New rules for 2027 expand access to infusion therapies, but gaps between Medicare’s parts can still cost people with movement disorders thousands of dollars. Open enrollment starts Oct. 15 2026. Here’s what people living with movement disorders need to know before choosing next year’s coverage.
If you’re a professional caregiver or a family member helping a loved one navigate insurance, the Caregiver Action Network (CAN) is a resource you can’t do without. This year, it offered a free webinar, “Medicare Made Clear: A Caregiver’s Guide to Understanding Coverage Before Open Enrollment,” to help anyone make sense of the changes coming in 2027. Caregiving isn’t limited to bathing, meals, and medication schedules. It also means sorting through premiums, comparing drug plans, and standing up for your loved one when a claim is denied. CAN helps caregivers handle all of it, so they can spend less time on paperwork and more time with the people they care for.
For about 9 in 10 people with Parkinson’s disease who rely on Medicare, the program is less a single insurance plan than a maze of lettered parts. Each part has its own rules, costs and blind spots. For people with progressive movement disorders, knowing which door to walk through can mean the difference between affordable care and a surprise bill. That maze gets its yearly reset soon. Medicare’s open enrollment runs Oct. 15 through Dec. 7, and any changes people make take effect Jan. 1, 2027. Some of next year’s numbers are already set. Others won’t be announced until November. The biggest change for Parkinson’s patients is the cost of prescription drugs. The yearly limit on what people pay for medications is rising by $300, the largest jump since the cap was created. At the same time, one drug used to treat movement disorders is getting a much lower Medicare price.
Here’s what people living with Parkinson’s, progressive supranuclear palsy, multiple system atrophy, corticobasal degeneration, essential tremor, dystonia, and related conditions need to know.
The parts of Medicare, briefly
Medicare Part A covers hospital care, including inpatient surgery, skilled nursing facility stays and home health care. Most people don’t pay a monthly premium for Part A if they or their spouse worked and paid Medicare taxes long enough. In 2026, patients pay a $1,736 deductible for each benefit period. The 2027 amount is expected in the fall.
Medicare Part B covers care you get outside the hospital, and it’s the part most people with movement disorders use the most. It pays for neurologist visits, lab work and imaging. It also covers physical, occupational and speech therapy, plus medical equipment like walkers and wheelchairs.
Part B costs $202.90 a month in 2026. Medicare’s trustees project it will rise to about $209.50 a month in 2027. The official figure, along with next year’s deductible, is usually announced in late October or November. In 2026, you pay the first $283 of your Part B care each year, called the deductible. After that, you usually pay 20% of the cost, and Medicare pays the rest.
Medicare Advantage, also called Part C, puts all of these benefits into one plan run by a private insurance company. Most of these plans also cover prescription drugs. In 2027, the most a plan can charge you out of pocket for care from its doctors is $9,850 a year, up from $9,250 in 2026. Many plans set a lower limit.
Medicare Part D pays for the prescription drugs you take at home. That includes most Parkinson’s medications, like carbidopa/levodopa, dopamine agonists and MAO-B inhibitors. There’s also a limit on how much you pay each year. In 2027, the most you’ll spend out of pocket on covered drugs is $2,400, up from $2,100 in 2026. After that, Medicare pays the rest. Plans can also charge a deductible of up to $700 before coverage begins, up from $615.
Even with the increase, the cap can save a lot of money for people who take several brand-name drugs. But patients who reach it every year should plan on paying $300 more in 2027. The trade-off is that you usually have to see doctors in the plan’s network. Some treatments also need the plan’s approval first, called prior authorization. That can make it harder to see a movement disorder specialist.
Medigap plans work differently. They’re sold by private insurance companies to people on Original Medicare, meaning Parts A and B. Medigap helps pay the costs Medicare doesn’t, like deductibles and the 20% share. Some Medigap plans cover all of those costs.
