Medicare Part D

How the 2027 Part D Cap Works for Topeka Medicare

TOPEKA, Kan. — Starting January 1, 2027, no one with a Medicare Part D drug plan will pay more than $2,400 out of pocket for covered prescriptions in a calendar year. The out-of-pocket cap moves up from $2,100 in 2026, and it's one reason this fall's Medicare Annual Enrollment Period — October 15 through December 7 — deserves a careful look, especially if your prescription costs have felt unpredictable.

Here's what's actually changing, how the new payment plan works, and where Topeka readers can get free, unbiased help before the December deadline.

The Part D out-of-pocket cap, in plain English

For 2027, Medicare Part D has a hard ceiling on what you pay out of pocket for covered drugs: $2,400 for the year. Once your out-of-pocket spending on covered prescriptions reaches that number, you pay $0 for covered drugs for the rest of the calendar year.

A few important details from CMS:

• The maximum Part D deductible is $615 in 2026 and $700 in 2027. Plans can set a lower deductible, but not higher.
• The cap applies to what you pay out of pocket on covered drugs — not the retail price of the medication.
• Premiums don't count toward the cap.
• The cap resets each January.

If you take even one high-cost specialty medication, this ceiling can meaningfully change how you plan your year.

The "donut hole" is gone

You may still hear neighbors talk about the coverage gap — the old middle stage where costs used to jump. That gap was eliminated in 2025. Part D now has just three phases:

1. Deductible (up to $700 in 2027, if your plan has one) 2. Initial coverage — you pay a share of drug costs 3. Catastrophic coverage — after you hit $2,400 out of pocket, you pay nothing for covered drugs

That's it. No more surprise middle stage where a familiar prescription suddenly costs more.

The Medicare Prescription Payment Plan

Here's the piece a lot of Topeka readers are just now hearing about: the Medicare Prescription Payment Plan, sometimes called "M3P" or drug cost smoothing.

Instead of paying a large amount at the pharmacy counter in a single month, you can choose to spread your out-of-pocket drug costs across the calendar year in monthly bills from your Part D plan.

Key points:

• It's optional. You have to opt in.
• It does not lower your total drug costs — it just spreads them out.
• You can sign up before the plan year starts or during the year.
• It's most useful for people who face a big out-of-pocket bill early in the year (for example, hitting a large share of the $2,400 in January or February).

If your prescriptions tend to be inexpensive and steady, this program may not do much for you. If you have one costly drug that lands hard in one month, it can make cash flow easier.

How to decide during AEP in Topeka

Topeka is in Shawnee County, where Medicare beneficiaries choose among Part D drug plans and Medicare Advantage plans with drug coverage sold in the county. Availability, formularies (the list of drugs a plan covers), and pharmacy networks are set at the county level — so a plan available in Shawnee County may not be sold the same way one county over.

Rather than starting from "which plan is best," start from your own information:

1. Make a current list of your prescriptions, including dose and how often you fill each one. 2. List the pharmacies you actually use in Topeka — a plan's price for the same drug can differ between pharmacies. 3. Use the Plan Finder at Medicare.gov, which lets you enter your drugs and ZIP code and compare every Part D and Medicare Advantage-with-drug plan sold in Shawnee County side by side. 4. Check the formulary — the $2,400 cap only applies to drugs your plan covers. If a drug isn't on the formulary, those costs don't count toward the cap. 5. Ask about the Prescription Payment Plan if a big monthly bill would strain your budget.

Two dates to keep in mind:

• Oct. 15 – Dec. 7, 2026: Annual Enrollment Period. Changes take effect Jan. 1, 2027.
• Jan. 1 – March 31, 2027: Medicare Advantage Open Enrollment. If you're already in a Medicare Advantage plan, you get one chance in this window to switch to another MA plan or return to Original Medicare.

A quick note on higher-income surcharges

If your income is above certain thresholds, you pay an Income-Related Monthly Adjustment Amount (IRMAA) on top of your Part B and Part D premiums. For 2026, IRMAA generally begins for single filers with income above $109,000 (and married-filing-jointly above roughly double that), based on your 2024 tax return. This doesn't change your cap ($2,100 in 2026, $2,400 in 2027) — it changes what you pay in premiums.