Medicare Part D
Covington Medicare drug costs: 2027 Part D cap
COVINGTON, La. — Starting Jan. 1, 2027, people with Medicare drug coverage will hit a firm ceiling on what they pay out of pocket for prescriptions: $2,400 for the year. Once you reach that number, your Part D plan covers 100% of your covered drugs for the rest of the calendar year. It's a continuation of the biggest shift in Medicare drug coverage in two decades, and the new figure lands right as Annual Enrollment wraps up on Dec. 7.
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Will your prescriptions still be covered in 2027?
Part D plans rewrite their drug lists every year — tiers move, pharmacies change, drugs drop off. One call checks your exact medications against the 2027 plans in your area.
- Every prescription checked, name by name
- Your pharmacy checked for preferred pricing
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Key takeaways
- The Part D out-of-pocket cap is $2,100 in 2026 and rises to **$2,400 in 2027**, after which covered drugs cost you nothing more that year.
- The old "donut hole" coverage gap is **gone** — Part D now has just three phases: deductible, initial coverage, and catastrophic.
- The **Medicare Prescription Payment Plan** lets you spread your drug costs across monthly bills instead of paying big amounts at the pharmacy counter.
- Annual Enrollment runs **Oct. 15 – Dec. 7**; Medicare Advantage Open Enrollment runs **Jan. 1 – March 31**.
For many older adults in Covington, especially those managing diabetes, heart conditions, or cancer treatments, this cap changes the math on what a year of medicine can cost.
What the Part D cap actually means
The cap is a hard limit on what you personally spend on covered prescription drugs through your Part D plan or a Medicare Advantage plan that includes drug coverage. It applies to deductibles, copays, and coinsurance for drugs on your plan's formulary.
A few things it does not cover:
- Your monthly Part D premium (that's separate).
- Drugs your plan doesn't cover.
- Medicines bought outside the plan's pharmacy network.
The maximum Part D deductible in 2026 is $615, though many plans set theirs lower. Once you meet the deductible, you move into the initial coverage phase, where you and your plan share costs until your out-of-pocket spending reaches $2,100 in 2026 ($2,400 in 2027). After that, you're done paying for the year.
The coverage gap is really gone
For years, the "donut hole" was the phase where people paid a bigger share of drug costs after their plan's initial coverage ran out. It confused a lot of people and hit hardest in the middle of the year.
That phase was eliminated in 2025. Part D now has just three phases: 1. Deductible — you pay full negotiated price until you meet it. 2. Initial coverage — you and the plan share costs. 3. Catastrophic — you pay nothing once you hit the out-of-pocket cap.
For 2027, that transition to the catastrophic phase happens at $2,400.
How the Medicare Prescription Payment Plan works
Even with a $2,400 ceiling in 2027, hitting that number in January or February can hurt. A single expensive prescription can wipe out your cap in one trip to the pharmacy.
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 into monthly payments instead of paying them at the pharmacy. You still owe the same total — the program doesn't reduce what you pay — but it smooths the timing.
To use it:
- You must opt in through your Part D or Medicare Advantage drug plan.
- You can sign up before the plan year starts or at any point during the year.
- At the pharmacy, you'll pay $0. Your plan bills you monthly instead.
This can help if you take a high-cost brand-name drug and don't want a large charge all at once. It may not be worth the paperwork if your yearly drug costs are low and predictable.
What Covington residents should check during enrollment
Covington is in St. Tammany Parish, where Medicare beneficiaries can choose between Original Medicare with a stand-alone Part D plan or a Medicare Advantage plan that bundles drug coverage. Plan formularies, pharmacy networks, and premiums change every year, so the plan that worked in 2026 may not be the right fit for 2027. The 2027 lineup is detailed in each plan's ANOC and on Medicare.gov's Plan Finder.
A few things worth reviewing before Dec. 7:
- Is every medication you take still on the formulary?
- Is your preferred Covington-area pharmacy still in network?
- Has your premium or deductible changed?
- Do you want to opt into the Prescription Payment Plan?
Higher-income beneficiaries should also note that IRMAA surcharges on Part B and Part D premiums begin above $109,000 in income for single filers in 2026 (higher for joint filers).
Where to get personalized help
For questions about your specific medications and plan options:
- Visit medicare.gov to compare Part D and Medicare Advantage plans.
- Call 1-800-MEDICARE (1-800-633-4227), open 24/7.
- Contact Louisiana SHIIP (Senior Health Insurance Information Program) for free, unbiased local counseling — no sales pressure.
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 St. Tammany Parish
(MA penetration in St. Tammany Parish)
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 plan premium?
Do I have to sign up for the Medicare Prescription Payment Plan?
What happens if I hit $2,400 in March?
When can I change my drug plan?
- CMS — Medicare Part D program rules (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.
Also for Covington
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This page was last updated: October 6, 2026.