Medicare Part D

North Lauderdale Part D in 2027: the $2,400 ceiling and the monthly payment option

NORTH LAUDERDALE, Fla. — The hard yearly ceiling on Part D out-of-pocket costs, which took effect in 2026, moves up for 2027. Starting Jan. 1, 2027, no one with a Medicare drug plan will pay more than $2,400 out of pocket for covered prescriptions in a calendar year. That ceiling replaced the old system where costs could keep piling up long past the point most household budgets could handle.

The change matters right now because Medicare's Annual Enrollment Period runs Oct. 15 through Dec. 7, and the plan you pick — or keep by default — is the plan that will apply this new rule to your medicines in January.

What the Part D cap actually does

Once your out-of-pocket spending on covered Part D drugs hits the yearly cap, you pay $0 for the rest of the year on those covered prescriptions. The cap is $2,100 in 2026 and $2,400 in 2027. It includes what you pay toward your deductible and your share of costs in the initial coverage phase.

A few things the cap does not do: it doesn't cover drugs your plan doesn't list on its formulary, and it doesn't apply to Part B drugs (like most infusions given in a doctor's office). Your monthly Part D premium also isn't counted toward the cap.

The Part D maximum deductible is $615 in 2026 and $700 in 2027, though individual plans may set theirs lower.

The coverage gap is gone

For years, Part D had a confusing middle stage called the coverage gap, or "donut hole," where your costs jumped after you and the plan had spent a certain amount together. That phase was phased out and is officially eliminated.

Part D now has three phases instead of four:

1. Deductible phase — you pay full negotiated price until you meet the plan's deductible (up to $700 in 2027). 2. Initial coverage phase — you pay a copay or coinsurance; the plan pays the rest. 3. Catastrophic phase — once your out-of-pocket total reaches the yearly cap ($2,400 in 2027), you pay nothing more for covered drugs the rest of the year.

That's it. No more math about a fourth stage.

The Medicare Prescription Payment Plan

Even with a $2,400 ceiling in 2027, hitting that number in January or February can be a shock. That's where the Medicare Prescription Payment Plan comes in.

This is a free, optional program. Instead of paying the pharmacy directly for your share, you pay $0 at the counter and your plan bills you monthly, spreading your yearly drug costs into smoother payments across the calendar year. You still owe the same total — the program doesn't lower your costs — but it changes the timing.

It tends to help most if you have one or two high-cost prescriptions that would otherwise cost hundreds of dollars in a single month. You can opt in through your Part D or Medicare Advantage drug plan; participation is your choice.

How this looks in North Lauderdale

North Lauderdale is in Broward County, where residents on Original Medicare can pair coverage with a stand-alone Part D plan, or get drug coverage bundled inside a Medicare Advantage plan. For 2027, CMS Landscape files list 87 Medicare Advantage plans from 16 carriers in the county. The 2027 rules — the $2,400 cap, the three phases, the payment plan option — apply to both routes.

If you're already enrolled, your plan should have mailed you an Annual Notice of Change in September explaining what's different for 2027. In Broward County, 41 continuing plans change something in their terms for 2027, 29 plans are not returning, 16 are new, and 19 have been renamed. It's worth reading the ANOC before Dec. 7, especially the formulary section, since a drug moving to a different tier can change how quickly you reach the ceiling.

For free, unbiased help specific to your situation, Florida's State Health Insurance Assistance Program (SHINE) offers one-on-one counseling to Broward County residents at no cost.