WASHINGTON — Millions of older Americans shopping for Medicare drug coverage this month face monthly premium increases of $50 or more if they stay in their current plan, after the federal government ended a temporary subsidy that had held stand-alone Part D prices down for two years.

Premiums for some stand-alone prescription drug plans are rising by $50 or more a month in 2027, adding at least $600 a year for people who keep their existing coverage, NBC News reported on Saturday, citing an analysis by the health policy group KFF. Roughly 25 million people have stand-alone Part D coverage, which pairs with traditional Medicare rather than a private Medicare Advantage plan.

The increases matter because most beneficiaries never compare plans. Nearly 70% keep the same coverage from one year to the next without checking the alternatives, according to a 2024 KFF analysis, and anyone who does nothing before the Dec. 7 deadline will be rolled into their current plan at its 2027 price.

The sharpest increases fall on UnitedHealthcare's AARP-branded plans, which together enrolled more than 2 million people without low-income subsidies in 2026, according to KFF. The AARP Medicare Rx Preferred plan will cost $50 or more a month extra in all 50 states and the District of Columbia for enrollees who stay put, with increases above $75 in 37 states and above $100 in four. The AARP Medicare Rx Saver plan rises by $50 or more in 33 states.

Averages tell a gentler story. The Centers for Medicare and Medicaid Services said on Sept. 28 that the average monthly premium for stand-alone drug plans would rise by less than $1, from $35.09 to $36. CMS Administrator Dr. Mehmet Oz said in the agency's announcement that "by slashing handouts to big insurance companies, CMS is keeping premiums stable."

The handouts Oz referred to were payments under the Part D Premium Stabilization Demonstration, a voluntary program created in 2024 to cushion insurers after the Inflation Reduction Act redesigned the drug benefit. In 2025 it cut the base premium by $15 and capped year-on-year increases at $35; in 2026 it was scaled back to a $10 cut and a $50 cap. It cost $9.8 billion over the two years, according to the Government Accountability Office.

CMS had said the program could run for at least three years but announced in July that it would end after 2026. Oz described the subsidies as a bailout of the insurance industry and said plans had had time to adjust, AARP reported.

KFF's analysts, Juliette Cubanski, Nancy Ochieng and Meredith Freed, wrote that the end of the demonstration did not produce broad premium increases, but that it likely explains why no stand-alone plan will be free next year and why some increases now exceed $50, since the cap no longer applies.

About 28% of stand-alone enrollees, roughly 4 million people, paid no premium in 2026, KFF said. All of them will pay something in 2027, whether they switch or not.

"The bottom line is that it will pay to shop around," Cubanski, who directs KFF's Medicare policy program, told AARP.

The cheapest options come from Centene. Its Wellcare Value Script plan costs $5.30 a month in 45 states and Wellcare Classic $7.30 in 33 states, according to KFF. Choice is narrowing. The number of stand-alone plans falls from 360 offered by 17 parent companies in 2026 to 316 offered by 15 in 2027, and the average beneficiary will have nine plans to choose from, down from 11, the fourth consecutive annual decline, KFF said. Health Care Service Corporation is withdrawing its HealthSpring Extra Rx plan from 22 regions and CVS Health is pulling SilverScript Choice from 13. Humana is the only insurer offering three plans in all 34 Part D regions.

The picture is different for the roughly 51% of Medicare's 70.6 million enrollees in private Medicare Advantage plans, which can use federal rebate dollars to lower drug premiums. CMS projects the average Medicare Advantage premium will fall 16.5% to $12 a month, and that the drug portion of those plans will drop 38% to $7. About eight in 10 Medicare Advantage members can keep their plan at the same or a lower premium, the agency said.

Other costs are moving up regardless of plan. The Part D out-of-pocket cap rises from $2,100 to $2,400 in 2027 under the 2022 drug pricing law, and the maximum deductible climbs from $615 to $700, according to CMS's payment policy for the year. The 2026 Medicare Trustees Report projects the standard Part B premium will rise $6.60 to $209.50 a month, TheStreet reported.

"We urge beneficiaries to use Open Enrollment as an opportunity to review their coverage," Oz said in the CMS statement. The agency said people can compare plans through the Medicare Plan Finder at Medicare.gov, call 1-800-MEDICARE or consult free State Health Insurance Assistance Program counsellors.

Open enrollment began on Oct. 15 and closes on Dec. 7. Medicare Advantage members who want to change again will get a second window from Jan. 1 to March 31, 2027, but people in stand-alone drug plans will be locked into their choice for the full year.