Medicare Advantage

Part D's $2,400 Cap: Bennington, VT 2027

BENNINGTON, Vt. — Starting January 1, 2027, no one with a Medicare Part D drug plan will pay more than $2,400 out of pocket for covered prescriptions in a calendar year. The out-of-pocket cap that began in 2025 is the biggest shift in how Medicare pays for medicine in a generation, and the 2027 figure lands just as Bennington residents are sorting through their choices during the fall Annual Enrollment Period, which runs through December 7.

Here is what actually changed, and what to think about before you lock in coverage for 2027.

The Part D cap, in plain English

Under the Inflation Reduction Act, Medicare set a hard ceiling on what you pay for covered Part D drugs. The ceiling was $2,000 in 2025 and $2,100 in 2026. For 2027, it moves to $2,400. Once your out-of-pocket spending on covered drugs hits that number, you pay $0 for the rest of the year on those drugs.

This applies whether you have a stand-alone Part D plan or a Medicare Advantage plan that includes drug coverage. It does not apply to drugs your plan doesn't cover, so the plan's formulary still matters.

Source: CMS — Medicare Part D program rules (medicare.gov).

The "donut hole" is gone

If you remember the old coverage gap — the middle stretch where costs jumped — that phase was eliminated in 2025 and stays gone in 2027. Part D now has three simpler phases:

1. Deductible — up to a maximum of $700 in 2027 (plans can set it lower, or use no deductible). 2. Initial coverage — you pay a share of the cost until you hit $2,400 out of pocket. 3. Catastrophic coverage — you pay nothing more for covered drugs the rest of the year.

That's it. No more confusing middle phase where prices suddenly climbed.

The Medicare Prescription Payment Plan

Here's a piece many Bennington readers have asked about: what if you hit expensive months early in the year — say, a $900 prescription in January?

The Medicare Prescription Payment Plan lets you spread your out-of-pocket drug costs across the calendar year in monthly installments instead of paying the pharmacy all at once. It's optional, free to join, and available through your Part D plan. You still pay the same total; you just smooth the timing.

It can help most if you have high drug costs early in the year. It may not help if your costs are low or spread evenly. You can sign up any time during the year through your plan.

What's available around Bennington

Bennington is in Bennington County, where plan availability — how many stand-alone Part D plans and how many Medicare Advantage plans with drug coverage are offered — is set at the county level by CMS and participating insurers. The specific count changes year to year as carriers enter or leave the market.

To see the exact plans available to your ZIP code for 2027, use the Plan Finder at medicare.gov, which pulls current, CMS-verified data. You can also call 1-800-MEDICARE.

A note on higher incomes (IRMAA)

If your income is above $109,000 as a single filer (or $218,000 married filing jointly) based on your 2024 tax return, you'll pay an income-related surcharge called IRMAA on top of your Part D premium in 2026. Social Security notifies you if this applies. You can appeal if you've had a life-changing event like retirement or a spouse's death.

Key dates to keep on the fridge

• October 15 – December 7, 2026: Annual Enrollment Period. Join, switch, or drop Part D or Medicare Advantage plans for 2027.
• January 1, 2027: New coverage — and the $2,400 cap — takes effect.
• January 1 – March 31, 2027: Medicare Advantage Open Enrollment. If you're in a Medicare Advantage plan, you get one chance to switch to another MA plan or return to Original Medicare.