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Board reviews 2027 Medicare benefit updates as CMS raises Part D out‑of‑pocket cap to $2,400
Summary
The Public Employees Benefits Board reviewed proposed 2027 Medicare benefit design changes, including CMS raising the Part D true out‑of‑pocket (TROOP) threshold from $2,100 to $2,400 and Kaiser proposals to expand nonemergency medical transportation and increase mail‑order supplies to 100 days.
The Public Employees Benefits Board on June 25 reviewed proposed 2027 Medicare benefit design changes, including a federal update to the Medicare Part D true out‑of‑pocket (TROOP) threshold and carrier proposals to expand transportation and pharmacy access.
Laura Ryan, retiree benefits manager, told the board that "for this year, 2026, that maximum was $2,100, and CMS has set the maximum to $2,400 for 2027," a change that applies across PEB plans with Part D coverage. Ryan said the TROOP increase will apply to Kaiser Northwest and Washington Medicare Advantage plans, UnitedHealthcare Medicare Advantage plans and the Uniform Medical Plan with Part D.
Ryan reviewed carrier proposals that would affect member access: Kaiser plans proposed expanded nonemergency medical transportation—"including nonemergency medical transportation by wheelchair and gurney vans"—at a $0 copay but subject to prior authorization for specific destination transfers (for example, hospital to skilled nursing facility). Kaiser also proposed increasing permitted mail‑order refills for maintenance medications to a 100‑day supply, intended to improve medication adherence and reduce pharmacy workload.
Staff said there are no benefit design changes for some plans beyond the Part D TROOP update; specifically, UnitedHealthcare Medicare Advantage, UMP Medicare Classic with Part D and Premera Medicare supplement plans F and G will only reflect the federal TROOP change. The agency will bring draft resolutions reflecting these benefit changes and the related premiums to the board for action at a future meeting.
The board did not take a final vote on benefit design at this session; staff said draft resolutions and the premium proposals will be on the July 9 agenda.