A lower price for a movement disorder drug
Starting Jan. 1, 2027, Medicare will pay a negotiated price for 15 more brand-name drugs. One of them is Austedo, used to treat tardive dyskinesia and chorea in Huntington’s disease. According to the Centers for Medicare & Medicaid Services, a 30-day supply of Austedo had a list price of $6,623 in 2024. Medicare’s negotiated price for 2027 is $4,093, a 38% drop. The negotiated price is what Medicare pays, not what patients pay at the pharmacy. But it can lower out-of-pocket costs, especially for people who pay a percentage of a drug’s price. None of the 15 drugs treat Parkinson’s itself.
The drug coverage trap
Many people assume Part D covers all prescription drugs. It doesn’t. According to Medicare.gov, Part B covers some drugs too. These are usually drugs given through medical equipment, like an infusion pump, or drugs a doctor or nurse gives you as a shot or IV. For people with Parkinson’s, that difference matters.
In January 2026, Medicare began covering external infusion pumps used to treat Parkinson’s. That opened a path to continuous levodopa therapies, which can smooth out the “off” periods many patients dread. But there’s a catch. If you take levodopa pills, Part D covers them, and the $2,400 yearly cap protects you. If you switch to a pump therapy like Vyalev or Duopa, your main Parkinson’s treatment may be billed under Part B instead. With Part B, you usually pay 20% of the cost, and Original Medicare has no yearly limit on that. A Medigap plan can help cover it.
The same split shows up in other treatments. Botox shots given in a neurologist’s office are usually covered by Part B. These include shots for neck spasms (cervical dystonia), eyelid spasms (blepharospasm) and drooling. Flu, pneumonia and COVID-19 vaccines are also covered by Part B. They’re free if your provider accepts Medicare’s approved price. Shingles and RSV vaccines are covered by Part D. The same drug can fall under either part, depending on how and where you get it. Before you start a new treatment, especially a pump, ask your neurologist’s office and your plan which part will pay for it.
Medicare before 65
Parkinson’s doesn’t only affect older adults. Some people have to stop working before 65 because of young-onset Parkinson’s or another movement disorder. For them, the path to Medicare goes through Social Security Disability Insurance, or SSDI. According to the Center for Medicare Advocacy, people under 65 can get Medicare after they’ve received SSDI payments for 24 months. There’s also a five-month wait before those payments start. Altogether, it can take about two and a half years from the date Social Security says your disability began to your first day of Medicare.
Parkinson’s doesn’t skip this wait. Only ALS and end-stage kidney disease do. That’s why it’s important to apply for disability benefits as early as you can. People with progressive supranuclear palsy, multiple system atrophy or corticobasal degeneration may get approved for disability faster. That’s because these conditions are on Social Security’s Compassionate Allowances list, which fast-tracks serious illnesses. But they still have to wait 24 months for Medicare.
Once you’re on Medicare, you get the same coverage as people 65 and older. As the Center for Medicare Advocacy points out, services “do not have to be related to the individual’s disability” to be covered. If you want to keep working, you can do that without losing Medicare right away. First, a nine-month Trial Work Period lets you try working while keeping your benefits. After that, Medicare can continue for up to 93 more months, and you still won’t pay a premium for Part A. In total, you can keep Medicare for up to eight and a half years while working. After that, you can keep it longer by paying premiums.
The protection every patient should know about
Perhaps the most important rule for people with progressive conditions is also the least understood: Medicare can’t deny therapy just because a patient isn’t getting better. “Physical therapy and other services can be covered even if they are only expected to maintain or slow deterioration,” according to the Center for Medicare Advocacy. The group specifically names Parkinson’s among the conditions protected against unfair denials. This principle comes from the 2013 Jimmo v. Sebelius settlement. It means coverage can’t be denied based on a diagnosis alone, a need for long-term care, or a lack of expected improvement.
Speech therapy programs like LSVT LOUD, balance-focused physical therapy and occupational therapy that helps patients stay independent are all eligible, even when the goal is holding ground rather than gaining it. Patients told they’ve “plateaued” have grounds to appeal, and a letter from their neurologist explaining why the care is needed can carry a lot of weight.
