Medicare Part D
Benton retirees: how the $2,400 Part D cap and monthly payment plan work in 2027
BENTON, Ark. — If you take prescription drugs and have Medicare, the Part D out-of-pocket cap is changing again for 2027. Starting January 1, no one with a Medicare drug plan will pay more than $2,400 out of pocket for covered prescriptions in a calendar year. That single number — a hard ceiling set by Medicare — is what Benton residents in Saline County should have front of mind as Annual Enrollment runs through December 7.
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Will your prescriptions still be covered in 2027?
Part D plans rewrite their drug lists every year — tiers move, pharmacies change, drugs drop off. One call checks your exact medications against the 2027 plans in your area.
- Every prescription checked, name by name
- Your pharmacy checked for preferred pricing
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Key takeaways
- In 2027, your out-of-pocket costs for covered Part D drugs are capped at $2,400 for the year.
- The coverage gap ("donut hole") has been eliminated; Part D now has three phases — deductible, initial coverage, and catastrophic.
- The Part D deductible can be no higher than $700 in 2027, though plans may set it lower.
- The Medicare Prescription Payment Plan is optional and free to join, and it spreads your drug costs into monthly payments instead of paying all at once at the pharmacy.
The cap is part of a bigger reset. The old "donut hole" coverage gap is gone. And a newer tool, the Medicare Prescription Payment Plan, lets you spread your drug costs across the year in monthly bills instead of paying big amounts at the pharmacy counter.
Here is what changed, how it fits together, and how to think through your choices.
What the Part D cap actually means
Once your out-of-pocket spending on covered prescriptions hits $2,400 in 2027, you pay nothing for the rest of the year on those drugs. That includes what you pay toward your deductible and your share of costs during the initial coverage phase.
A few things the cap does not cover:
- Your monthly Part D premium.
- Drugs your plan does not cover (non-formulary drugs).
- Over-the-counter medicines.
- Drugs paid for outside your Part D plan.
If you have been rationing pills or skipping refills because of cost, this ceiling is the change most worth understanding right now.
The end of the donut hole
For years, Part D had four phases, and the "coverage gap" in the middle was where many people got hit with higher costs. That gap is gone. As of 2025, Part D has three phases:
1. Deductible phase — you pay full negotiated price until you meet your plan's deductible (no more than $700 in 2027). 2. Initial coverage phase — you pay a copay or coinsurance; your plan pays the rest. 3. Catastrophic phase — once you hit the $2,400 cap, you pay nothing for covered drugs the rest of the year.
Simpler math, and a clear finish line.
The Medicare Prescription Payment Plan
Here is where a lot of people in Benton get confused. Even with the cap ($2,100 in 2026, $2,400 in 2027), someone with an expensive prescription could still hit that ceiling in a single month early in the year. That is a real problem if the bill lands in January.
The Medicare Prescription Payment Plan (sometimes called "M3P") lets you say to your drug plan: don't charge me at the pharmacy — send me a monthly bill instead. Your total for the year is the same, but it is broken into predictable monthly payments through December.
A few things to know:
- It is optional. You have to opt in.
- It is free — there is no fee to participate.
- It does not lower what you owe; it only spreads it out.
- You can sign up before the plan year starts or any month during the year.
- It works best for people who face large drug costs early in the year. For someone with low, steady costs, it may not be worth the paperwork.
Your drug plan (or the Part D portion of your Medicare Advantage plan) is who you contact to enroll.
How to think through your choices during AEP
Annual Enrollment runs October 15 through December 7, 2026. Changes you make take effect January 1, 2027.
A few questions worth asking before you decide:
- Are my drugs on my plan's 2027 formulary? Plans update their drug lists every year. A drug covered in 2026 may not be covered the same way in 2027.
- What pharmacies are preferred? In-network and preferred pharmacies usually cost less.
- Would the payment plan help me? If you take a high-cost specialty drug, smoothing payments could ease cash flow.
- Do I qualify for Extra Help? The federal Low-Income Subsidy can lower drug costs substantially for people who qualify.
Benton is in Saline County, and the Medicare drug plans and Medicare Advantage plans with drug coverage available to you are set at the county level. You can compare every option side-by-side using the Plan Finder at medicare.gov.
A word on higher incomes and IRMAA
If your income (from two years back) is above $109,000 as a single filer for 2026, you will pay an Income-Related Monthly Adjustment Amount, or IRMAA, on top of your Part B and Part D premiums. This is not new, but the threshold has moved for 2026, so it is worth checking if you are near the line.
Where to get real, personalized help
The rules above apply to everyone with Part D. What is right for you depends on your drugs, your pharmacy, and your budget. For personalized help:
- Medicare.gov — use the Plan Finder to compare plans available in Saline County.
- 1-800-MEDICARE (1-800-633-4227) — available 24/7.
- Arkansas SHIIP (Senior Health Insurance Information Program) — free, unbiased Medicare counseling from trained volunteers. Call 1-800-224-6330.
By the numbers
Medicare Part B premium, 2006–2026
The standard monthly Part B premium has climbed from $88.50 in 2006 to $202.90 in 2026. Hover any point for that year’s premium.
Source: CMS. Standard premium shown; in some hold-harmless years many existing enrollees paid less. Confirm at Medicare.gov.
By the numbers
How people get Medicare in Saline County
(MA penetration in Saline County)
MA penetration from CMS enrollment data; Medigap share is an estimate. U.S. average is about 54% Medicare Advantage. These are area-level figures, not plan-specific.
Prescription coverage
How Medicare Part D works in 2027
The old coverage gap (“donut hole”) was eliminated as of 2025 (three phases now). For 2027, there's a hard yearly cap of $2,400 on what you pay out of pocket for covered drugs, and you can spread those costs across the year with the Medicare Prescription Payment Plan.
Try it
How the 2026 Part D drug cap works
Slide to your estimated yearly prescription costs and see how the new $2,100 out-of-pocket cap protects you. This illustrates the standard Part D benefit; your plan may structure costs differently.
Once your out-of-pocket spending on covered drugs reaches $2,100, you pay nothing more for the rest of 2026. Confirm details at Medicare.gov.
Explore
When can you enroll? An interactive year
Enrollment windows are federal and the same nationwide. Confirm your personal dates at Medicare.gov or 1-800-MEDICARE.
Good to know
Frequently asked questions
When does the $2,100 Part D cap start?
Does the cap include my monthly premium?
How do I sign up for the Medicare Prescription Payment Plan?
What if I miss the December 7 deadline?
- CMS — Medicare Part D program rules (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.
Also for Benton
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This page was last updated: October 6, 2026.