Medicare Part D
Why Joliet Sees a Firm Medicare Part D Cap in 2026
JOLIET, Ill. — On Jan. 1, 2026, Medicare Part D did something it had never done before: put a firm ceiling on what you pay out of pocket for covered prescription drugs. That ceiling was $2,100 for 2026, and it rises to $2,400 for 2027. Once you hit it, you pay nothing more for the rest of the year on drugs your Part D plan covers.
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Key takeaways
- The Part D out-of-pocket cap is $2,100 in 2026 and $2,400 in 2027 for covered prescription drugs. Once you reach it, you pay nothing more for covered drugs the rest of the year.
- The old Part D "donut hole" is gone, leaving a simpler three-phase structure: deductible, initial coverage, and catastrophic coverage where you pay nothing more once you hit the cap.
- The Medicare Prescription Payment Plan is a free, optional program offered through every Part D plan that lets you spread your drug costs into monthly bills instead of paying it all at the pharmacy.
- People with higher incomes may owe an extra IRMAA charge on top of their Part B and Part D premiums, and it's worth reviewing your plan options during the Annual Enrollment Period, which runs October 15 through December 7.
For Will County residents comparing coverage during this fall's Annual Enrollment Period, which runs Oct. 15 through Dec. 7, 2026, the Part D changes remain the biggest shift in years. Here's what's changing for 2027, in plain English.
The Part D out-of-pocket cap, explained
In 2027, no one enrolled in a Medicare Part D plan — whether it's a stand-alone drug plan or the drug coverage built into a Medicare Advantage plan — will pay more than $2,400 out of pocket for covered prescriptions during the calendar year. That's up from the $2,100 cap in 2026, and the figure is indexed to rise modestly each year.
A few things to keep in mind:
- The cap applies to what you pay for covered drugs (deductibles, copays, coinsurance). It does not include your monthly premium.
- It only counts drugs your plan covers. If a medication isn't on your plan's formulary, those costs don't count toward the cap.
- The Part D maximum deductible is $615 in 2026 and $700 in 2027, per CMS.
The "donut hole" is gone — for good
For years, the coverage gap, or "donut hole," was one of the most confusing parts of Medicare. You'd hit a middle stretch where your share of drug costs jumped, then eventually reach "catastrophic" coverage.
That's over. As of 2025, Part D has just three phases: the deductible, the initial coverage phase, and catastrophic coverage — where you pay nothing more once you hit the annual cap. The 2027 rules keep that simpler three-phase structure in place.
For Joliet residents who take several brand-name medications, this is the change most likely to be felt at the pharmacy counter.
The Medicare Prescription Payment Plan
Hitting the annual cap is helpful — but $2,400 in January isn't the same as $2,400 spread across the year. That's where the Medicare Prescription Payment Plan comes in.
This is a free, optional program available through every Part D plan. Instead of paying a large amount at the pharmacy when you pick up an expensive prescription, you can spread your out-of-pocket drug costs across the remaining months of the calendar year in monthly bills from your plan.
A few things to know:
- It doesn't lower your total drug costs — it just smooths them out.
- You still pick up your prescriptions at the pharmacy; the plan handles billing.
- You can opt in before the year starts or at any point during the year by contacting your Part D plan.
For people on a fixed income who take a high-cost medication early in the year, this option can make budgeting more predictable.
What this looks like in Joliet
Joliet is in Will County, where Medicare beneficiaries choose from a mix of stand-alone Part D drug plans and Medicare Advantage plans that include drug coverage. Both types of plans must follow the 2027 rules — the $2,400 cap, the $700 maximum deductible, and access to the Prescription Payment Plan. The 2027 lineup for each plan appears in its Annual Notice of Change and on Medicare.gov's Plan Finder.
Plan formularies, pharmacy networks, and premiums, however, still vary from plan to plan. That's why CMS encourages every beneficiary to review their Annual Notice of Change letter each fall and compare options during AEP.
Higher-income filers: watch IRMAA
If your income is above $109,000 as a single filer (or $218,000 filing jointly) in 2026, you may owe an Income-Related Monthly Adjustment Amount, or IRMAA, on top of your standard Part B and Part D premiums. IRMAA is based on your tax return from two years earlier and is billed separately by Medicare. It's worth checking if a recent income change — a home sale, a Roth conversion, an inheritance — could push you into a higher bracket.
Key dates to circle
- Oct. 15 – Dec. 7, 2026: Annual Enrollment Period. Join, switch, or drop a Part D or Medicare Advantage plan for 2027.
- Jan. 1, 2027: New $2,400 cap and updated Part D rules take effect.
- Jan. 1 – March 31, 2027: Medicare Advantage Open Enrollment. If you're in a Medicare Advantage plan, you get one chance to switch to another MA plan or return to Original Medicare.
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 Will County
(MA penetration in Will 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). There's a hard yearly cap on what you pay out of pocket for covered drugs — $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 Prescription Payment Plan, do I pay less overall?
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.