Help for people with limited income
Costs add up fast when you need frequent specialist visits, ongoing therapy and several medications. Four Medicare Savings Programs, run by each state, can help pay those costs. Many people who qualify never apply. The most helpful is the Qualified Medicare Beneficiary program, or QMB. It pays your Part A and Part B premiums, your deductibles, and your share of the cost for care.Under the current limits, you can qualify if you’re single, earn up to $1,350 a month, and have up to $9,950 in savings and other assets. For married couples, the limits are $1,824 a month and $14,910. The limits are usually updated each spring. With QMB, doctors and hospitals can’t bill you for any care Medicare covers.
Two other programs pay just your Part B premium, which would save about $2,500 a year in 2027 at the projected rate:
- Specified Low-Income Medicare Beneficiary, or SLMB: for single people earning up to $1,616 a month.
- Qualifying Individual, or QI: for single people earning up to $1,816 a month.
A fourth program, called Qualified Disabled and Working Individual, or QDWI, pays the Part A premium for people with disabilities who have gone back to work.
If you qualify for QMB, SLMB or QI, you’ll also get Extra Help automatically. Extra Help lowers what you pay for prescription drugs. In 2026, you pay no more than $12.65 for each covered drug. That amount is adjusted each year. With Part D costs rising in 2027, Extra Help is worth even more.
Even if your income is a little too high, it’s still worth applying. Medicare.gov says you “may still qualify for these programs in your state even if your income or resources are higher than the federal limits.” To apply, contact your state Medicaid office, not Medicare.
What else to watch in 2027
- Telehealth: Medicare’s expanded telehealth coverage has been extended through Dec. 31, 2027. That helps people who have trouble traveling to a movement disorder specialist.
- Prior authorization pilot: A pilot program that began in 2026 requires approval first for certain Original Medicare services in six states: Arizona, New Jersey, Ohio, Oklahoma, Texas and Washington. Patients in those states who are planning advanced procedures should ask their care team whether the rules affect them.
- Coordinated care: Advanced Primary Care Management services, added in 2026, support coordinated, personalized care for people who see several specialists.
A note on referrals
Nearly every service a person with a movement disorder depends on over the long term falls under federal self-referral rules known as the Stark Law. That includes therapy, imaging, lab work, home health and medical equipment. The Centers for Medicare & Medicaid Services keeps a list of these “designated health services,” updated each January. For patients, the takeaway is simple. When a neurology practice refers you to its own therapy clinic, imaging center or equipment supplier, it’s a recommendation, not a requirement. You have the right to choose where you get care.
What you can do before open enrollment
- Read your plan’s Annual Notice of Change, which should arrive by Sept. 30. It lists what’s changing in your coverage next year.
- Make sure your Parkinson’s medications are still on your plan’s list of covered drugs for 2027, and check whether their price tier changed.
- Compare plans on Medicare.gov between Oct. 15 and Dec. 7.
- If you’re on Medicare Advantage, confirm that your movement disorder specialist and hospital are still in your plan’s network.
- Before starting a pump therapy or new injection, ask which part of Medicare will pay and what your share will be.
- If you’re on Original Medicare, consider a Medigap plan, especially if advanced therapies may be in your future.
- Check whether you qualify for a Medicare Savings Program or Extra Help, even if your income seems a little too high.
- Appeal any therapy denial based on a lack of improvement.
- Contact your State Health Insurance Assistance Program for free, unbiased counseling.
The bottom line
For most people with Parkinson’s, Medicare will cost more in 2027. A patient on Original Medicare who reaches the drug cap can expect to pay about $380 more than this year, based on the higher cap and the projected Part B premium. That’s before any change to the Part B deductible. Medicare Advantage members could face a higher out-of-pocket limit, too. The coverage is there, and some of it is getting better. The challenge is knowing where to find it, and this fall’s open enrollment is the time to look.
Resources for all caregivers can be found at https://www.caregiveraction.org.
This is one of many services offered by CAN for anyone in a position to support a loved one living with Parkinson’s disease or another movement disorder, dementia, or the everyday challenges of aging. Whether you’re just starting to sort through Medicare options or you’re years into the caregiving journey, CAN can help you find resources, connect with others who understand, and make informed decisions about your loved one’s care. You don’t have to navigate it alone.
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