Medicare Part D
Medicare Part D in Brockton: 2027 Cap & Rules
BROCKTON, Mass. — 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 cap continues a major shift in how seniors pay for medicine, and it lands right as Medicare's Annual Enrollment Period (October 15 – December 7) is underway.
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Key takeaways
- Starting January 1, 2027, Medicare Part D out-of-pocket costs for covered drugs are capped at $2,400 per year, up from $2,100 in 2026.
- The old "donut hole" coverage gap is gone as of 2025, leaving just three phases: deductible, initial coverage, and $0 catastrophic coverage after you hit the cap.
- The Medicare Prescription Payment Plan is a free, optional program you can join through your Part D plan to spread out-of-pocket drug costs into monthly payments instead of paying it all at the pharmacy.
- The $2,400 cap and the 2027 rules apply to all Part D coverage no matter which plan or carrier you pick, though premiums, formularies, pharmacy networks, and deductibles still vary by plan.
For older residents in Brockton — many of whom manage multiple prescriptions — the new cap and a related monthly payment option could reshape how the year's drug bills feel. Here's a plain-English guide to what's changing.
The Part D cap, explained
The Part D out-of-pocket cap is $2,100 in 2026 and $2,400 in 2027, indexed to keep pace with drug spending. Once your out-of-pocket costs for covered drugs hit that amount in a year, you pay $0 for the rest of the year on covered prescriptions under your plan.
A few things to keep in mind:
- The cap applies to covered drugs under your Part D plan's formulary. Drugs your plan doesn't cover don't count toward it.
- Monthly premiums don't count toward the cap.
- The 2026 maximum Part D deductible is $615, though many plans set theirs lower.
Source: CMS — Medicare Part D program rules (medicare.gov).
The "donut hole" is gone
For years, Part D had a confusing middle stage called the coverage gap — the "donut hole" — where people paid more once their drug spending hit a certain level. That gap was eliminated as of 2025.
Now there are just three phases:
1. Deductible (if your plan has one) 2. Initial coverage (you pay a copay or coinsurance) 3. Catastrophic coverage ($0 for covered drugs after you reach the annual cap)
That's it. No more falling into a hole midway through the year.
The Medicare Prescription Payment Plan
Even with a $2,100 in 2026 ($2,400 in 2027) ceiling, hitting that amount early in the year can sting — especially if you take a high-cost specialty medicine and owe a big share at the pharmacy counter in January.
That's what the Medicare Prescription Payment Plan is for. It's a free, optional program that lets you spread your out-of-pocket drug costs across monthly payments instead of paying all at once at the pharmacy.
How it works:
- You still owe the same total for the year — the program doesn't lower your costs.
- Instead of paying the pharmacy, you pay your Part D plan a monthly bill.
- You can opt in before the year starts or at any point during the year.
- It tends to help most if you have high drug costs early in the year.
You sign up through your Part D plan, not through Medicare directly.
What this means locally
Brockton is in Plymouth County, where residents choose among a range of stand-alone Part D plans and Medicare Advantage plans that include drug coverage. The 2027 rules — the $2,400 cap, the $700 deductible ceiling, the three-phase design, and the payment plan option — apply to all Part D coverage, regardless of which plan or carrier you're enrolled in. For the 2027 plan lineup in your area, check each plan's ANOC and Medicare.gov's Plan Finder.
That's worth repeating during AEP: the cap is a program-wide protection, not a plan-specific perk. What still varies from plan to plan is the premium, the formulary (which drugs are covered and at what tier), the pharmacy network, and the deductible.
If you're comparing options, focus on whether your specific medications are covered and how the plan tiers them — that's usually what drives your real out-of-pocket cost before you'd hit the cap.
A quick note on higher-income enrollees
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 B and Part D premiums in 2026. IRMAA doesn't change the cap ($2,100 in 2026, $2,400 in 2027) — it only affects premiums.
Key dates to remember
- October 15 – December 7, 2026: Medicare Annual Enrollment Period. Switch, join, or drop Part D or Medicare Advantage plans for 2027.
- January 1, 2027: New Part D figures take effect, including the $2,400 cap.
- January 1 – March 31, 2027: Medicare Advantage Open Enrollment Period. If you're already in a Medicare Advantage plan, you get one chance to switch or return to Original Medicare.
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 Plymouth County
(MA penetration in Plymouth 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). There’s a hard yearly cap of $2,400 on what you pay out of pocket for covered drugs 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 premiums?
If I sign up for the monthly payment plan, will I pay less overall?
What if my drug isn't on my plan's formulary?
- CMS — Medicare Part D program rules (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.