2027 Part D Changes: What South Carolina Medicare Members Need to Know
The Part D out-of-pocket cap rises to $2,400 in 2027, the standard deductible goes up to $700, and South Carolina has fewer stand-alone drug plans than last year. Check your prescriptions, pharmacy and plan before December 7.
Reviewed by Will Murdock, Director of Medicare Benefits, Agent & Broker
Published · Updated
In this guide
For 2027, the most you can pay out of pocket for covered Part D drugs is $2,400 for the year, up from $2,100 in 2026. The standard Part D deductible rises from $615 to $700. Both figures come from CMS's 2027 Rate Announcement, and they apply whether you get drug coverage from a stand-alone Part D plan or a Medicare Advantage plan with drug coverage.
In South Carolina, the bigger change for many people is the plan list itself. CMS reports 8 stand-alone Part D plans available here for 2027. KFF counted 11 in 2026. If you have a stand-alone plan, your premium, pharmacy network and drug list may all look different on January 1.
The 2027 Part D numbers at a glance
| Part D item | 2026 | 2027 |
|---|---|---|
| Standard deductible (maximum a plan can charge) | $615 | $700 |
| Annual out-of-pocket cap | $2,100 | $2,400 |
| Insulin, per one-month supply of each covered insulin | $35 max | $35 max |
| National base beneficiary premium (used to figure late penalties) | — | $41.33 |
| Stand-alone Part D plans offered in South Carolina | 11 | 8 |
| Lowest stand-alone Part D premium in South Carolina | — | $5.30/month |
Sources: CMS 2027 Rate Announcement; CMS July 28, 2026 Part D announcement; CMS 2027 South Carolina fact sheet; KFF; Medicare.gov.
$700 is the most a plan can charge. Some plans charge a lower deductible or none at all on certain drug tiers, so two plans with similar premiums can cost you very different amounts.
How the $2,400 out-of-pocket cap works
Everything you pay for covered Part D drugs counts toward the cap: your deductible, copays and coinsurance. Once your share reaches $2,400 in 2027, you pay nothing for covered Part D drugs for the rest of the calendar year.
Your monthly premium doesn't count toward the cap, and neither do drugs your plan doesn't cover, so check the formulary as closely as the price.
Who benefits most? People who take a brand-name drug for diabetes, COPD, a heart condition or cancer often hit the cap by spring or summer. If that's you, a plan with a higher premium but better tier placement for your drug may cost less over the full year. Our agents check this first in a review, especially for people who take two or three brand-name maintenance drugs.
The Medicare Prescription Payment Plan now renews automatically
The Medicare Prescription Payment Plan lets you spread your out-of-pocket drug costs into monthly payments across the year instead of paying a large amount at the pharmacy counter in January or February. It's free and optional. It changes when you pay, not how much.
What's different now, according to Medicare's September 2026 guide:
- Automatic renewal. If you're enrolled and you keep the same plan, your plan renews your participation each year unless you opt out.
- Changing plans means signing up again. If you switch plans during Annual Enrollment, you'll need to opt in with the new plan.
- No interest or fees, even if a payment is late. If you miss a payment by the due date on your reminder, you can be removed from the program, but you still owe the balance.
- Join or leave any time by calling your plan.
This program usually makes sense for people who expect to reach the cap early in the year. If your drugs are mostly low-cost generics, it may not help much.
Stand-alone Part D plans in South Carolina for 2027
If you have Original Medicare, with or without a Medigap policy, you get drug coverage through a stand-alone Part D plan (PDP). That market changed for 2027.
- Fewer choices. CMS lists 8 stand-alone plans in South Carolina for 2027, compared with 11 in 2026 (KFF).
- The premium support program ended. CMS discontinued the Part D Premium Stabilization Demonstration after 2026. KFF notes this ended the extra payments to stand-alone plans and the $50 cap on monthly premium increases that applied in 2026.
- No $0-premium stand-alone plans. KFF reports no $0-premium PDPs are available anywhere in 2027. In South Carolina, the lowest stand-alone premium is $5.30 a month (CMS).
- Switching can save. CMS says 46.24% of South Carolinians in a stand-alone plan have access to a plan with a lower premium than they paid in 2026.
Nationally, KFF estimates the average stand-alone premium would rise from $34 to $51 a month in 2027 if everyone stayed in their current plan. Comparing plans before December 7 is how you find out whether a cheaper one covers your drugs.
One more change: Elevance stopped offering stand-alone Part D plans in 2026, and it is leaving South Carolina Medicare Advantage for 2027. If you're a Wellpoint member, see our guide to your options before December 7.
