Medicare Part D
Part D's $2,400 Drug Cap in 2027: Prairie Village, KS
PRAIRIE VILLAGE, Kan. — Starting Jan. 1, 2027, the way you pay for prescription drugs under Medicare Part D changes again. The annual out-of-pocket cap at the pharmacy counter adjusts to $2,400. Once you hit that number, your covered Part D drugs cost you nothing for the rest of the year.
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Click to call 855-729-3240Key takeaways
- Starting January 1, 2027, the Medicare Part D annual cap on out-of-pocket drug costs is $2,400, and covered drugs cost nothing for the rest of the year once you hit that amount.
- The old coverage gap, or "donut hole," is gone, leaving Part D with just three phases: deductible, initial coverage, and catastrophic.
- The Medicare Prescription Payment Plan is a free, optional program that lets you spread your out-of-pocket drug costs into monthly installments instead of paying it all at once.
- For 2026, IRMAA surcharges begin for single filers with income above $109,000, based on your tax return from two years earlier, so plan details are worth reviewing during the Oct. 15–Dec. 7 Annual Enrollment Period.
Prairie Village retirees, here's what's new for Part D in 2027
This is one of the biggest changes to Medicare in years, and it lands right as the Annual Enrollment Period (Oct. 15 – Dec. 7) is underway. Here's a plain-English look at what's different and what it means for households in Johnson County.
The Part D out-of-pocket cap, explained
Before 2024, there was no ceiling on how much a person could spend out of pocket on Part D drugs in a year. People taking expensive specialty medications could pay many thousands of dollars.
In 2025, Medicare set the first-ever cap at $2,000. The cap is $2,100 in 2026 and $2,400 in 2027. Once your out-of-pocket spending on covered Part D drugs hits the annual cap, you pay nothing for the rest of that year on those covered drugs.
A few things to keep in mind:
- The cap applies to Part D drugs — the medications you pick up at the pharmacy. It does not cover Part B drugs (like most infusions given in a doctor's office).
- Premiums don't count toward the $2,100 in 2026 ($2,400 in 2027).
- The Part D maximum deductible is $615 in 2026 and $700 in 2027, though many plans set theirs lower.
The "donut hole" is gone
If you've been on 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's over. As of 2025, the coverage gap was eliminated. Part D now has just three phases: the deductible, the initial coverage phase, and the catastrophic phase (where you pay nothing after hitting the annual cap). It's a much simpler structure.
The Medicare Prescription Payment Plan
Hitting the annual cap sounds great — but what if most of that spending lands in January and February? For people on high-cost drugs, a big bill early in the year can still be painful.
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.
A few basics:
- You still pay the same total amount — this is a smoothing tool, not a discount.
- You sign up through your Part D or Medicare Advantage drug plan, not through Medicare directly.
- You can opt in before the year starts or at any point during the year.
- If you rarely hit high drug costs, this program may not help you much. It's designed for people facing large bills.
If you're not sure whether it fits your situation, your plan is required to give you information about it.
What Prairie Village residents should do during AEP
Prairie Village is in Johnson County, where Medicare beneficiaries have a range of stand-alone Part D and Medicare Advantage plans with drug coverage to choose from during Annual Enrollment (Oct. 15 – Dec. 7). For 2027, the county has 29 Medicare Advantage plans from 7 carriers, with 6 new plans, 16 not returning, and 14 renamed; Blue Cross Blue Shield (HCSC) is not offering plans in the county next year. Even though the cap applies to every Part D plan, the details vary a lot from plan to plan:
- Formularies (the list of covered drugs) differ.
- Deductibles can vary, up to the annual maximum ($615 in 2026; $700 in 2027).
- Pharmacy networks — including which local pharmacies are "preferred" — vary.
- Tier placement of your specific medications affects what you pay before reaching the cap.
A plan that worked well for you in 2026 may look different in 2027. Insurers can change formularies and cost-sharing each year, and they're required to send you an Annual Notice of Change every fall. Read it.
If you have Medicare Advantage, you also get a second window: the Medicare Advantage Open Enrollment Period, Jan. 1 – March 31, when you can switch Advantage plans or return to Original Medicare.
A quick note on IRMAA
If your income is on the higher side, you may pay an income-related surcharge on top of your Part B and Part D premiums. For 2026, IRMAA begins for single filers with income above $109,000 (and higher thresholds for married couples filing jointly). This is based on your tax return from two years ago, so 2024 income drives 2026 premiums.
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 Johnson County
(MA penetration in Johnson 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). For 2027, there’s a hard yearly cap of $2,400 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
Does the $2,100 cap include my monthly premium?
If I take only generic drugs, will this change help me?
Do I have to sign up for the Prescription Payment Plan?
- CMS — Medicare Part D program rules (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.