Medicare Part D

How Medicare Part D Changed for Elkhart in 2026

Medicare's prescription drug coverage got a real makeover over the past two years, and 2027 keeps that momentum going. If you live in Elkhart and take even one prescription, it's worth knowing how Part D is structured now — because the rules that apply to your wallet have changed in ways that favor most people.

Here's a plain-language walk-through of the 2027 deductible, the out-of-pocket cap, and the three phases your drug costs move through during the year.

The three phases of Part D in 2027

Since 2025, Part D has had three phases instead of four. The coverage gap — the "donut hole" that used to trip people up — is officially retired. Here's what replaces it:

1. Deductible phase. You pay the full negotiated price of your drugs until you meet your plan's deductible. The maximum deductible is $615 in 2026 and $700 in 2027, per CMS. Some plans set it lower, and some drugs may be covered before you hit the deductible.

2. Initial coverage phase. After the deductible, you pay a copay or coinsurance for each prescription while your plan pays the rest. You stay in this phase until your out-of-pocket spending hits the annual cap.

3. Catastrophic phase. Once your out-of-pocket costs reach the annual cap — $2,100 in 2026 and $2,400 in 2027 — you pay nothing for the rest of the year on covered Part D drugs. This is the big one — a hard ceiling that didn't exist before 2025.

What the $2,100 cap actually covers

The cap applies to what you spend out of pocket on drugs covered by your Part D plan (or the drug portion of a Medicare Advantage plan that includes drug coverage). Premiums don't count toward the cap, and drugs your plan doesn't cover don't count either. That's why checking a plan's formulary — its list of covered drugs — matters as much as looking at the price tag.

Once you hit $2,100 in a calendar year, the meter resets on January 1.

Spreading costs with the Payment Plan

A cap of $2,100 is good news, but hitting it in January when you fill an expensive prescription can still sting. That's what the Medicare Prescription Payment Plan is for.

You can opt in through your Part D plan, and instead of paying a big bill at the pharmacy counter, your yearly drug costs get spread into monthly payments billed by your plan. It doesn't lower what you owe overall, and it isn't automatic — you have to sign up. But for people on fixed incomes, it can smooth out a rough month.

What this looks like in Elkhart

Elkhart is in Elkhart County, where residents choose from a range of stand-alone Part D plans as well as Medicare Advantage plans that bundle in drug coverage. Availability is set at the county level, so two neighbors in different counties may see different plan menus even if they use the same pharmacy.

The federal rules — the maximum deductible, the out-of-pocket cap, the three phases — apply the same way no matter which plan you pick or where in Indiana you live. The 2027 plan lineup for Elkhart County is detailed in each plan's Annual Notice of Change and on Medicare.gov's Plan Finder.

When you can make changes

Two windows matter most:

• Annual Enrollment Period: October 15 through December 7. This is when anyone with Medicare can join, switch, or drop a Part D plan for the following year.
• Medicare Advantage Open Enrollment Period: January 1 through March 31. If you're already in a Medicare Advantage plan, you can switch to another one or return to Original Medicare with a stand-alone Part D plan.

One note on higher incomes: if your income was above $109,000 as a single filer (based on your 2024 tax return for 2026 premiums), you may pay an IRMAA surcharge on top of your Part D premium. That's set by Social Security, not your plan.