Medicare Part D

Medicare's $2,400 Drug Cap in 2027: What Stamford Should Know

STAMFORD, Conn. — If you take prescription drugs and have Medicare, 2027 brings another update to Part D. Starting January 1, your out-of-pocket spending on covered prescriptions will be capped at $2,400 for the year. Once you hit that number, you pay $0 for the rest of 2027 on covered Part D drugs.

Stamford seniors, here's what's shifting on Jan. 1

That's a hard ceiling written into federal law — and for Stamford residents managing insulin, cancer medications, blood thinners, or other high-cost prescriptions, it may be the most important Medicare update to understand this Annual Enrollment Period (October 15 – December 7).

The Part D cap, in plain English

Before 2025, Part D had four phases and no true annual limit on what you could spend at the pharmacy counter. People with expensive drugs sometimes paid thousands out of pocket each year.

Here's what 2027 looks like:

• Deductible phase: You pay up to the plan's deductible, which cannot exceed $700 in 2027.
• Initial coverage phase: You pay a share of drug costs (coinsurance or copays set by your plan).
• Catastrophic phase: Once your out-of-pocket costs reach $2,400, you pay nothing more for covered Part D drugs the rest of the year.

That's it — three phases. The old "donut hole" coverage gap was eliminated in 2025 and is not coming back.

What counts toward the $2,400?

Only your out-of-pocket spending on covered Part D prescriptions counts. That includes your deductible, copays, and coinsurance for drugs on your plan's formulary.

What doesn't count: your monthly Part D premium, over-the-counter medications, and drugs your plan doesn't cover. If you're unsure whether a specific medication is on your plan's formulary, check with the plan directly or use the Plan Finder tool at Medicare.gov.

The Medicare Prescription Payment Plan: spreading the cost

Hitting $2,400 in January is possible if you take a very expensive drug. To help with that timing problem, Medicare created the Prescription Payment Plan — an optional program that lets you spread your out-of-pocket drug costs across the calendar year in monthly payments instead of paying the pharmacy all at once.

A few things to know:

• It's optional and free to join.
• You don't save money overall — you pay the same total, just monthly.
• You can sign up before the plan year starts or any month during the year.
• You request it through your Part D plan (not through Medicare directly).

This can be helpful if a big pharmacy bill in January would strain your budget. It's less useful if your drug costs are modest and spread out already.

Stamford is in Fairfield County — here's how that matters

Medicare plan availability is set at the county level, not the city level. Stamford is in Fairfield County, where Connecticut residents choose from a range of stand-alone Part D plans and Medicare Advantage plans that include drug coverage. The exact number of options changes each year as carriers file new plans with CMS; the 2027 lineup is in each plan's ANOC and on Medicare.gov's Plan Finder.

Because the annual cap is a federal rule, every Part D plan and every Medicare Advantage plan with drug coverage must honor it in 2027 — no matter which one you pick. What varies plan to plan is the premium, the deductible (up to the $700 max in 2027), the formulary, and the pharmacy network.

IRMAA: the income surcharge to watch

If your income is higher than average, you may pay an Income-Related Monthly Adjustment Amount on top of your Part D premium. In 2026, IRMAA surcharges start for single filers with modified adjusted gross income above $109,000 (higher thresholds apply for married couples filing jointly). Social Security uses your tax return from two years earlier to determine this.

If your income has dropped since then — because of retirement, a spouse's death, or another life event — you can ask Social Security to reconsider.

Key dates for Stamford residents

• October 15 – December 7, 2026: Medicare Annual Enrollment Period. Change or join a Part D or Medicare Advantage plan for 2027.
• January 1, 2027: New coverage begins. The $2,400 cap starts.
• January 1 – March 31: Medicare Advantage Open Enrollment. If you're in a Medicare Advantage plan, you can switch to another MA plan or return to Original Medicare once during this window.