Medicare Part D on Long Island in 2027: The Complete Guide

Oct 30, 2026 · @Paul

If you live in Nassau or Suffolk County, your 2027 drug coverage costs are capped at $2,400 for the year. But the deductible is going up, there are fewer stand-alone plans to pick from, and some premiums are jumping by $50 a month or more. Here’s everything you need to know, in plain English, from a local agent who has lived on Long Island for 55 years.

I’m Paul Barrett. I’ve helped more than 5,000 people with Medicare over 18 years. Two weeks into this year’s Open Enrollment, the questions I hear most are about Part D. People ask, “Why is my drug plan so expensive?” and “What does the $2,400 cap actually mean?” and “Why can’t I find anyone to help me?” This guide answers all of them.

The quick answer: 2027 Part D on Long Island

Paul’s Honest Take: The $2,400 cap is the best thing to happen to Part D in years. But it does not include your monthly premium. So the real most you could spend is your premium for 12 months plus $2,400. Keep that in mind as you read on.

What’s changing for 2027

Five changes matter most for Long Islanders this year. Some help you and some cost you more.

1. The yearly cap goes up to $2,400. Last year it was $2,100. Once you’ve paid $2,400 out of pocket for covered drugs, you pay $0 for the rest of the year.
2. The deductible can be as high as $700. That’s up from $615. Six of New York’s nine stand-alone plans charge the full $700, and none has a $0 deductible.
3. A federal “premium cushion” is gone. For 2024 through 2026, a program called the Part D Premium Stabilization Demonstration kept stand-alone premiums from jumping too much in one year. CMS ended it after 2026. So some plans raised prices by $50 a month or more. KFF found that AARP Medicare Rx Preferred went up $50 or more in every state.
4. Fewer plans to choose from. New York has 9 stand-alone plans in 2027, down from 10. HealthSpring Extra Rx is ending. Its members will be moved automatically to HealthSpring Assurance Rx, according to NY Health Access.
5. Lower prices on 15 more brand-name drugs. Medicare’s negotiated prices kick in on January 1, 2027 for drugs like Ozempic, Trelegy Ellipta and Xtandi. More on this below.

Why New Yorkers pay more than the rest of the country

The same plan can cost very different amounts depending on where you live. KFF reports that Wellcare Value Script is $5.30 a month in 45 states. In New York, the state’s own plan list shows it at $37.30. Plans set prices by region, and New York is its own region (CMS calls it Region 3). That’s one reason I always tell people not to trust national “best plan” articles. Look at the New York numbers.

How Part D costs really work (the part that confuses everyone)

There are four pieces to what you pay. Only three of them count toward the $2,400 cap. Most of the confusion I see comes from mixing these up.

The formula to remember:

Your worst-case year = (monthly premium × 12) + $2,400

A real-life example: Margaret from Huntington

Margaret takes one brand-name medicine. Its full price is $800 a month. She picks the lowest-premium plan in New York, which is $37.30 a month with a $700 deductible and 25% coinsurance on her drug. Here’s how her year plays out:

1. January: she pays $725. That’s the whole $700 deductible, plus 25% of the remaining $100. This is the month that shocks people.
2. February through September: she pays $200 a month. That’s 25% of $800. By the end of September she has paid $2,325.
3. October: she pays $75. That brings her to the $2,400 cap.
4. November and December: she pays $0. The cap has done its job.

Margaret’s total for the year: $2,400 at the pharmacy + $447.60 in premiums = $2,847.60.

Without the cap, she would have kept paying $200 a month and spent $2,925 at the pharmacy alone. And if January’s $725 is too much at once, the free Medicare Prescription Payment Plan can spread it out. I explain how further down.

What if you only take generics?

This is most of my clients. If you take a few inexpensive generic drugs, you’ll likely never come close to the $2,400 cap. For you, the premium is the biggest cost, along with whether your plan charges the deductible on generics. A $37 premium versus a $170 premium is a difference of about $1,600 a year for the very same pills.

Paul’s Honest Take: Don’t pick a plan by premium alone, and don’t pick it by deductible alone. Add up all 12 months: premiums plus what your medicines will cost at your pharmacy. That total is the only number that matters.

All 9 stand-alone Part D plans for Long Island in 2027

Every stand-alone drug plan in New York is sold statewide, so all 9 are available to you whether you live in Freeport or Montauk. Here they are, sorted from lowest to highest premium, using figures from the New York State Office for the Aging.

