# Medicare Part D Plans 2027: North Carolina Guide

> North Carolina has 11 standalone Part D plans for 2027. The $700 deductible, the $2,400 cap, the $35 insulin limit, and how to compare them fairly in 2027.

Canonical: https://christianbrinkleync.com/guides/medicare-part-d-plans-2027-nc

## Quick answer

North Carolina has 11 standalone Part D plans for 2027. Every one follows the same federal limits: a deductible of no more than $700, a $2,400 yearly cap on covered drug costs, and no more than $35 a month for each covered insulin.

## The 2027 numbers are final

CMS finalized the 2027 Part D standard benefit in its Rate Announcement on April 6, 2026. The maximum deductible rises to $700, from $615 in 2026. The annual out-of-pocket cap rises to $2,400, from $2,100. The national base beneficiary premium is $41.33 a month, up from $38.99. These are final figures, not projections. The deductible, copays, and coinsurance you pay for covered drugs count toward the $2,400 cap. Premiums do not. Once your out-of-pocket costs for covered drugs reach the cap, you pay $0 for covered drugs for the rest of the year.

## North Carolina's 11 plans

North Carolina has 11 standalone Part D plans for 2027, down from 12 in 2026, according to the state's SHIIP program. Part D plans are sold by region, not by county, so everyone in North Carolina sees the same standalone list. CMS puts the lowest standalone premium at $5.30 a month in most states for 2027, and projects the average standalone premium at about $36 a month. KFF found a different number for people who stay in the same plan: an average of $51 a month nationally. The federal program that held standalone premiums down ends after 2026, so premiums can move more freely for 2027. Your plan's own premium is the only one that matters, and it is in your Annual Notice of Change.

## How to compare: your drugs, your pharmacy, your year

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. 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. A plan that covers your neighbor's drugs well can still be the wrong plan for yours.

## The $35 insulin cap

A month's supply of each Part D-covered insulin costs no more than $35, and the Part D deductible does not apply to insulin. The cap applies per insulin product, per month, so if you take two insulins, each one has its own $35 ceiling. It applies in every coverage phase, and it applies to people with Extra Help too. Insulin used with a traditional pump covered under Part B is also capped at $35 for a month's supply. The cap covers insulin on your plan's formulary. If your insulin is not covered, ask your doctor about a formulary alternative or an exception.

## Coverage phases in 2027

A Part D year has three phases in 2027. First, the deductible phase: you pay the plan price for covered drugs until you meet the deductible, which can be no more than $700. Some plans charge no deductible, or none for lower tiers. Second, initial coverage: in the standard benefit you pay 25 percent coinsurance until your out-of-pocket costs reach $2,400. Third, catastrophic coverage: you pay $0 for covered drugs for the rest of the year. There is no coverage gap phase. The gap, once called the donut hole, ended with the $2,000 cap in 2025 and stays gone in 2027.

## Extra Help and benchmark plans

Extra Help, also called the Low Income Subsidy, pays part or all of the Part D premium, deductible, and copays for people with limited income and resources. Each year CMS sets a benchmark premium amount for each region. If you have full Extra Help, a plan with a premium at or below the benchmark costs you $0 in premium. Plans above the benchmark cost you the difference. You apply for Extra Help through Social Security, and North Carolina's SHIIP counselors can walk through the application with you at no charge.

## Smoothing payments across the year

The Medicare Prescription Payment Plan lets you spread out-of-pocket drug costs into monthly payments across the year instead of paying large amounts in January and February. It is optional, it costs nothing to join, and it is not a discount: the total you owe stays the same. It helps most when your drug costs pile up early in the year. Ask your plan about it during Open Enrollment, before December 7.

## Part D limits, 2026 and 2027

| Part D feature | 2026 / 2027 |
| --- | --- |
| Maximum standard deductible | $615 / $700 |
| Annual out-of-pocket cap | $2,100 / $2,400 |
| Insulin, per month's supply | $35 / $35 |
| Coverage gap phase | Gone in 2025 / Still gone |

## Checklist

- [ ] Bring your full drug list, doses, and pharmacy name.
- [ ] Read the Annual Notice of Change before you compare anything.
- [ ] Enter your exact drugs into the Medicare plan finder.
- [ ] Add 12 months of premium to your drug costs for each plan.
- [ ] Check insulin, deductible, and tier rules for your drugs.

## Frequently asked questions

### How many standalone Part D plans does North Carolina have for 2027?

Eleven, down from 12 in 2026, according to the state's SHIIP program. Part D plans are sold by region, so the same 11 plans are offered across the state. Medicare Advantage plans with drug coverage are separate, and their drug lists differ.

### What are the 2027 Part D deductible and out-of-pocket cap?

CMS finalized them in the CY2027 Rate Announcement on April 6, 2026: the standard deductible rises to a $700 maximum, from $615, and the annual out-of-pocket cap rises to $2,400, from $2,100. Once your out-of-pocket costs for covered drugs reach the cap, you pay $0 for covered drugs the rest of the year.

### Does the $35 insulin cap apply if I have Extra Help?

Yes. Medicare.gov states the $35 limit applies to everyone who takes insulin, even with Extra Help. The cap is $35 for a one-month supply of each covered insulin, with no deductible, in every coverage phase.

### What is a benchmark plan?

Each year CMS sets a benchmark premium amount for each region. If you have full Extra Help, a plan priced at or below the benchmark costs you $0 in premium. A plan above it costs you the difference between its premium and the benchmark.

### When can I change my Part D plan for 2027?

During Open Enrollment, October 15 through December 7, 2026. Changes take effect January 1, 2027. Outside that window you generally need a Special Enrollment Period, such as a move or losing other drug coverage.

## Sources

- [CMS: CY2027 Medicare Advantage and Part D Rate Announcement](https://www.cms.gov/files/document/2027-announcement.pdf)
- [Medicare: Insulin costs](https://www.medicare.gov/coverage/insulin)
- [Medicare: Find health and drug plans](https://www.medicare.gov/plan-compare)

## Related

- [How do I compare Medicare drug plans during Open Enrollment?](https://christianbrinkleync.com/answers/compare-part-d-plans-open-enrollment-2027)
- [Do I need Medicare drug coverage?](https://christianbrinkleync.com/answers/do-i-need-medicare-drug-coverage)
- [The Part D late enrollment penalty](https://christianbrinkleync.com/answers/medicare-part-d-late-penalty)
- [The Part D cap, explained](https://christianbrinkleync.com/medicare-part-d-donut-hole-2027)
- [Every 2027 Medicare cost, final vs projected](https://christianbrinkleync.com/medicare-costs-2027)

---

Educational content only, not financial or tax advice. Published by Christian Brinkley, christianbrinkleync.com.