Your Medicare Advantage plan covered your prescriptions throughout 2026, so you might assume the same medications will cost roughly the same next year. Unfortunately, that assumption could lead to an expensive surprise at the pharmacy.
Medicare prescription drug coverage is changing for 2027, including new negotiated prices for 15 high-cost medications and adjustments to annual out-of-pocket limits. Meanwhile, individual insurance plans can change their formularies, drug tiers, and pharmacy arrangements.
According to the Centers for Medicare & Medicaid Services (CMS), the next round of negotiated Medicare drug prices takes effect January 1, 2027.
That doesn’t mean every medication will become cheaper for every patient, but it makes reviewing Medicare Advantage drug coverage for 2027 especially important.
Here are eight medications worth checking before Open Enrollment ends December 7.
1. Ozempic, Wegovy, and Rybelsus
Ozempic, Wegovy, and Rybelsus contain semaglutide, although their approved uses and Medicare coverage rules differ. These medications are among the products included in Medicare’s second round of drug price negotiations for 2027. According to CMS, approximately 2.3 million Medicare Part D enrollees used products in this group during the agency’s November 2023 through October 2024 review period. However, Medicare generally excludes medications used solely for weight loss from Part D coverage, so a negotiated price doesn’t automatically make every prescription eligible for reimbursement. If you use one of these medications, confirm whether your specific diagnosis and prescription qualify under your plan’s 2027 coverage rules.
2. Trelegy Ellipta
Trelegy Ellipta is a prescription inhaler used to manage chronic obstructive pulmonary disease (COPD) and certain cases of asthma. For retirees who depend on daily respiratory medications, even modest changes in copayments can affect a carefully planned monthly budget. CMS included Trelegy Ellipta in the medications selected for negotiated prices beginning in 2027. However, the amount an individual pays will still depend on the plan’s deductible, cost-sharing requirements, and applicable coverage arrangements. Before renewing your Medicare Advantage drug coverage for 2027, compare Trelegy’s estimated annual cost across available plans rather than focusing exclusively on premiums.
3. Linzess
Linzess is prescribed for certain gastrointestinal conditions, including irritable bowel syndrome with constipation and chronic idiopathic constipation. The medication is another drug included in Medicare’s 2027 negotiated pricing program. CMS reported that approximately 627,000 Medicare Part D beneficiaries used Linzess during its drug selection review period. If you’re taking Linzess regularly, check whether your plan will require prior authorization, apply quantity restrictions, or change your prescription cost-sharing. A plan offering a slightly lower premium could still be more expensive overall if your medication costs increase substantially.
4. Breo Ellipta
Breo Ellipta is another inhaled medication used to manage respiratory conditions, including asthma and COPD. It appears on CMS’ list of medications receiving negotiated prices for 2027, making it worth reviewing during Medicare Open Enrollment. However, patients shouldn’t assume that every inhaler used for similar conditions will have identical coverage or costs. Plans may differ in their preferred medications, pharmacy networks, and applicable restrictions, even when treating the same medical condition. Ask your pharmacist or insurance plan to estimate your 2027 costs for Breo Ellipta using your exact prescription and preferred pharmacy.
5. Tradjenta
Tradjenta is a prescription medication used to help manage blood sugar in adults with type 2 diabetes. CMS selected the drug for its second round of Medicare price negotiations, with negotiated prices scheduled to become effective in January 2027. For retirees managing diabetes alongside other health conditions, prescription costs can accumulate quickly when several medications are required. A lower negotiated price may help reduce costs, but the savings reaching an individual beneficiary depend on plan design and cost-sharing. Check Tradjenta’s coverage alongside your other diabetes medications when comparing Medicare Advantage drug coverage for 2027.
6. Xifaxan
Xifaxan is prescribed for several conditions, including irritable bowel syndrome with diarrhea and reducing the risk of recurrence of overt hepatic encephalopathy in certain patients. CMS included the medication among the 15 drugs selected for negotiated prices taking effect in 2027. Because Xifaxan can be an important part of ongoing treatment, unexpected coverage restrictions could create both financial and medical complications. Review your plan’s formulary and ask whether prior authorization or other coverage requirements will apply to your particular prescription. Never stop taking a prescribed medication or switch treatments solely because another insurance plan appears cheaper without discussing the change with your healthcare provider.
7. Ibrance
Ibrance is a prescription cancer medication used to treat certain forms of breast cancer. It is included in Medicare’s 2027 negotiated drug price list, alongside several other medications used to treat serious or chronic illnesses. For patients undergoing cancer treatment, maintaining access to an established medication and oncology team may be more important than small differences in monthly insurance premiums. Before changing plans, verify that Ibrance remains covered, that your oncology providers participate in the network, and that any applicable authorization requirements are understood. Also confirm whether your treatment involves other medications or services billed under Medicare Part B, because those expenses follow different coverage rules.
8. Vraylar
Vraylar is prescribed for certain mental health conditions, including schizophrenia, bipolar I disorder, and major depressive disorder as an adjunctive treatment. The medication is among those selected for Medicare’s negotiated prices beginning in 2027. Patients who depend on consistent treatment should carefully review formulary placement, pharmacy availability, and any applicable authorization requirements before switching coverage. Even when a drug remains covered, changes in plan rules or cost-sharing can create unnecessary complications if they’re discovered only when a refill is due. If you’re considering a different plan, work with your prescriber and pharmacist to avoid interruptions in medically necessary treatment.
What Else Is Changing for Medicare Prescriptions in 2027?
The eight medications listed above aren’t the only prescriptions affected by Medicare’s changing drug pricing system. CMS selected 15 drugs or drug groups for the second round of negotiations, including additional treatments for cancer, autoimmune conditions, and neurological disorders. Meanwhile, the maximum Medicare Part D deductible increases from $615 in 2026 to $700 in 2027, although some plans charge lower deductibles or none at all. The annual out-of-pocket threshold for covered Part D medications also increases from $2,100 to $2,400, after which beneficiaries generally pay nothing for covered Part D drugs for the remainder of the year. These changes make comparing total annual prescription expenses essential, even when a plan advertises a low monthly premium.
Check Your Medications Before December 7
Choosing Medicare Advantage drug coverage for 2027 shouldn’t come down to which insurance company offers the most attractive advertisement. Start by gathering your prescriptions, dosages, preferred pharmacies, and your current plan’s Annual Notice of Change. Then use the official Medicare Plan Finder to compare available plans and estimate your annual prescription expenses.
If you need assistance, your State Health Insurance Assistance Program offers free Medicare counseling, and eligible beneficiaries with limited income and resources may qualify for Extra Help. Spending time reviewing your medications before Open Enrollment closes could help you avoid expensive surprises and protect access to the treatments you need.
Have you noticed changes in what Medicare charges for your prescriptions, and are you planning to compare drug coverage before choosing your 2027 plan? Share your experience in the comments.
What to Read Next
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