How to read this table

• Look at the gap. Three plans cost about $40 a month. The other six cost $166 to $238. That’s a difference of $1,500 to $2,400 a year in premiums alone.
• A lower deductible costs you up front. AARP Preferred has a $300 deductible, which is $400 less than most. But its premium is about $2,400 a year more than the cheapest plans. For most people, that’s a bad trade.
• “Basic” vs. “Enhanced” describes how the plan is built, not how good it is. Enhanced plans may cover more drugs or have lower copays on some tiers. Judge them by your own medicines.
• Don’t go by the name. “Value Rx” is one of the most expensive plans on the list.
• The worst-case column is your true ceiling for covered drugs. Even in a terrible year, Margaret’s plan can’t cost more than $2,847.60.

Paul’s Honest Take: The expensive plans aren’t always wrong. A higher-premium plan can win if it covers a brand-name drug the cheaper plans don’t, or puts it on a much lower tier. That’s exactly why we run your actual medication list before recommending anything.

Stand-alone Part D vs. drug coverage inside a Medicare Advantage plan

There are two ways to get Part D on Long Island. Which one you need depends on how you get the rest of your Medicare.

There are far more Advantage choices than stand-alone choices on Long Island. For 2027, Nassau County has 28 standard Medicare Advantage plans and Suffolk has 18. A few of those plans don’t include drug coverage, so check before you enroll.

What’s the same either way

• The $2,400 yearly cap applies to every Part D plan, stand-alone or Advantage.
• Deductibles can’t be more than $700.
• Insulin is no more than $35 a month, and recommended vaccines are $0.
• The new negotiated drug prices apply to both.

What’s different

Advantage plans set their own drug deductibles and tiers. The three Long Island Advantage plans I reviewed for a client couple this season had drug deductibles of $275, $650 and $700, and all three offered $0 preferred generics at their preferred pharmacies. Never assume. Look up each plan’s drug costs the same way you would a stand-alone plan.

A trap that catches people every year

If you’re in a Medicare Advantage plan with drug coverage and you sign up for a stand-alone Part D plan, Medicare will take you out of your Advantage plan and put you back on Original Medicare. You’d lose your doctors’ network, your copays, your dental and your vision benefits. If you’re happy with your Advantage plan but unhappy with its drug costs, call me before you change anything.

Paul’s Honest Take: If you have a Medigap plan, you need a stand-alone Part D plan, so pick carefully from the 9. If you’re open to Medicare Advantage, compare your drug costs inside each Advantage plan along with your doctors and copays. Drugs are only one piece of the decision.

New savings for 2027: negotiated drug prices and the GLP-1 Bridge

15 more drugs get Medicare-negotiated prices on January 1, 2027

Medicare negotiated lower prices for 10 drugs starting in 2026. Now 15 more join the list. CMS expects about $685 million in out-of-pocket savings for people with Medicare, according to ElderLawAnswers.

What this means for you: The negotiated price lowers what the drug costs. You save the most when you’re paying a percentage of the price, such as during your deductible or on a coinsurance tier. If your plan charges a flat copay for the drug, your copay may not change much. Either way, cheaper drug prices can help keep plan costs down.

The Medicare GLP-1 Bridge: $50 a month for certain weight-loss drugs

This is a temporary Medicare program. It runs from July 1, 2026 through December 31, 2027. If you qualify, you pay $50 for a one-month supply of Wegovy (shot or pill), Zepbound KwikPen or Foundayo. Here’s what NCOA says you need to know:

• You must have a Part D plan or a Medicare Advantage plan with drug coverage.
• Your doctor must confirm you qualify. In general, that means a BMI of 35 or higher, or a lower BMI (27 to 30 and up) along with certain conditions like heart failure, high blood pressure that isn’t under control, kidney disease, prediabetes, or a past heart attack or stroke.
• Your doctor submits a prior authorization. It isn’t automatic, so you have to ask.
• The $50 does not count toward your Part D deductible or your $2,400 cap.
• Extra Help can’t lower the $50.

Learn more at Medicare.gov/glp1bridge or call 1-800-MEDICARE.

Paul’s Honest Take: If you’re already on Ozempic for diabetes, the Bridge doesn’t apply to you. Ozempic is covered through your regular Part D plan, and it’s one of the newly negotiated drugs. The Bridge is for weight-management drugs that Part D normally doesn’t cover.

New York’s two best-kept secrets: EPIC and Extra Help

This is the section most Long Islanders have never heard about, and it can save some families thousands of dollars.

