Medicare Part D
Houma Medicare Part D Payment Plan and Drug Cap Explained
HOUMA, La. — Starting January 1, 2027, Medicare Part D will place a firm $2,400 ceiling on what you pay out of pocket for covered prescription drugs in a calendar year. For people in Houma and across Terrebonne Parish who take costly medications, this is one of the biggest changes to hit Medicare drug coverage in years — and it carries forward just as the Annual Enrollment Period wraps up on December 7.
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Key takeaways
- The Part D out-of-pocket cap is $2,100 in 2026 and $2,400 in 2027, and once you reach it you pay $0 for the rest of the year on covered drugs.
- The cap only counts deductibles and copays for covered drugs, not your monthly premium. The maximum deductible a plan can charge is $615 in 2026 and $700 in 2027.
- The old coverage gap, or "donut hole," was eliminated in 2025, leaving just three phases: deductible, initial coverage, and catastrophic.
- A free, optional Medicare Prescription Payment Plan lets you spread your out-of-pocket drug costs into monthly installments instead of paying it all at the pharmacy at once, and you can sign up before the plan year starts or anytime during the year.
Here's what the new cap actually does, what happened to the old "donut hole," and how a new monthly payment option can spread your drug costs across the year.
The $2,100 cap, explained
Under Medicare Part D rules, once your out-of-pocket spending on covered prescriptions reaches the yearly cap, you pay $0 for the rest of the year on those drugs. That cap is $2,100 in 2026 and $2,400 in 2027. The figure is set by the Centers for Medicare & Medicaid Services (CMS) and applies whether your drug coverage comes through a stand-alone Part D plan or a Medicare Advantage plan that includes drugs.
The cap only counts what you spend on covered drugs at the pharmacy — things like your deductible and copays. It does not include your monthly premium.
The maximum Part D deductible a plan can charge is $615 in 2026 and $700 in 2027. Plans can set a lower deductible, but not a higher one.
The "donut hole" is gone
For years, Medicare drug coverage had a confusing middle stage called the coverage gap, or "donut hole," where people paid a bigger share of their drug costs before catastrophic coverage kicked in.
That gap was eliminated in 2025. Part D now has just three phases:
1. Deductible phase — you pay the full negotiated price until you meet your plan's deductible (up to $615 in 2026 and $700 in 2027). 2. Initial coverage phase — you pay a copay or coinsurance while the plan pays the rest. 3. Catastrophic phase — once you hit the yearly out-of-pocket cap ($2,100 in 2026, $2,400 in 2027), you pay nothing more for covered drugs the rest of the year.
That's it. No more falling into a gap partway through the year.
The Medicare Prescription Payment Plan
Hitting the yearly ceiling is helpful — but $2,400 in January is still a lot of money at once. That's where the Medicare Prescription Payment Plan comes in.
This is a free, optional program from Medicare that lets you spread your out-of-pocket drug costs into monthly payments across the calendar year instead of paying the pharmacy the full amount at pickup. You still owe the same total; you just pay the plan in installments, not the pharmacy up front.
A few things worth knowing:
- It's offered by every Part D and Medicare Advantage drug plan — you opt in through your plan.
- It tends to help people most who face large drug bills early in the year.
- It does not lower your drug prices. It smooths the timing.
You can sign up before the plan year starts or at any point during the year. If you think you might benefit, call your plan directly.
What this means around Houma
Houma is in Terrebonne Parish, where Medicare beneficiaries choose drug coverage either through a stand-alone Part D plan or a Medicare Advantage plan that includes drugs. The $2,400 cap in 2027, the $700 maximum deductible in 2027, and access to the payment plan apply the same way in Terrebonne Parish as they do everywhere else in the country — these are federal program rules, not local ones.
What can differ locally is which plans are available and what each one charges in premiums, copays, and pharmacy network terms. The 2027 lineup is detailed in each plan's Annual Notice of Change and on Medicare.gov's Plan Finder. That's why comparing plans on Medicare.gov during Annual Enrollment (October 15 – December 7, 2026) matters.
A note on higher-income enrollees
If your income is above $109,000 as a single filer in 2026 (or higher thresholds for joint filers), you may pay an Income-Related Monthly Adjustment Amount, or IRMAA, on top of your Part D premium. IRMAA is based on your tax return from two years earlier. It doesn't change the $2,100 cap — it changes what you pay in 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 Terrebonne Parish
(MA penetration in Terrebonne 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 in 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 yearly out-of-pocket cap include my monthly premium?
What if my drug isn't on my plan's formulary?
Do I have to sign up for the payment plan?
- CMS — Medicare Part D program rules (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.