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Medicare Part D
Prescription Drug Coverage 2027
How to Get Medicare Part D for Free in 2027: What Still Works
Reviewed by Russell Noga, Licensed Medicare Insurance Broker (all 50 states) — Last updated November 3, 2026
For 2027, the main way to get Medicare Part D for free is Extra Help, because KFF found no standalone drug plan with a $0 premium for people without it. The other routes are a Medicare Advantage plan with a $0 drug premium, where available, or state and Medicaid programs that cover the cost.
2027 by the Numbers
0
standalone drug plans with a $0 premium for non-subsidy enrollees in 2027 (KFF)
$5.30
lowest standalone plan premium in most states for 2027 (CMS)
$7.00
projected average drug premium inside Medicare Advantage plans for 2027 (CMS)
150%
of the poverty level: income ceiling for full Extra Help since 2024 (SSA)
Free drug coverage got harder to find for 2027. In its October 30, 2026 review, KFF reported that, for the first time since Part D began, no standalone plan charges a $0 monthly premium to people who pay their own way. The federal premium subsidy that helped hold prices down in 2025 and 2026 is gone.
That leaves a short list of real paths to $0, and each comes with conditions. This page sorts them by who qualifies and what they actually cover. The broader rules for the year are on the Medicare Part D plans 2027 hub, and premium figures for paying enrollees are on the Medicare Part D premium 2027 page.
Key Takeaways
- Without Extra Help, the cheapest standalone plan in most states costs $5.30 a month in 2027, or $63.60 for the year.
- Medicaid, a Medicare Savings Program or SSI brings Extra Help automatically, with no separate application.
- A $0 drug premium inside Medicare Advantage is common, but the deductible and copays still apply.
- Some states, such as New York through EPIC, pay part or all of a Part D premium for residents who qualify.
- A $0 premium plan is only free if it covers your drugs; uncovered drugs are paid in full.
Four Routes to a $0 Drug Premium
| Route | Who it fits | What becomes $0 | What may still cost money |
|---|---|---|---|
| Extra Help in a benchmark plan | Income up to 150% of poverty and limited savings | Premium and deductible | Small copays per fill |
| Medicaid or a Medicare Savings Program | People who qualify under state rules | Brings Extra Help automatically | Copays; plan choice still matters |
| Medicare Advantage plan with a $0 drug premium | Anyone with Parts A and B in the plan’s area | The drug part of the premium | Drug deductible, copays, and the Part B premium |
| State pharmacy assistance program | Residents of states that run one | Varies; some pay premiums | Depends on the state’s rules |
Rules summarized from CMS, SSA and state program materials. Plan-level details vary by plan and area.
Why Paying Enrollees Lost the $0 Standalone Option
From 2025 through 2026, a CMS demonstration paid standalone drug plans a monthly subsidy and limited how much their premiums could rise. CMS ended it after 2026. Plans now price their premiums without that help, and the base beneficiary premium rose to $41.33 for 2027.
$5.30
lowest standalone premium in most states (CMS)
$10.30
or less for a basic plan, available to 88% of non-subsidy enrollees (CMS)
$51
KFF projected average if current members stay put
If your 2026 plan was $0: check the 2027 Annual Notice of Change. A plan that cost nothing this year will charge something next year unless Extra Help or another program pays it.
The Automatic Route: Medicaid, MSPs and SSI
Medicare grants Extra Help on its own, without an application, to anyone who has full Medicaid, gets Supplemental Security Income, or is enrolled in a Medicare Savings Program that pays the Part B premium. This is often called deeming.
1
Apply for a Medicare Savings Program through your state Medicaid office. These programs pay the Part B premium, and some states use looser income or asset tests than Extra Help.
2
Watch for the Medicare letter. Once the state approves you, Medicare sends notice that you qualify for Extra Help.
3
Pick or keep a benchmark plan. If you do not choose, Medicare may place you in one so you are not left without coverage.
Since January 2024, everyone who qualifies for Extra Help gets the full subsidy, as the partial level was ended by law. People on Medicaid can read how the two programs fit together on if I have Medicaid, do I need Medicare Part D.
