Medicare Part D Explained: Coverage, Costs, and 2027 Changes
Medicare Part D helps pay for prescription medications, including many drugs you pick up at a retail pharmacy or receive through mail order.
Coverage is offered through Medicare-approved private insurance companies, and each plan sets its own drug list, pharmacy network and costs.
Here are the numbers that matter most for 2027:
Sources: CMS CY 2027 Rate Announcement (April 2026) for the cap and deductible; CMS 2027 Part D landscape files (September 2026) for Florida plan data.
Quick answer: Part D is Medicare's prescription drug coverage.
You get it either through a standalone drug plan (alongside Original Medicare, with or without a Medicare Supplement) or through a Medicare Advantage plan that includes drug coverage.
The right plan is the one with the lowest total yearly cost for your medications at your pharmacy — not the lowest premium.
Open Enrollment is happening now. You can switch Part D plans from October 15 through December 7, 2026, and your new coverage starts January 1, 2027.
Want help comparing your options? Talk with a licensed Florida Medicare agent or call (888) 414-4547.
How Does Medicare Part D Work?
Original Medicare — Part A and Part B — doesn't cover most prescriptions you fill at a pharmacy.
Part D fills that gap. There are two ways to get it:
- A standalone Part D plan — you add it to Original Medicare. If you have a Medicare Supplement (Medigap) plan, this is how you get drug coverage, since Medigap plans don't include it.
- A Medicare Advantage plan with drug coverage — your medical and drug coverage are bundled into one Medicare Advantage plan.
Every plan has to meet Medicare's minimum standards.
But two plans can cover the same drug at very different prices — which is why comparing plans against your own prescriptions matters.
| Standalone Part D plan | Medicare Advantage with drug coverage | |
|---|---|---|
| Works with Original Medicare + Medigap | Yes | NoThe plan delivers your Part A and Part B benefits instead of Original Medicare. You're still in Medicare and still pay your Part B premium. |
| Separate monthly premium for drugs | Yes | VariesDrug coverage is built into the plan premium |
| Doctor and hospital network | NoneMedical care goes through Original Medicare — any provider that accepts Medicare | UsuallyHMO or PPO network rules apply |
| Pharmacy network | YesOften with lower-cost "preferred" pharmacies | YesOften with lower-cost "preferred" pharmacies |
| Where the plan is sold in Florida | Statewide | By county |
| $2,400 drug cap applies in 2027 | Yes | Yes |
The drug-cost rules are the same either way. The bigger decision is how you want your medical coverage to work — the drug plan follows from that.
- Have Original Medicare, with or without a Medicare Supplement
- Want to see any doctor who accepts Medicare
- Spend part of the year outside Florida
- Want medical and drug coverage in one plan
- Are comfortable using a local doctor network
- Mostly stay in your home county year-round
What Medications Does Medicare Part D Cover?
Part D plans cover a wide range of generic and brand-name drugs.
Each plan publishes its own list of covered drugs, called a formulary.
Formularies sort drugs into tiers. Lower tiers (usually preferred generics) cost less; higher tiers (brand-name and specialty drugs) cost more.
Some drugs also come with rules attached:
- Prior authorization — the plan has to approve the drug before it will pay.
- Step therapy — you may need to try a lower-cost drug first.
- Quantity limits — the plan caps how much you can fill at once.
Before you enroll, check each of your drugs at your exact dosage — not just the drug name.
Does Part D Cover Every Prescription?
No. Federal law excludes certain categories, such as most over-the-counter medications and drugs used only for cosmetic purposes.
Some drugs are covered under Part B instead — for example, many medications given in a doctor's office or as an infusion.
If a drug you need isn't on your plan's formulary, your doctor can ask the plan for a coverage exception.
Your doctor can also help you find a covered alternative that works for you.
How Much Does Medicare Part D Cost in 2027?
What you pay depends on the plan you pick and the drugs you take. Four costs show up on every plan:
- Monthly premium — what you pay to keep the coverage.
- Annual deductible — what you pay for covered drugs before the plan starts sharing the cost. It can't be higher than $700 in 2027, and some plans charge less.
- Copayments — a fixed dollar amount per prescription.
- Coinsurance — a percentage of the drug's cost.
The Three Stages of Part D Coverage in 2027
Your deductible counts toward the $2,400. Many plans skip the deductible for low-tier generics. Medicare explains each stage in its guide to drug coverage costs.
The $2,400 cap tracks qualifying out-of-pocket spending, not every dollar you spend at the pharmacy.
What generally counts:
- Your deductible, copays and coinsurance for covered Part D drugs.
- Certain payments made on your behalf — for example, by Extra Help, a family member or some assistance programs.
What generally doesn't count:
- Your monthly premium.
- Drugs your plan doesn't cover (unless you get an exception).
- Drugs bought outside your plan's rules, such as at most out-of-network pharmacies.
Two protections apply no matter which plan you choose: covered insulin costs no more than $35 a month, and recommended adult vaccines like shingles cost $0.
If you'd rather not pay large drug bills all at once early in the year, you can sign up for the Medicare Prescription Payment Plan, which spreads your out-of-pocket drug costs into monthly payments.
