Medicare Part D
Orlando Medicare Part D: $2,100 Cap Starts January 2026
ORLANDO, Fla. — Starting January 1, 2027, no one with Medicare Part D will pay more than $2,400 out of pocket for covered prescription drugs in a calendar year. The out-of-pocket cap rises from $2,100 in 2026, and for Orlando-area retirees who take costly medicines, the change lands right in the middle of Annual Enrollment (October 15 – December 7).
Compare Medicare Part D options near you
Answer 3 quick questions to see Medicare Part D listings from licensed insurance partners.
What’s your ZIP code?
Plan availability is set by your county, so we start here.
How old are you?
This helps match you with options you’re eligible for.
Do you have Medicare Parts A & B?
This affects which Medicare Part D options you can choose.
These listings are provided by licensed insurance partners.
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
Available now — current wait: 0 min
A real person answers. No phone menu, ever.
Advertising disclosure: MyMedicarePlans.org may be compensated when you contact a partner or licensed agent. Listings are not ranked or endorsed by us, and we do not recommend specific plans. You can also contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.
Speak to a Licensed Insurance Agent
Click to call 855-729-3240Key takeaways
- The Part D out-of-pocket cap is $2,100 in 2026 and $2,400 in 2027. Once you hit that amount, covered prescriptions are $0 for the rest of the calendar year.
- The old coverage gap, or "donut hole," is gone, leaving just three phases: deductible (up to $615 in 2026 and $700 in 2027), initial coverage, and catastrophic coverage.
- The Medicare Prescription Payment Plan is a free, opt-in option that lets you spread your out-of-pocket drug costs into monthly bills instead of paying it all at once at the pharmacy.
- Annual Enrollment runs October 15 through December 7, 2026, and any plan changes you make take effect January 1, 2027.
Here's what's actually changing, in plain English.
The 2027 cap: a hard ceiling on drug costs
For 2027, Medicare sets the Part D out-of-pocket maximum at $2,400, up from $2,100 in 2026. Once your spending on covered prescriptions hits that number, you pay $0 for the rest of the year on those drugs. This cap applies whether you have a stand-alone Part D plan or drug coverage built into a Medicare Advantage plan.
A few things to know:
- The cap counts what you pay (and certain payments made on your behalf) for drugs on your plan's formulary.
- Premiums don't count toward the cap.
- Over-the-counter medicines and drugs not covered by your plan don't count either.
This is a program-wide rule set by CMS under the Inflation Reduction Act. It applies the same way in Orange County as it does anywhere else in the country.
The "donut hole" is gone
If you've had Medicare for a while, you probably remember the coverage gap — the dreaded "donut hole" where your share of drug costs jumped in the middle of the year. That phase was eliminated in 2025.
Part D now has just three phases: 1. Deductible — up to a maximum of $700 in 2027, up from $615 in 2026 (plans can set a lower one, or none). 2. Initial coverage — you pay a share of costs until you hit the yearly cap. 3. Catastrophic coverage — you pay $0 for covered drugs the rest of the year.
No more falling into a gap partway through the year. The math is simpler, and the ceiling is firm.
The Medicare Prescription Payment Plan
Here's the piece a lot of people miss. Even with the yearly cap, some folks could face a big bill in January or February if they fill an expensive prescription early in the year. That's where the Medicare Prescription Payment Plan comes in.
It's a free, optional program that lets you spread your out-of-pocket drug costs across the calendar year in monthly installments instead of paying the pharmacy all at once. You still pay the same total — up to the yearly cap — but the payments arrive as a monthly bill from your plan rather than a lump sum at the counter.
Who might find it helpful:
- People who take a high-cost specialty drug.
- People who hit their deductible in the first month or two.
- Anyone on a tight fixed monthly budget.
You have to opt in — it doesn't happen automatically. You can enroll before the plan year starts or any time during the year. Contact your Part D or Medicare Advantage plan to sign up.
What this means during Annual Enrollment
Annual Enrollment runs October 15 through December 7, 2026. Any changes you make take effect January 1, 2027.
For Orlando residents, plan availability is set at the county level. Orlando is in Orange County, where a range of stand-alone Part D plans and Medicare Advantage plans with drug coverage are offered each year. To see the current options in your ZIP code, use the Plan Finder at Medicare.gov.
A few things worth checking during AEP:
- Is every drug you take still on your plan's formulary for 2027?
- Are your pharmacies still in the plan's preferred network?
- Has your monthly premium or deductible changed?
Plans send an Annual Notice of Change (ANOC) each fall spelling out what's different for the coming year. In Orange County, 30 continuing plans are changing something in their terms for 2027, so it's worth 15 minutes of your time.
A quick note on higher incomes (IRMAA)
If your income is above $109,000 as a single filer (or $218,000 filing jointly) in 2026, you'll pay an income-related monthly adjustment amount, or IRMAA, on top of your Part B and Part D premiums. It's based on your tax return from two years earlier. If your income has dropped since then — retirement, loss of a spouse, reduced work hours — you can ask Social Security to reconsider.
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 Orange County
(MA penetration in Orange 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). The yearly out-of-pocket cap on covered drugs is $2,100 in 2026 and $2,400 in 2027, 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 pay more overall?
What if I hit $2,400 in March?
- CMS — Medicare Part D program rules (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.