Medicare Part D
How Medicare Part D's Out-of-Pocket Cap Works in Hattiesburg
Hattiesburg, Miss. — Starting Jan. 1, 2027, no one with Medicare Part D will pay more than $2,400 out of pocket for covered prescription drugs in a calendar year. It's one of the biggest changes to Medicare in years, and for people in the Pine Belt who take costly medications, it lands right as the Annual Enrollment Period (Oct. 15 – Dec. 7) is underway.
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Key takeaways
- Starting Jan. 1, 2027, Medicare Part D out-of-pocket drug costs are capped at $2,400 per year, after which covered drugs cost $0 for the rest of the year.
- The old coverage gap, or "donut hole," was eliminated in 2025 and stays gone, with drug costs now split into a deductible phase (up to $700 in 2027), an initial coverage phase, and a $0 catastrophic phase.
- A free, optional Medicare Prescription Payment Plan lets people spread their out-of-pocket drug costs into monthly installments instead of paying it all at the pharmacy at once.
- These federal rules apply the same way to both Original Medicare and Medicare Advantage plans, but formularies, pharmacy networks, and drug tiers can still differ, so it helps to check your medications against a plan's formulary during the Oct. 15–Dec. 7 enrollment period.
Here's what's actually changing, and what Hattiesburg-area residents should keep in mind before Dec. 7.
The $2,100 cap, in plain English
In 2027, Medicare sets a hard ceiling of $2,400 on what you personally pay for covered Part D drugs during the year. Once your out-of-pocket spending on covered prescriptions hits that number, you pay $0 for covered drugs for the rest of the calendar year.
A few important details:
- The cap applies to covered Part D drugs. Drugs your plan doesn't cover don't count toward it.
- Your monthly Part D premium does not count toward the $2,100.
- The Part D deductible in 2026 can be no higher than $615. Plans can charge less, but not more.
- The cap resets every January.
This is a big deal for people managing conditions like cancer, diabetes, heart disease, or autoimmune disorders, where a single specialty drug can blow past $2,100 in a month or two.
The "donut hole" is gone
If you've had 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 gap was eliminated in 2025 and stays gone in 2027.
Part D now has just three phases:
1. Deductible phase — you pay full negotiated price until you meet the deductible (up to $700 in 2027). 2. Initial coverage phase — you pay a copay or coinsurance until you hit $2,400 in out-of-pocket costs. 3. Catastrophic phase — you pay $0 for covered drugs the rest of the year.
No more math about where you are in the donut hole. It's simpler on purpose.
The Medicare Prescription Payment Plan
Hitting $2,400 is a ceiling — but it doesn't mean the bills come evenly. If you fill an expensive prescription in January, you could owe a large amount right then.
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 the calendar year in monthly installments, instead of paying at the pharmacy counter.
Key things to know:
- You still pay the same total — the plan just smooths it out.
- You have to opt in through your Part D or Medicare Advantage drug plan.
- It works best for people who expect high drug costs early in the year.
- If your drug costs are low and predictable, you may not need it.
You can sign up before the year starts or during the year. Ask your plan how to enroll.
What this means locally
Hattiesburg is in Forrest County, where Medicare beneficiaries choose between Original Medicare (often paired with a stand-alone Part D plan) and Medicare Advantage plans that include drug coverage. The 2027 rules — the $2,400 cap, the $700 maximum deductible, and the payment plan — apply the same way in both, because they're set at the federal level by CMS. The Forrest County carrier counts shown below are for 2026; the 2027 lineup is in each plan's ANOC and on Medicare.gov's Plan Finder.
What can differ from plan to plan is the formulary (the list of covered drugs), the pharmacy network, and the tier your medications fall into. Two plans can both follow the $2,100 rule and still treat your specific prescriptions very differently. That's why it pays to check your drugs against a plan's formulary every fall, even if you're happy with your current coverage.
Dates to circle
- Oct. 15 – Dec. 7, 2026: Medicare Annual Enrollment Period. Join, switch, or drop Part D and Medicare Advantage plans for 2027.
- Jan. 1, 2027: New coverage — and the $2,400 cap — begins.
- Jan. 1 – Mar. 31, 2027: Medicare Advantage Open Enrollment. If you're in a Medicare Advantage plan, you get one chance to switch to another MA plan or return to Original Medicare.
One more note: higher-income beneficiaries pay an extra amount called IRMAA on top of Part B and Part D premiums. In 2026, IRMAA starts above $109,000 in income for single filers (higher for joint filers). It's based on your tax return from two years ago.
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 Forrest County
(MA penetration in Forrest 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”) is eliminated as of 2025 (three phases now). In 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 insulin or vaccines?
If I don't take expensive drugs, does any of this matter to me?
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.