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Medicare Part D
Prescription Drug Coverage 2027
Medicare Part D Eligibility 2027: Who Qualifies and When You Can Join
Reviewed by Russell Noga, Licensed Medicare Insurance Broker (all 50 states) — Last updated November 3, 2026
You are eligible for Medicare Part D in 2027 if you have Medicare Part A, Part B or both, live permanently in a plan’s service area, and are a U.S. citizen or lawfully present. Age, income and health do not matter, but being eligible does not mean you can join at any time; you need an enrollment period.
2027 by the Numbers
323
standalone Part D plan bids for 2027 nationwide (our count of CMS 2027 plan filings)
7 to 12
standalone plans per state in 2027 (our count of CMS 2027 plan filings)
7 months
length of the Initial Enrollment Period around age 65 (Medicare)
Part D eligibility is simpler than most people expect. CMS enrollment rules list only three tests, and none of them involve a medical exam, a drug list or a minimum income. A person who qualifies can be accepted by any standalone drug plan serving their area, and a plan cannot turn someone down because of their prescriptions.
The harder part is timing. Each of the windows below decides when coverage can start, and missing the first one can trigger a penalty. The full 2027 picture of premiums and plan rules is on our Medicare Part D plans 2027 hub, and next year’s costs are broken down on the Medicare Part D premium 2027 page.
Key Takeaways
- Having only Part A, or only Part B, is enough to join a standalone drug plan.
- Medicare Advantage plans with drug coverage need both Part A and Part B.
- People who are incarcerated or living outside the U.S. are treated as living outside any plan’s service area.
- Our count of CMS filings shows between 7 and 12 standalone plans per state for 2027, with 7 in Maine and New Hampshire and 12 in Kansas.
- Part D penalties that start before 65 for people on disability end when the person turns 65.
The Three Tests CMS Uses
1
Medicare entitlement. You must have Part A, Part B or both in effect on the date your drug coverage would begin.
2
Permanent residence. You must live in the plan’s service area. A winter home or short trip does not change your permanent address.
3
Citizenship or lawful presence. You must be a U.S. citizen or lawfully present under federal immigration rules.
These rules come from the CMS enrollment and disenrollment guidance that plans must follow. Plans cannot add tests of their own, such as a health questionnaire or a credit check.
Situations That Change Your Eligibility
| Your situation | Standalone drug plan | Medicare Advantage with drugs |
|---|---|---|
| Part A only | Eligible | Not eligible |
| Part B only | Eligible | Not eligible |
| Both Part A and Part B | Eligible | Eligible if you live in the plan’s area |
| Living outside the U.S. | Not eligible while abroad | Not eligible while abroad |
| Incarcerated | Not eligible, even if the facility is inside the service area | Not eligible |
| End-stage renal disease | Eligible | Eligible since 2021 |
Based on CMS Medicare Advantage and Part D enrollment guidance. Moving back to the U.S. or release from incarceration opens a Special Enrollment Period.
Little-known rule: Because an incarcerated person is treated as living outside the service area, a plan must end that person’s coverage. Release then opens a Special Enrollment Period, generally lasting about two months, to join a plan again.
Eligibility Under 65
People under 65 qualify for Part D as soon as they get Medicare. That usually means after 24 months of Social Security disability benefits, right away with ALS, or after a qualifying period with kidney failure. Each of these starts its own seven-month Initial Enrollment Period.
Age 65 reset: A person under 65 who pays a late enrollment penalty gets a fresh Initial Enrollment Period at 65. The penalty stops at that point, according to Medicare Rights Center guidance on Part D enrollment.
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When an Eligible Person Can Join
Windows open to everyone
✔
Initial Enrollment Period: three months before your 65th birthday month, that month and three months after
✔
Annual Enrollment Period: October 15 to December 7, 2026, for coverage January 1, 2027
Windows tied to an event
✔
Moving to a new service area
✔
Losing employer or union drug coverage
✔
Getting Medicaid or Extra Help
✔
Release from incarceration or return from abroad
Event-based windows are listed in more depth on our 2027 special enrollment period guide, and the sign-up steps are in how to enroll in Medicare Part D 2027.
How Many Plans an Eligible Person Can Choose From
323
2027 standalone plan bids nationwide
15
sponsors with at least one 2027 standalone plan
7 to 12
standalone plans per state
These figures are our count of CMS 2027 plan filings for individual standalone plans; Medicare Plan Finder counts can differ slightly. Humana filed the most, followed by UnitedHealthcare and Wellcare. Kansas has the most standalone options at 12, while Maine and New Hampshire have the fewest at 7. Medicare Advantage plans with drug coverage are counted separately and vary by county. State-by-state detail is on our compare plans by state for 2027 page.
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Groups Enrolled Automatically
Medicare may place you in a drug plan if you
✔
Have both Medicare and full Medicaid benefits
✔
Qualify for Extra Help and have not picked a plan
✔
Get help from a Medicare Savings Program, which also qualifies you for Extra Help
Automatic placement uses a plan with a premium at or below the regional low-income benchmark. You can switch to a different plan if the assigned one does not list your drugs, depending on the plan and area. People with Extra Help can change plans once a month for another standalone drug plan.
Eligible but Late: What It Costs
If you go 63 days or more without Part D or other creditable drug coverage after your first window closes, Medicare adds a penalty to your premium. For 2027 it is 1% of the $41.33 base premium for each uncovered month, rounded to the nearest 10 cents.
| Months without coverage | 2027 monthly penalty | Added per year |
|---|---|---|
| 6 | $2.50 | $30.00 |
| 18 | $7.40 | $88.80 |
| 30 | $12.40 | $148.80 |
Our math from the CMS 2027 base beneficiary premium of $41.33. The base premium is reset each year, so the dollar penalty can change.
The full penalty rules are on our 2027 late enrollment penalty page.
The Bottom Line
The Bottom Line
Part D eligibility in 2027 comes down to having Part A or Part B, a permanent home in a plan’s area and lawful presence in the U.S. Once those boxes are checked, the real question is timing, because joining during your first window keeps you clear of a lifelong penalty. Check which 2027 plans serve your ZIP code before your window closes.
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
➤ Can I join a Part D plan if I only have Part B?
Yes. A standalone drug plan needs Part A, Part B or both. A Medicare Advantage plan with drug coverage needs both.
➤ Does my income affect Part D eligibility?
No. Income does not decide eligibility, though higher earners pay an extra monthly amount called IRMAA and lower earners may get Extra Help.
➤ Can a drug plan refuse me because of my prescriptions?
No. A plan must accept any eligible person who applies during a valid enrollment period, regardless of health or drug use.
➤ Am I eligible for Part D if I live overseas?
Not while you live outside the U.S., because you are not living in any plan’s service area. Returning to the U.S. opens a window to join.
➤ Can someone in jail keep a Part D plan?
No. CMS treats incarcerated people as living outside the service area, so plan coverage ends. Release opens a special window to enroll again.
➤ Do green card holders qualify for Part D?
Yes, if they are lawfully present and have Medicare Part A or Part B. Lawful presence is checked under federal immigration rules.
➤ When does a person on disability first become eligible?
Usually after 24 months of Social Security disability benefits, or right away with ALS. A seven-month enrollment window starts around that date.
➤ Is there an age limit for Part D?
No. There is no upper or lower age limit; eligibility follows your Medicare entitlement, whether that starts at 65 or earlier through disability.
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