Medicare Part D

Part D in 2027: Norwalk, CT Drug Cap Guide

NORWALK, Conn. — Starting January 1, 2026, no one with a Medicare Part D drug plan will pay more than $2,100 out of pocket for covered prescriptions in a calendar year. It is the second year of the hard cap Congress built into the Inflation Reduction Act, and it is $100 higher than the 2025 ceiling of $2,000. For Norwalk residents choosing a drug plan this fall, that number — and a lesser-known monthly payment option — should shape how you compare coverage during Open Enrollment.

What the $2,400 cap actually means

The cap applies to what you pay out of pocket at the pharmacy for drugs covered by your Part D plan. That includes your deductible and your share of the cost during the year. It does not include your monthly premium, and it does not include drugs your plan does not cover.

Once your out-of-pocket spending reaches $2,400 in 2027, you move into the catastrophic phase and pay nothing more for covered prescriptions until the calendar resets on January 1, 2028. The Part D deductible can be no higher than $615 in 2026 and $700 in 2027, though some plans set it lower.

This is a real change for people who take expensive brand-name or specialty drugs. Before 2024, there was no annual limit at all on Part D out-of-pocket spending.

The coverage gap is gone

If you have been on Medicare for a while, you probably remember the "donut hole" — the confusing middle stretch where your costs jumped after you and your plan hit a spending trigger. That phase was eliminated in 2025 and stays gone in 2027.

Part D now has three phases, in order:

1. Deductible — you pay full negotiated price until you meet the plan's deductible (up to $700 in 2027). 2. Initial coverage — you pay a share (often 25%) until your out-of-pocket total reaches $2,400 in 2027. 3. Catastrophic — you pay nothing for covered drugs for the rest of the year.

That is it. No more math about "true out-of-pocket" thresholds and no more sticker shock in the middle of the year.

The Medicare Prescription Payment Plan

Here is the piece a lot of people miss. Even with a $2,400 cap in 2027, you could still face a big bill in January if an expensive prescription lands early in the year. The Medicare Prescription Payment Plan — sometimes called "M3P" — lets you spread those costs into monthly installments billed by your Part D plan, instead of paying it all up front at the pharmacy counter.

A few things to know:

• It is free to sign up. There is no interest and no fee.
• It does not lower your total drug costs — it just spreads them over the remaining months of the year.
• You can enroll before the year starts or at any point during the year, though signing up earlier gives you more months to spread payments across.
• It works best for people with high or unpredictable drug costs. If your prescriptions are inexpensive, it may add paperwork without much benefit.

You sign up through your Part D plan, not through Medicare directly.

What Norwalk readers should do this fall

Norwalk is in Fairfield County, where Medicare beneficiaries can choose among stand-alone Part D plans and Medicare Advantage plans that include drug coverage. Availability and formularies vary, so the plan that fit you in 2026 may not be the same fit in 2027. The 2027 lineup is in each plan's Annual Notice of Change and on Medicare.gov's Plan Finder.

A few common mistakes to avoid during Open Enrollment (October 15 – December 7):

• Assuming your current plan is unchanged. Every fall, plans send an "Annual Notice of Change." Read it. Premiums, drug lists, and pharmacy networks can shift.
• Comparing only premiums. A low monthly premium can come with a higher deductible or different drug tiers. Look at total expected cost for your prescriptions.
• Forgetting about IRMAA. Higher-income beneficiaries pay an income-related surcharge on Part B and Part D. In 2026, IRMAA begins above $109,000 in income for a single filer, based on your 2024 tax return.
• Skipping the payment plan question. If your drug costs are high, ask whether M3P makes sense for you before January hits.

You can compare plans at medicare.gov, by calling 1-800-MEDICARE, or with free one-on-one help from CHOICES, Connecticut's State Health Insurance Assistance Program (SHIP).