sixth Tier, which did not exist before.

Check your mail: During September all plans are required by law to send via USPS the Annual Notice of Change (ANOC) document to every Medicare enrollee in their plan. Additionally, Medicare will mail the official Medicare booklet entitled “ Medicare & You 2027” prior to October 15.

What questions should be asked?

• What will the new monthly premium be for 2027?

• What are your medication copays costs? Did they change?

• Has prescription coverage or tier status changed for needed medications?

• Are doctors still in-network?

• Are dental, vision, and hearing benefits included?

• Is your pharmacy network still the same?

• Is your current plan still offering coverage, or did the plan leave the state?

What is expected to remain the same?

Insulin costs for covered insulin products continue to be capped at $35 a month or less. The drug payment option continues: If enrolled in 2026, re-enrollment is automatic in 2027. This allows Medicare subscribers to spread annual costs over 12 months, making payments easier on a fixed income.

Where can I go for help in choosing a plan that works best?

The Plan Finder tool on medicare.gov offers a comparison tool based on plans offered in your zip code. Have a current list of your medications handy, and know the names of your physicians. Scheduling an appointment at a senior center/Council on Aging with a SHINE counselor may be beneficial. Medicare insurance agents/brokers often represent many different carriers and provide thoughtful guidance about plans for no fee.

Take time during the Medicare Open Enrollment period to evaluate your own medical status and utilization of prescriptions to choose a plan that is the right fit for your needs and budget.

Content provided is for education purposes only and is not intended as a substitute for advice from a qualified medical professional. The opinions expressed within are those of the author.

About the Author: Patricia Prewitt is a local Massachusetts resident who spent more than 30 years in the pharmaceutical industry. Tricia is a consumer education advocate, and loves helping people find ways to save money on their prescriptions. More information and free resources are available on her website at https://mypersonalrxadvisor.com/resources or call her at 508-507-8840. Favorite Quote: ”Act as if what you do makes a difference. It does.” – William James