EPIC: New York’s own drug coverage for seniors

EPIC (Elderly Pharmaceutical Insurance Coverage) is a New York State program. It works alongside your Part D plan and helps pay what Part D leaves behind. You don’t have to be low-income to qualify. Here’s what the Medicare Rights Center and the NY Department of Health say:

• Who qualifies: New York residents age 65 or older with yearly income up to $75,000 (single) or $100,000 (married), who aren’t on full Medicaid.
• It works with Medicare Advantage too, as long as your plan includes drug coverage.
• Copays after deductibles are just $3 to $20 per prescription.
• It can help pay your Part D premium. In 2026, EPIC paid up to $58.82 a month toward the premium for members with lower incomes.
• It covers many drugs Part D doesn’t.
• It gives you an extra chance to switch plans. EPIC members get one Special Enrollment Period a year to change their Part D or Advantage plan.

There are two EPIC plans, based on income:

Call the EPIC Helpline: 1-800-332-3742 (TTY 1-800-290-9138).

Extra Help: federal help with premiums, deductibles and copays

Extra Help (also called the Low-Income Subsidy, or LIS) is a federal program that can lower your drug costs dramatically. With full Extra Help in 2027:

• You pay $0 premium on Wellcare Classic or HealthSpring Assurance Rx, the two “benchmark” plans in New York. On any other plan, you pay a reduced premium.
• You pay no deductible.
• Your copays are small. In 2026 they were no more than $5.10 for generics and $12.65 for brand-name drugs.

In 2026, you could qualify with income up to about $24,180 a year (single) or $32,700 (married) and savings under about $18,090 or $36,100, according to NCOA. New limits are published early each year.

The New York back door to Extra Help

Here’s the part even many agents miss. If you qualify for New York’s Medicare Savings Program (MSP), you automatically get Extra Help too. New York’s MSP has no asset limit, and its income limits are higher. In 2026, they went up to $2,474 a month for a single person and $3,355 a month for a couple, according to New York legal aid figures. The MSP also pays your Part B premium.

So a retired couple with a paid-off house and savings in the bank, living on Social Security, may qualify. They’d get their Part B premiums paid, plus Extra Help on their drugs.

Paul’s Honest Take: I’ve watched clients go years without applying for these programs because they assumed they made too much. If your income is anywhere close to these numbers, apply. The worst they can say is no.

Three rules that can save (or cost) you real money

1. The Medicare Prescription Payment Plan: spread big costs over the year

Remember Margaret’s $725 January bill? Every Part D plan, stand-alone or Advantage, offers a free option to spread those costs into monthly payments. There’s no interest and no fee. You still pay the same total, just not all at once.

• It helps most if you have high drug costs early in the year.
• You can sign up any time during the year by contacting your plan.
• New for 2027: if you used it in 2026, you’re automatically re-enrolled for 2027, as Optum explains. But if you switch plans, you must sign up again with the new plan.

2. The late-enrollment penalty: it lasts as long as you have Part D

If you go 63 days or more without Part D or other “creditable” drug coverage after you first become eligible, Medicare adds a penalty to your premium. You pay it for as long as you have Part D.

The penalty is 1% of the national base premium for every month you went without coverage. For 2027, that base premium is $41.33, per CMS.

Example: Two years (24 months) without coverage = 24% × $41.33 = about $9.90 a month extra. That doesn’t sound like much until you realize it can last 20 years or more. And because it’s tied to the base premium, it can go up over time.

Paul’s Honest Take: Even if you take no medicines today, I usually suggest a low-cost Part D plan to protect yourself from the penalty and from a surprise diagnosis.

3. “Creditable coverage”: know where you stand

If you’re still working or have retiree coverage, you may not need Part D yet. But only if that drug coverage is creditable, meaning it’s at least as good as Medicare’s. Your employer or union must tell you in writing each year. Keep that letter. You’ll need it to prove you shouldn’t owe a penalty when you join Part D later.

Coverage from the VA and TRICARE generally counts as creditable. Coverage from a spouse’s employer may or may not. Ask the plan.

“Why won’t anyone help me with my drug plan?” The honest answer

If you’ve called several agents this fall and been turned away when you asked about a stand-alone Part D plan, you’re not imagining it. Here’s what’s going on behind the scenes.

For about three years now, the insurance companies that sell stand-alone Part D plans have not paid agents to help people enroll in them. Many agents’ professional liability insurance also won’t cover them for enrolling clients in plans they aren’t paid or authorized to sell. So a lot of agents simply stopped helping with Part D. It isn’t that they don’t care. They’re not allowed to do it safely.