Lower Medicare prices on 15 drugs start January 1
Medicare negotiated prices on 15 drugs that take effect January 1, 2027. The list includes Ozempic, Rybelsus and Wegovy; Trelegy Ellipta; Breo Ellipta; Janumet; Tradjenta; Linzess; Xifaxan; Vraylar; Otezla; Austedo; Ofev; Ibrance; Xtandi; Pomalyst; and Calquence.
These are the prices Medicare plans pay, not your copay. What you pay still depends on your plan's tier and deductible. If one of these drugs is on your list, check how your 2027 plan treats it.
Extra Help can lower your costs a lot
Extra Help is a federal program that helps people with limited income and resources pay Part D premiums, deductibles and copays. For 2027, qualifying members pay no deductible, and copays for the lowest-income groups are capped at a few dollars per prescription. CMS reports that 21.99% of South Carolinians in stand-alone drug plans get Extra Help. If your income has dropped, ask us or your SHIP counselor whether you might qualify.
What to check before December 7
Annual Enrollment runs October 15 through December 7, and changes take effect January 1. Before you renew without a look:
- Read your Annual Notice of Change. It lists 2027 premium, deductible, tier and pharmacy changes. Our ANOC guide walks through it line by line.
- Run your exact drug list, including dosage and how often you fill it. A drug moving from Tier 3 to Tier 4 can cost more than a premium increase.
- Confirm your pharmacy. Preferred pharmacies can mean lower copays. Check that your Publix, CVS, Walgreens or local independent pharmacy is still preferred.
- Look at the full-year total: premiums plus expected drug costs, up to the $2,400 cap.
- Decide on the Payment Plan if you expect high costs early in the year.
If you're in a Medicare Advantage plan and change your mind after January 1, the Medicare Advantage Open Enrollment Period runs January 1 to March 31. For the full Annual Enrollment checklist, see our 2027 AEP guide.
Frequently asked questions
$2,400. After your deductible, copays and coinsurance for covered Part D drugs reach $2,400 in 2027, you pay $0 for covered Part D drugs for the rest of the year. Premiums don't count toward the cap.
The standard deductible is $700, up from $615 in 2026. That's the most a plan can charge. Some plans charge less or waive it for certain tiers.
Yes. It applies to Part D drug coverage whether it comes from a stand-alone plan or a Medicare Advantage plan that includes drug coverage.
If you're already enrolled and you keep the same plan, your participation renews automatically. If you switch plans, you'll need to opt in with your new plan.
CMS lists 8 stand-alone Part D plans in South Carolina for 2027, with premiums starting at $5.30 a month. Your actual cost depends on your drugs and pharmacy.
If you go 63 days or more without Part D or other creditable drug coverage after you're first eligible, Medicare adds a late enrollment penalty of 1% of the national base beneficiary premium ($41.33 in 2027) for each month you went without coverage. You generally pay it for as long as you have Part D.
Sources
- CMS: 2027 Medicare Advantage and Part D Rate Announcement (Table V-2 — Part D benefit parameters)
- CMS: July 28 — 2026 Parts C & D announcement (2027 base beneficiary premium; end of Premium Stabilization Demonstration)
- CMS: 2027 Medicare Advantage & Part D landscape state-by-state fact sheets (South Carolina)
- Medicare.gov: What's the Medicare Prescription Payment Plan? (Product No. 12211 — September 2026)
- Medicare.gov: Saving money with the prescription drug law
- Medicare.gov: Avoid late enrollment penalties
- KFF: Medicare Part D Premiums and Cost Sharing in 2027
- KFF: Number of Medicare Stand-alone Prescription Drug Plans — by state
- Becker's Hospital Review: CMS to cut prices on 15 costly drugs in 2027
- Becker's Payer Issues: Elevance among latest insurers to pull back on Medicare Advantage
- Becker's Payer Issues: Medicare Advantage looks stable for 2027. Underneath — it's shifting
- Murdock Insurance Group analysis of PY2027 SC Marketplace rate filings / plan data
Murdock Insurance Group is an independent insurance agency. We are not affiliated with or endorsed by Medicare, CMS or any government agency. Plan availability, premiums, drug lists and pharmacy networks vary by plan and county. Networks and drug lists can change; we verify with the carrier before you enroll. Last verified: November 2026. For free, unbiased Medicare counseling, you can also contact South Carolina's State Health Insurance Program, I-CARE / Insurance Counseling Assistance and Referral for Elders, at 1-800-868-9095. We don't offer every plan available in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.