Medicare Part D
Lafayette Part D 2027: phases & yearly cap
LAFAYETTE, Ind. — If you take prescription drugs and rely on Medicare, 2027 brings a few numbers worth knowing by heart. Part D — the part of Medicare that helps pay for prescription drugs — now works in three phases, with a firm yearly cap on what you pay out of pocket. Here in Lafayette, and across Tippecanoe County, the rules are the same as they are nationwide, because Part D is a federal program.
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Speak to a Licensed Insurance Agent
Click to call 855-729-3240Key takeaways
- In 2027, Part D drug coverage has three phases: a deductible phase, an initial coverage phase, and a catastrophic phase, and the old "donut hole" gap no longer exists.
- The most any plan can charge as a Part D deductible is $615 in 2026 and $700 in 2027, though some plans set it lower or skip it for certain drug tiers.
- Once your out-of-pocket spending on covered drugs reaches the yearly cap — $2,100 in 2026 and $2,400 in 2027 — you pay $0 for covered Part D drugs for the rest of the year, and this cap resets every January.
- A Medicare Prescription Payment Plan lets you spread your Part D costs into monthly payments at no extra fee, though it doesn't reduce the total amount you owe.
A clearer look at Part D for 2027
This guide walks through how Part D is set up for 2027, what the cap really means, and how to think about your choices during open enrollment.
The three phases of Part D in 2027
Since 2025, the old “donut hole” coverage gap is gone. Part D now moves through three phases in a plan year:
1. Deductible phase. You pay the full negotiated price for your drugs until you meet your plan’s deductible. The maximum Part D deductible any plan can charge is $615 in 2026 and $700 in 2027. Some plans set a lower deductible, and some drug tiers may skip the deductible entirely. 2. Initial coverage phase. After the deductible, you pay a copay or coinsurance for each prescription, and your plan pays the rest. You stay in this phase until your out-of-pocket spending on covered drugs hits the yearly cap. 3. Catastrophic phase. Once your out-of-pocket drug spending reaches the yearly cap — $2,100 in 2026 and $2,400 in 2027 — you pay $0 for the rest of the calendar year on covered Part D drugs. That’s the hard cap, and it resets every January.
Only what you actually spend on covered drugs counts toward the $2,100 in 2026 ($2,400 in 2027) — premiums do not count.
What the Part D cap really means
Before 2024, there was no yearly limit on Part D out-of-pocket costs. People with expensive drugs could pay many thousands of dollars a year. The cap changed that.
Once your covered drug spending adds up to the yearly cap — $2,100 in 2026 and $2,400 in 2027 — you’re done paying at the pharmacy counter for the rest of the year for drugs your plan covers. This is a program-wide rule set by CMS — it applies whether your Part D coverage comes through a stand-alone drug plan or is built into a Medicare Advantage plan.
The Medicare Prescription Payment Plan
There’s also an option called the Medicare Prescription Payment Plan. It lets you spread your Part D out-of-pocket costs across the year in monthly payments instead of paying big amounts at the pharmacy.
It does not lower what you owe — the total is the same — but it can smooth things out if you have a costly month early in the year. You can ask your drug plan to enroll you, and there’s no extra fee to use it.
Where Lafayette fits in
Lafayette is in Tippecanoe County, where Medicare beneficiaries can choose Part D coverage in one of two ways: a stand-alone Part D drug plan paired with Original Medicare, or a Medicare Advantage plan that includes drug coverage. Multiple carriers offer plans in the county each year.
Availability, formularies (the list of covered drugs), pharmacy networks, and premiums vary plan by plan. The rules above — the $615 maximum deductible, the three phases, the cap ($2,100 in 2026, $2,400 in 2027) — apply across all Part D plans, but which specific drugs are covered and at what tier is set by each plan.
To compare what’s actually available in your ZIP code, the Medicare Plan Finder at medicare.gov lets you enter your prescriptions and see how each plan would handle them.
A note on higher-income enrollees (IRMAA)
If your income is above $109,000 as a single filer (or $218,000 filing jointly) based on your 2024 tax return, you may pay an IRMAA surcharge on top of your Part D premium in 2026. Social Security will notify you if this applies. It’s a monthly amount added to your premium, not to your drug costs.
Key dates to remember
- Annual Enrollment Period: October 15 – December 7, 2026. This is when you can join, switch, or drop a Part D or Medicare Advantage plan for 2027 coverage.
- Medicare Advantage Open Enrollment: January 1 – March 31. If you’re already in a Medicare Advantage plan, you can switch to another Advantage plan or return to Original Medicare (with a stand-alone Part D plan) once during this window.
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 Tippecanoe County
(MA penetration in Tippecanoe 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”) is eliminated as of 2025 (three phases now). There’s now a hard yearly cap of $2,100 in 2026 ($2,400 in 2027) on what you pay out of pocket for covered drugs, 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
Do my monthly premiums count toward the $2,100 cap?
What if my drug isn’t on my plan’s formulary?
Does the $2,100 cap apply to insulin or vaccines?
- CMS — Medicare Part D program rules (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.