How do I compare Medicare drug plans during Open Enrollment?

01Start with the letter you already got

By September 30 your plan mails an Annual Notice of Change. It is the single most useful document of the season: exactly what your plan changes for next year. Premium, deductible, copay and coinsurance tiers, which drugs stay on the formulary, and which pharmacy network applies. Read that first, before any advertising.

Watch for two red flags. A drug you take moves to a higher tier or leaves the formulary, or your pharmacy drops out of the preferred network. Either one is a signal to shop, even if the premium barely moved.

02The 2027 numbers you can trust

CMS finalized the core 2027 Part D numbers on April 6, 2026, in the CY2027 Rate Announcement. These are not projections.

Once your out-of-pocket costs for covered drugs reach the $2,400 cap, you pay $0 for covered drugs the rest of the year. The deductible counts toward the cap. Premiums do not.

Two footnotes. The base beneficiary premium is the number used to calculate late-enrollment penalties. It is not what any specific plan charges. And the federal demonstration that held stand-alone plan premiums down ends with 2026, so premiums can move more freely for 2027. Read your notice instead of assuming a small increase.

03Compare your total year, not the monthly premium

Take the premium off the table first. Multiply it by 12. Then add what your drugs cost under each plan's rules: deductible, copays or coinsurance by tier, and whether your pharmacy is preferred. The plan with the lowest premium often loses on the total.

See how the pieces fit with the 2027 standard benefit. A covered prescription that costs $100 a month and is subject to the deductible runs about $100 a month January through July to meet the $700 deductible, then 25 percent, or $25 a month, August through December. That is $825 for the year before the premium. Your plan's tiers set your real numbers. The standard benefit shows you the shape of the math.

Then check the formulary itself. Plans change which drugs they cover and which tier each drug sits in every year. Enter your exact drugs, doses, and pharmacy into the Medicare plan finder at medicare.gov to see your real total by plan.

04The deadline, and what happens if you do nothing

Open Enrollment ends December 7. Your plan must receive your enrollment form by then, and changes take effect January 1. Miss the window and you are generally locked in until next October, outside a few special exceptions.

If your plan still fits, you do not have to do anything. Coverage generally renews automatically with the new year's terms. The risk is assuming nothing changed. Plans change formularies and tiers every year, and the premium in your notice is the only number that matters.

05When a ten-minute review beats an afternoon of tabs

Twenty minutes with your drug list and the Medicare plan finder handles most comparisons. The people who get burned are the ones who never open the Annual Notice of Change.

If the letter confuses you, get a second pair of eyes before December 7. A free review in Greensboro or anywhere in the Triad takes your actual drug list against next year's plans and tells you the real yearly cost. Bring the notice, your drug bottles, and your pharmacy name.

06Questions people ask me about this