Annual Enrollment opens October 15 and closes December 7, and the Part D plan you pick in that window is the one you live with for all of 2027. Most people compare drug plans by looking at the monthly premium, picking the cheapest one, and moving on. That is the single most expensive habit in Medicare, because the premium is usually the smallest number in the whole calculation. Here is how to actually compare them.
What Is Changing for 2027
Two figures move every year and both go up for 2027. The highest deductible a Part D plan is allowed to charge rises to $700, up from $615 in 2026. The annual cap on what you pay out of pocket for covered drugs rises to $2,400, up from $2,100 in 2026. Once you reach that cap, your plan covers your covered prescriptions for the rest of the calendar year.
Those are ceilings, not the numbers on your own plan. A plan can charge less than the maximum deductible or none at all, and many do. What matters is what your plan chose, and that is on the Annual Notice of Change that arrived in your mail in September.
Start With Your Own Drug List, Not the Plan List
Before you look at a single plan, write down every prescription you take. Include the exact name, the dose, and how often you take it. Brand versus generic matters, and so does the dose, because plans price the same drug differently at different strengths.
That list is the only thing that makes a comparison meaningful. Two people in Knoxville looking at the same three plans will often get three different answers about which one is cheapest, and both of them are right, because they take different drugs. A plan that is excellent for your neighbor can be the worst of the three for you.
The Five Things Worth Checking on Each Plan
- Is every drug you take on the formulary. A formulary is the plan’s list of covered drugs. If one of your prescriptions is not on it, the plan does not pay toward that drug at all, and a low premium will not make up the difference.
- What tier is each drug on. Plans sort covered drugs into tiers, and your share is set by the tier rather than by the drug. The same medication can sit on a preferred tier in one plan and a higher tier in another, which can change your yearly cost substantially.
- Is your pharmacy preferred. Plans have pharmacy networks, and inside those networks some pharmacies are preferred and cost you less. Filling the same prescription at a standard network pharmacy instead of a preferred one can cost noticeably more all year.
- Does the plan require extra steps. Prior authorization, step therapy and quantity limits are all common. None of them mean the drug is not covered, but they do mean your doctor has to do something before the plan pays, and it is better to know that in December than at the pharmacy counter in January.
- What is the deductible. A plan with no deductible starts paying its share immediately. A plan at or near the $700 maximum means you pay full price until you clear it. Which is better depends entirely on what you spend in a year.
Compare the Annual Total, Not the Monthly Premium
The number that decides this is premium for twelve months, plus the deductible you will actually pay, plus your share of each prescription across the year. Run that total for each plan you are considering. It is common for a plan with a higher monthly premium to come out several hundred dollars cheaper over the year because it covers one of your drugs on a better tier.
The Medicare Plan Finder at medicare.gov will do this arithmetic for you once you enter your drug list and your pharmacy. It is worth the twenty minutes. If you would rather someone else sit with you and go through it, that is what we do, and there is no cost to you for it.
If the Yearly Cost Is Still More Than You Can Manage
Two things can help, and they work differently. Extra Help and the Medicare Savings Programs lower what you pay based on income and resources, and in Tennessee more people qualify than apply. That is the first thing to check.
Separately, the Medicare Prescription Payment Plan lets you spread your out of pocket drug costs across the months of the year in level payments instead of paying a large amount at the pharmacy in January. It does not reduce the total you owe, so it is not a discount. It is useful when the total is manageable over a year but not manageable in one month.
If Your Drug Coverage Comes Through a Medicare Advantage Plan
Most Medicare Advantage plans in Knox County include drug coverage, which means the formulary, the tiers and the pharmacy network all belong to that plan rather than to a separate Part D policy. The five checks above still apply exactly the same way. The difference is that you cannot change just the drug half. Switching away because the formulary dropped one of your prescriptions also changes your doctors, your hospital network and your medical cost sharing, so those have to be weighed together.
That is worth saying plainly because it catches people. A drug plan comparison that ignores whether your cardiologist is still in network is not a comparison, it is half of one. If you are on an Advantage plan, check the provider directory for every doctor you see in the same sitting as the drug list, and see our comparison of Advantage and Supplement coverage if you are reconsidering the structure itself rather than just the plan.
Do This Before December 7
If you make no change, your current plan generally rolls into 2027 with whatever its new premium, deductible, formulary and network happen to be. That is fine if you checked and it still fits. It is expensive if you assumed.
Write your drug list down, read your Annual Notice of Change, and compare the annual total on two or three plans rather than the premium on all of them. If you want help doing it, call (865) 591-9884 or reach out through the site and we will go through your own list with you.
Leave a Reply