The people this hurts most are folks with a Medicare Supplement. Every one of them needs a stand-alone drug plan, often has several prescriptions, and doesn’t want to sort through nine plans alone.

How we handle it at The Modern Medicare Agency

We still help. We just do it the right way:

1. You send us your medication list. We send you a simple form for every drug name, strength and how often you take it, plus your pharmacy.
2. We research it. We run your exact list through all 9 New York plans and find the lowest total yearly cost.
3. We give you our recommendation and step-by-step instructions to enroll yourself safely on Medicare.gov. It takes about 10 minutes.

There’s no cost to you.

Other free, unbiased help on Long Island

• HIICAP (New York’s free Medicare counseling program): 1-800-701-0501. Say “Nassau” or “Suffolk” and you’ll be connected to local counselors. Many Long Island libraries also host HIICAP sessions during Open Enrollment.
• Medicare: 1-800-MEDICARE (1-800-633-4227), 24 hours a day.
• Medicare Plan Finder: Medicare.gov/plan-compare
• EPIC Helpline: 1-800-332-3742

Paul’s Honest Take: Be careful with the TV ads and random callers promising to “lower your drug costs.” If someone won’t ask for your medication list first, they can’t possibly know which plan is cheapest for you.

How to pick the right Part D plan, step by step

The right plan for your neighbor may be the wrong plan for you. It all comes down to your medicines and your pharmacy.

Step 1: Make your medication list (the step almost everyone skips)

Most people I talk to can’t tell me the exact names and doses of everything they take. That’s normal, but no one can compare plans without it. Here’s the easy way:

• Gather every pill bottle, inhaler, pen and cream you use, including ones you only take now and then.
• Take a photo of each label with your phone, or write down what it says.
• For each one, write down: the exact name (like “atorvastatin” or “Eliquis”), the strength (like “20 mg”), and how often you take it (like “once a day”).
• Note whether it’s a 30-day or 90-day supply.
• Don’t forget anything your doctor plans to start in the coming months.

Step 2: Pick your pharmacy (or two)

On Long Island, most of my clients use CVS, Walgreens, Walmart or Costco. Prices for the same drug on the same plan can be very different at a “preferred” pharmacy than at a “standard” one. Many plans also offer lower prices by mail order. Decide where you’re willing to fill your prescriptions.

Step 3: Compare the total yearly cost

On Medicare.gov/plan-compare, enter your drugs and pharmacy. Then sort the plans by “lowest drug + premium cost.” That number already includes your premium, your deductible and your copays for the whole year. That’s the number to compare, not the premium.

Step 4: Check the fine print on your top choice

• Is every drug on the plan’s list (called the formulary)?
• Do any of your drugs need prior authorization, step therapy (trying a cheaper drug first), or have quantity limits?
• Is your pharmacy preferred for that plan?

Step 5: Enroll by December 7

You can enroll on Medicare.gov or by calling 1-800-MEDICARE. Your new plan starts January 1, 2027. If you’re changing stand-alone plans, the new one automatically replaces the old one, so you don’t need to cancel anything.

Step 6: Read your mail

Your current plan mailed you an Annual Notice of Change in September. It lists every change for 2027. If you didn’t read it, look your plan up now. Doing nothing means you stay in the same plan at the new 2027 price.

Paul’s Honest Take: Each spouse should be checked separately. Married couples often take very different medicines. The best plan for one of you may not be best for the other, and there’s no discount for being on the same plan.

9 Part D mistakes I see Long Islanders make every year

1. Letting the plan renew without looking. With the federal premium cushion gone, some plans jumped $50 a month or more. Staying put could cost you $600 or more extra this year.
2. Choosing the plan with the lowest premium, or the lowest deductible. Neither number alone tells you what you’ll pay. Only the total yearly cost does.
3. Thinking the premium counts toward the $2,400 cap. It doesn’t. Your worst case is premiums plus $2,400.
4. Not knowing your own medicine list. Without exact names and doses, no one can find you the right plan.
5. Using a “standard” pharmacy when a “preferred” one is down the road. The same prescription can cost noticeably more.
6. Signing up for a stand-alone Part D plan while in a Medicare Advantage plan. This takes you out of your Advantage plan.
7. Skipping Part D because you don’t take any medicines. The late penalty can follow you for life.
8. Never applying for EPIC, Extra Help or the Medicare Savings Program. New York’s limits are higher than most people think.
9. Waiting until December. Pharmacies, phone lines, HIICAP counselors and agents all get swamped. And the deadline doesn’t move: December 7.