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Our Math: A Free Premium Is Not Free Drugs
Three ways to cover the same drug list priced at $150 a month, or $1,800 for the year, show how much a $0 premium does and does not save.
| Coverage for 2027 | Premiums for the year | Pharmacy cost for the year | Total |
|---|---|---|---|
| Standalone plan at $10.30, $700 deductible, 25% after | $123.60 | $975.00 | $1,098.60 |
| Medicare Advantage plan, $0 drug premium, $489 deductible, 25% after | $0 | $816.75 | $816.75 |
| Full Extra Help in a benchmark plan | $0 | Small fixed copays per fill | Usually the lowest, depending on how many fills |
Our math from CMS 2027 parameters and the KFF 2027 average Medicare Advantage drug deductible of $489. Real plans may use copays instead of 25%. Medicare Advantage members still owe the Part B premium unless another program pays it.
Reading the table: the $0-premium Medicare Advantage row still leaves $816.75 at the pharmacy. Only the Extra Help row removes the deductible as well as the premium.
Medicare Advantage Plans With a $0 Drug Premium
What makes these plans attractive
✔
KFF found nearly 8 in 10 MA drug plan members paid no drug premium in 2026
✔
CMS projects the average drug premium inside these plans at $7.00 for 2027
✔
Drug, medical and often dental benefits in one card
What to weigh first
✔
Provider networks replace Original Medicare’s open access
✔
KFF found 85% of MA drug plan members face a 2027 drug deductible
✔
Plans and premiums differ by county, and many plans end or change each year
A $0 drug premium does not mean a $0 plan in every county. Availability depends on the plan and area, and not all plans cover every drug, so the formulary check matters as much as the price.
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Extra Help Members Who Pay When They Do Not Have To
Extra Help pays the premium in full only for plans priced at or below a regional limit set each year. Members who picked a plan above that limit pay the difference. Justice in Aging, citing KFF, reported that about 600,000 Extra Help members in 2025 were paying a premium in a standalone plan even though a $0 plan was open to them.
How to stay at $0 with Extra Help
✔
Members who chose their own plan are not moved automatically when it loses $0 status; they receive a tan notice in the fall listing $0 options
✔
Members Medicare placed in a plan are usually reassigned to a new $0 plan if theirs no longer qualifies
✔
Extra Help members can switch standalone plans once a month, effective the first of the next month
✔
Full rules, income limits and copay math are on the Extra Help 2027 page
State Programs That Help With Premiums
NCOA reports that fewer than half of states run a state pharmaceutical assistance program, and each sets its own rules. New York’s EPIC is one example: for 2026, it paid the Part D premium up to a $58.82 monthly benchmark for members with income up to $23,000 single or $29,000 married. The 2027 benchmark may differ.
Finding your state’s program: Medicare.gov lists state pharmacy assistance programs by state, and your State Health Insurance Assistance Program can say whether one exists where you live. If none does, the cheapest standalone plan that covers your drugs is covered on the cheapest Medicare Part D plan 2027 page.
The Bottom Line
The Bottom Line
In 2027, a truly free Part D premium is open mainly to people with Extra Help, which also comes automatically with Medicaid, SSI or a Medicare Savings Program. A $0 drug premium inside Medicare Advantage removes the monthly charge but usually not the deductible. Everyone else pays something, starting at $5.30 a month in most states.
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE (TTY 1-877-486-2048) to get information on all of your options.
Frequently Asked Questions
➤ Is any Medicare Part D plan free in 2027?
Not for people paying on their own. KFF found no standalone plan with a $0 premium for 2027. Extra Help members can still get $0 premiums in benchmark plans.
➤ How do I qualify for free Part D through Extra Help?
Income up to 150% of the poverty level and savings under the yearly limit, or automatic qualification through Medicaid, SSI or a Medicare Savings Program.
➤ Can a Medicare Savings Program get me free drug coverage?
It can lead there. Joining a Medicare Savings Program that pays your Part B premium also gives you Extra Help automatically.
➤ Are Medicare Advantage plans with $0 drug premiums really free?
The drug premium may be $0, but deductibles and copays usually still apply, and you keep paying the Part B premium unless another program covers it.
➤ What is the cheapest standalone plan if I do not qualify for help?
CMS reported a lowest premium of $5.30 a month in most states for 2027. Check that it covers your drugs before choosing it.
➤ Why did my $0 plan start charging a premium?
The federal premium demonstration ended after 2026, so plans priced 2027 premiums without that subsidy.
➤ Will Extra Help pay any plan’s premium?
Only up to a regional limit. Choose a plan priced above it and you pay the difference each month.
➤ Does my state pay Part D premiums?
Some do through state pharmacy assistance programs, such as New York’s EPIC. Medicare.gov and your local SHIP can confirm whether your state has one.
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