It's that time of year again. AEP is here, phone lines are ringing, enrollment platforms are humming, and Medicare beneficiaries are looking for answers.
The good news? The Medicare Part D market appears more stable than many expected heading into 2027.
The challenging news? Clients still need your help more than ever and compensation for Part D plans is down.
While average premiums remain relatively steady, plan options continue to shrink, deductibles and out-of-pocket costs are increasing, federal premium stabilization support has ended, and formularies remain one of the most important factors in selecting a plan.
In this guide, we'll cover the biggest Part D changes for 2027, discuss what agents should be watching during AEP, review carrier highlights, and explain why reviewing every client's medications remains the most important thing you can do this fall.
Originally published October 8, 2019. Last updated October 2026.
Please Check Client Formularies
Before we discuss carriers, premiums, and industry trends, there is one thing every agent needs to hear:
Check every client's formulary.
If you've been in this business for any length of time, you already know a low premium means very little if a client's medications aren't covered.
Many carriers continue making adjustments to their formularies, preferred pharmacy networks, and utilization management requirements. A plan that worked perfectly in 2026 may no longer be the best fit for 2027.
While Medicare requires plans to cover representative drugs in each therapeutic category, that does not mean all plans cover the same medications. Drug coverage can vary significantly from carrier to carrier.
Do not assume. Verify.
Your clients depend on you to identify the coverage option that best matches their medications, pharmacy preferences, and budget.
The Part D Market Continues to Shrink
The number of standalone Medicare Part D Prescription Drug Plans continues to decline in 2027.
Over the past several years, carriers have steadily reduced their PDP offerings as the Part D landscape has evolved. Many companies that once offered multiple plans have consolidated their portfolios, while others have chosen to exit certain markets altogether.
For Medicare beneficiaries, fewer plans may mean a simpler shopping experience. For agents, however, it means fewer opportunities to simply default to last year's enrollment strategy.
As options decrease, finding the right fit becomes increasingly important.
The days of dozens of nearly identical PDPs are largely behind us. Today's market demands a more personalized approach.
The Inflation Reduction Act Continues to Reshape Part D
The redesigned Part D benefit structure remains in place for 2027, but several important cost-sharing amounts are increasing.
The annual out-of-pocket threshold increases to $2,400 in 2027, up from $2,100 in 2026. The standard deductible also increases to $700, up from $615 in 2026.
Although beneficiaries continue to benefit from having a maximum annual out-of-pocket limit for prescription drugs, those higher thresholds mean some clients may spend more before receiving catastrophic-level protection.
For agents, this makes annual drug reviews even more important, especially for clients taking expensive brand-name medications.
Premiums Remain Relatively Stable
One of the biggest surprises heading into 2027 is that average PDP premiums remain relatively stable for consumers with a reduction in commissions to agents.
CMS projects the average premium for standalone Part D plans to increase only slightly, from approximately $35.09 in 2026 to about $36.00 in 2027.
At first glance, that sounds like good news.
However, average numbers rarely tell the whole story.
Some beneficiaries will experience little or no premium increase, while others could see more significant changes depending on their carrier, location, and current plan.
That's because the federal Part D Premium Stabilization Demonstration, which helped suppress premium increases during the transition to the new Part D benefit structure, has ended.
As a result, we expect greater variation in premiums from carrier to carrier and market to market.
The lesson for agents is simple:
Do not auto-renew clients without comparison shopping.
Review their Annual Notice of Change (ANOC) carefully and make sure their current coverage still represents the best value.
Some Clients Will Lose Their Zero-Premium Plans
Another trend agents are seeing this year is the continued reduction of ultra-low-cost PDP options.
Many beneficiaries became accustomed to paying little or nothing for their Part D coverage. In 2027, some of those same beneficiaries may find themselves facing monthly premiums they did not previously have.
This will likely generate questions from clients who assume something has gone wrong.
Help them understand that these changes are occurring throughout the industry as carriers adjust pricing and benefits under the redesigned Part D structure.
Don't Forget About Pharmacies
Drug coverage isn't just about formularies.
It is also about where clients fill their prescriptions.
Preferred pharmacy networks continue to play a major role in determining overall drug costs. Even when two plans cover the same medication, the client's costs can vary significantly depending on the pharmacy they choose.
As you complete drug comparisons, make sure you're checking:
- Medication coverage
- Drug tier placement
- Preferred pharmacies
- Mail-order options
- Utilization management requirements
Sometimes the difference between a good plan and a great plan is simply selecting the right pharmacy.
Prioritizing Your Book of Business During AEP
AEP always feels like a sprint, but a little planning goes a long way.
Start by identifying clients who:
- Received significant premium increases
- Are enrolled in discontinued plans
- Have expensive prescriptions
- Experienced major health changes during the year
- Use medications with complex formulary requirements
These clients typically have the most to gain from a comprehensive review.
Rather than working your book randomly, focus first on the beneficiaries most likely to be affected by 2027 changes.
Non-Commissionable Plans Continue to Grow
Agents shouldn't be surprised to see the list of non-commissionable plans continue expanding.
As carriers face ongoing financial pressure, product design and compensation strategies continue to evolve.
While commissions are important, remember that your primary responsibility is helping clients identify the plan that best meets their needs. Sometimes the right recommendation may not be the most lucrative one.
The agents who build long-term trust are the agents who consistently put clients first.
2027 Part D Carrier Highlights
As always, carrier performance varies by state and market. The following observations are intended as general guidance.
Wellcare
Wellcare remains one of the most dominant players in the standalone Part D market.
The company continues offering its two primary PDP options:
- Wellcare Value Script
- Wellcare Classic
Wellcare continues promoting affordable prescription drug coverage nationwide and remains one of the largest standalone PDP providers in the country.
As always, remember that:
Wellcare does not pay commission on Part D plans.
Cigna Healthcare
Cigna remains a strong competitor in many regions.
Agents should pay close attention to plan-specific formularies, pharmacy networks, and premium changes when evaluating Cigna's offerings.
For many beneficiaries, the decision will come down to medication coverage rather than headline premium numbers.
Humana
Humana continues to be a major force in the Part D space.
The carrier offers multiple standalone PDP options designed to serve beneficiaries with varying prescription needs and budgets.
Humana's extensive pharmacy partnerships and integrated prescription drug resources remain attractive features for many Medicare consumers.
As always, compare drugs carefully before making recommendations.
SilverScript (CVS Health)
SilverScript Choice remains CVS Health's flagship standalone PDP offering nationwide.
The plan continues to be a viable option for certain beneficiaries, particularly when its formulary aligns well with a member's medication needs.
However, agents should compare SilverScript carefully against competing carriers, as lower-premium alternatives may be available depending on the beneficiary's location and medications.
Tools to Help You During AEP
IntegrityCONNECT remains one of the most valuable resources available to agents during AEP.
Use it to:
- Compare prescription drug costs
- Analyze formulary coverage
- Review pharmacy networks
- Quote Medicare plans
- Complete enrollments
The faster you can analyze medications, the more clients you'll be able to serve effectively during the busy enrollment season.
If you haven't created your account yet, now is the time.
Conclusion
The biggest lesson for 2027 is simple:
Don't assume last year's Part D plan is still the right plan.
The market continues to evolve. Premiums are shifting. Deductibles are increasing. Formularies continue changing. Carriers are constantly adjusting benefits and pricing.
That means every client deserves a fresh review.
The agents who will be most successful this AEP aren't necessarily the ones who write the most applications. They're the ones who carefully compare plans, verify medications, review ANOCs, and help beneficiaries make informed decisions.
Check every formulary. Review every ANOC. Compare every plan.
Comments