Frequently asked questions

Is there a $0-premium stand-alone Part D plan on Long Island in 2027? No, not unless you get Extra Help. The lowest premium is $37.30 a month. With full Extra Help, Wellcare Classic and HealthSpring Assurance Rx are $0.

Does the $2,400 cap include my monthly premium? No. The cap only counts what you pay at the pharmacy: your deductible, copays and coinsurance. Premiums are on top of that.

What happens after I reach $2,400? You pay $0 for covered Part D drugs for the rest of the calendar year. The count starts over on January 1.

Do I have to pay the deductible on generic drugs? It depends on the plan. Many plans waive the deductible for their lowest-cost generic tiers. Check the plan’s Summary of Benefits.

My Medicare Supplement (Medigap) covers everything. Does it cover drugs? No. Medigap plans don’t cover prescriptions. You need a separate stand-alone Part D plan.

Are the plans different in Nassau and Suffolk? No. All 9 stand-alone plans are sold statewide at the same price. Medicare Advantage plans are a different story. Those vary by county.

Can I change my Part D plan after December 7? Usually not until next fall, with some exceptions. If you’re in Medicare Advantage, you can make one change from January 1 to March 31. You may also get a Special Enrollment Period if you move, lose other coverage, get Extra Help, or join EPIC.

What if a drug I take isn’t covered? Ask your doctor about a covered alternative. Or ask the plan for an “exception,” which your doctor supports in writing. If the plan says no, you can appeal.

My plan’s premium went way up. Did I do something wrong? No. The federal program that limited how much premiums could rise in one year has ended. Some plans raised prices sharply. That’s exactly why it pays to compare every fall.

Is insulin really capped at $35? Yes. Covered insulin is no more than $35 for a month’s supply on every Part D plan, and the deductible doesn’t apply.

The bottom line

For 2027, Part D on Long Island comes down to three things:

1. Your total yearly cost (premiums plus what your medicines cost at your pharmacy) is the only number that matters.
2. The $2,400 cap protects you in a bad year. Just remember the premium is extra.
3. Don’t auto-renew this year. With the premium cushion gone, the plan that was right in 2026 may not be right in 2027.

And if your income is anywhere near the limits, look into EPIC, Extra Help and the Medicare Savings Program. They’re some of the most valuable programs New York has to offer.

Want a second set of eyes on your drug plan?

There’s no pressure and no cost. Reach out whichever way is easiest for you:

• Call or text: 631-358-5793. I answer my own phone.
• Email: medicare@paulbinsurance.com
• Request our free medication list form and we’ll run your drugs through all 9 plans for you.
• Come to a free Medicare seminar or webinar. See upcoming dates at paulbinsurance.com.

Paul Barrett, CMIP, is the founder of The Modern Medicare Agency in Melville, NY. He’s an independent, Medicare-only broker with 18+ years of experience, the author of Medicare Mastery Unlocked, and host of the Wise Guys Retirement Talk podcast.

We do not offer every plan available in your area. Currently we represent 9 organizations which offer 24 products in Nassau County and 16 products in Suffolk County. Please contact Medicare.gov, 1-800-MEDICARE (TTY 1-877-486-2048), or your local State Health Insurance Program (SHIP) to get information on all of your options. Figures in this article come from CMS, New York State and other public sources as of October 30, 2026, and may change. Always confirm plan details on Medicare.gov before you enroll. This article is for education only and isn’t legal or tax advice.

Sources

• New York State Office for the Aging: 2027 Stand-Alone Part D Plans in New York
• NY Health Access: 2027 Medicare Part D Plans in New York State
• CMS: CY 2027 Part D Bid Information and Demonstration Announcement
• KFF: Many Part D Stand-Alone Enrollees Will See Modest Increases for 2027, but Others Could Pay Much More
• Optum: 3 Key Part D Changes in 2027
• ABC7 NY: A New Medicare Season Begins
• ElderLawAnswers: 2027 Will Bring Lower Prices for 15 Part D Drugs
• NCOA: The Medicare GLP-1 Bridge Program
• Medicare Rights Center: EPIC Program Overview
• NY Department of Health: EPIC 2026 Program Highlights
• NCOA: 2026 Part D Extra Help Eligibility and Benefits Chart
• Medicare Savings Programs in New York, 2026
• NYSOFA: HIICAP