It doesn't lower what you owe, but it can make January and February much easier on your budget.
Also new for 2027: Medicare's negotiated prices take effect for 15 more drugs on January 1, including Ozempic, Wegovy and Rybelsus.
If you take one of those drugs, your costs may change — another reason to re-run your plan comparison this fall.
Medicare Part D in Florida for 2027
Florida is its own Part D region, so every standalone plan sold here is available in all 67 counties.
For 2027, Floridians can choose from 11 standalone Part D plans from 6 insurance companies (counted by parent company) — one more plan than in 2026.
Monthly premiums range from $5.30 to $326.
Unlike 2026, there are no $0-premium standalone plans in Florida for 2027, and no plan has a $0 deductible.
One reason premiums moved so much: CMS ended its Part D Premium Stabilization Demonstration at the end of 2026.
That temporary, voluntary program gave participating standalone drug plans extra federal subsidies and limited how much their premiums could rise in 2025 and 2026.
If you kept the same plan without checking, your January premium could look very different.
For snowbirds and part-time residents: a standalone Part D plan covers you nationwide, but its preferred-pharmacy pricing may not follow you to another state.
If you split the year between Florida and somewhere else, check whether the plan's network includes a pharmacy near your second home — or whether mail-order works for your maintenance drugs.
Medicare Advantage plans work differently, since their networks are local. Our snowbird Medicare guide covers this in detail.
When Should You Enroll in Medicare Part D?
Most people first sign up for Part D when they first become eligible for Medicare. Our guide to signing up for Medicare walks through that timeline.
To join a standalone Part D plan, you need Medicare Part A and/or Part B and must live in the plan's service area.
Waiting can cost you. If you go 63 consecutive days or more without Part D or other creditable prescription drug coverage after your initial enrollment period, you may owe a late enrollment penalty when you eventually enroll.
Certain exceptions apply.
Creditable coverage means drug coverage that's expected to pay, on average, at least as much as Medicare's standard drug coverage.
Many employer, retiree, VA and TRICARE plans qualify. Your plan sends a yearly notice telling you whether yours does — keep it.
How the penalty adds up: Medicare charges 1% of the national base premium ($41.33 in 2027) for each full month you went without creditable coverage. Partial months don't count.
Example: going 20 months without coverage means a 20% penalty — about $8.30 a month added to your Part D premium in 2027.
The penalty is added once you enroll in Part D later, is recalculated each year, and generally lasts as long as you have Part D coverage.
People who qualify for Extra Help don't pay a Part D late penalty.
This is separate from the Part B late penalty, which has its own rules and applies to your Part B premium.
Before dropping employer or retiree drug coverage, confirm how it works with Medicare. Dropping some retiree plans can also end medical coverage for you or your spouse.
How to Compare Part D Plans
The most useful comparison starts with your prescriptions, not the insurance company's name.
Write down each drug name, dosage, and how often you refill it. Dosage matters — a plan may cover one strength at a lower tier than another.
Many plans have "preferred" pharmacies with lower copays. The same drug can cost noticeably more at a standard network pharmacy.
Enter your drugs and pharmacy in Medicare's Plan Finder. Sort by total drug costs plus premiums, not premium alone.
Look for prior authorization, step therapy, or quantity limits on your medications. A covered drug with a step-therapy rule may not be covered for you right away.
Formularies, premiums and pharmacy networks change every January. Last year's best plan isn't automatically this year's.
Can You Change Your Part D Plan?
Yes. During Medicare Open Enrollment, October 15 through December 7, Medicare beneficiaries can make eligible changes to their Medicare Advantage or Part D coverage for the following year.
Changes take effect January 1.
If you're in a Medicare Advantage plan, you also get a second chance from January 1 through March 31 to switch to another Advantage plan or return to Original Medicare and add a standalone Part D plan.
Certain life events — like moving, losing employer coverage, or qualifying for Extra Help — can open a Special Enrollment Period at other times of year.
See our full guide to Medicare enrollment periods for the details, or our guide to moving to Florida with Medicare if you're relocating.
Help Paying for Prescriptions in Florida
If you have limited income and savings, Extra Help (also called the Low-Income Subsidy) can lower your Part D premium, deductible, and copays.
You apply through Social Security, and there's no cost to apply.
If you're already enrolled in a Florida Medicare Savings Program or Medicaid, you automatically qualify for Extra Help.
With full Extra Help, one Florida standalone plan for 2027 has a $0 monthly premium.
The Bottom Line
Part D helps pay for covered prescription drugs and limits your qualifying out-of-pocket costs to $2,400 in 2027.
But plans vary more than most people expect — especially in Florida for 2027, with premiums from about $5 to over $300 a month.
The only reliable way to choose is to compare your actual medications, your pharmacies, and your estimated total yearly cost.
Don't assume your current plan is still your best option. Open Enrollment runs through December 7.
Questions? A licensed Florida Medicare agent can run the comparison with you — call (888) 414-4547.
With over 20 years of experience, Mark Prip is a dedicated licensed Medicare insurance agent in Florida. His expertise lies in simplifying the Medicare coverage process by providing comprehensive education to beneficiaries.
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