Medicare Part D
The $2,100 Part D cap and what it means in Jonesboro
JONESBORO, Ark. — On Jan. 1, 2027, the yearly limit on what people with Medicare Part D drug coverage pay out of pocket for prescriptions rises to $2,400 for the year. Once you reach that amount, your covered drugs cost you nothing more for the rest of the calendar year. It's one of the biggest shifts to Medicare in years — and if you take expensive medicines, it changes the math in a real way.
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Key takeaways
- Starting January 1, 2027, the yearly out-of-pocket cap for Medicare Part D prescription costs is $2,400, and covered drugs cost nothing more once you hit that limit.
- The Part D coverage gap, or "donut hole," is gone as of 2025, leaving just three phases: deductible, initial coverage, and catastrophic (where you pay nothing).
- The Medicare Prescription Payment Plan is a free, program-wide option that lets you spread your out-of-pocket drug costs into monthly bills across the year instead of paying it all at once.
- If your 2024 income was above $109,000 (single) or $218,000 (joint), you'll owe an IRMAA surcharge on top of your Part D premium in 2026, though you can appeal if your income has since dropped.
Here's a plain-language look at what's changing, what stayed, and how the new monthly payment option works.
The $2,100 cap, in plain English
Medicare Part D is the part of Medicare that helps pay for prescription drugs. For years, there was no true ceiling on what you could spend out of pocket. That changed in 2025, when Congress set the cap at $2,000. The cap is $2,100 in 2026 and $2,400 in 2027.
What counts toward the cap? Your deductible, copays, and coinsurance for covered Part D drugs. What doesn't count? Your monthly premium, and drugs that aren't on your plan's formulary.
The maximum Part D deductible any plan can charge is $615 in 2026 and $700 in 2027, according to CMS. Plans can set a lower deductible, but not a higher one.
The "donut hole" is gone
If you've had Medicare for a while, you probably remember the coverage gap — often called the donut hole. That was a middle stretch where you suddenly paid more out of pocket after your drug spending hit a certain point.
As of 2025, the coverage gap is eliminated. Part D now has just three phases:
1. Deductible phase — you pay the full negotiated price until you meet the deductible (up to $700 in 2027). 2. Initial coverage phase — you pay a share (copay or coinsurance) and your plan pays the rest, until your out-of-pocket spending hits $2,400. 3. Catastrophic phase — you pay nothing for covered drugs for the rest of the year.
That's it. No more surprise jump in the middle of the year.
The Medicare Prescription Payment Plan
Hitting $2,400 in January or February can still hurt if it lands all at once. That's where the Medicare Prescription Payment Plan comes in — a free option that lets you spread your out-of-pocket drug costs across the calendar year in monthly bills.
A few things to know:
- It's optional. You have to opt in.
- It doesn't lower your total costs — it just smooths them out.
- You pay nothing at the pharmacy counter for covered drugs; the plan bills you monthly instead.
- You can sign up before the year starts or during the year through your Part D plan.
For someone who fills a high-cost prescription early in the year, this can be the difference between one large January bill and twelve smaller monthly bills.
What this means in Jonesboro
Jonesboro sits in Craighead County, where Medicare beneficiaries choose Part D coverage either through a stand-alone drug plan (paired with Original Medicare) or through a Medicare Advantage plan that includes drug coverage. The $2,400 cap and the payment plan option apply to both routes — they're program-wide rules, not plan-specific perks. The 2027 lineup for Craighead County is in each plan's ANOC and on Medicare.gov's Plan Finder.
If you want to see what's offered in Craighead County, the Plan Finder tool at Medicare.gov lets you compare by ZIP code, enter your prescriptions, and see estimated yearly costs.
Higher earners: watch for IRMAA
If your income is above $109,000 as a single filer (or $218,000 filing jointly) 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 by mail if this applies. You can appeal if your income has dropped due to a life event like retirement.
Key dates to keep on the fridge
- Oct. 15 – Dec. 7, 2026 — Medicare Annual Enrollment Period. This is when you can join, switch, or drop a Part D or Medicare Advantage plan for 2027.
- Jan. 1, 2027 — new $2,400 cap takes effect.
- Jan. 1 – March 31, 2027 — Medicare Advantage Open Enrollment (for people already in an MA plan who want to switch once).
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 Craighead County
(MA penetration in Craighead 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”) is eliminated as of 2025 (three phases now). There's a hard yearly cap of $2,400 in 2027 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
Does the $2,400 cap include my monthly premium?
If I sign up for the payment plan, do I still hit the $2,400 cap?
What if my drug isn't on my plan's formulary?
- CMS — Medicare Part D program rules (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.