Medicare Part D

Part D in Columbia, Mo. — 2027 Part D guide

COLUMBIA, Mo. — If you take prescription drugs and rely on Medicare, the Part D out-of-pocket cap that reshaped the program in 2026 continues in 2027 at a higher amount. Combined with the end of the old "donut hole," Part D is simpler to follow — but it still helps to know the three phases your costs move through during the year.

Here's a plain-English look at how Part D works for 2027, and where to get help in Columbia if you have questions.

The three phases of Part D for 2027

Part D used to have four phases, including the well-known "donut hole." As of 2025, that gap is gone. In 2027, your prescription costs move through three phases:

1. Deductible phase. You pay the full negotiated price for your covered drugs until you meet your plan's deductible. The maximum Part D deductible a plan can charge is $615 in 2026 and $700 in 2027, per CMS. Some plans set it lower, and some cover certain drug tiers before the deductible is met.

2. Initial coverage phase. Once you meet the deductible, you pay a copay or coinsurance for each prescription, and your plan pays the rest. You stay in this phase until your out-of-pocket spending reaches the yearly cap.

3. Catastrophic phase. After your out-of-pocket spending hits the yearly cap — $2,100 in 2026 and $2,400 in 2027 — you pay nothing for your covered Part D drugs for the rest of the calendar year. This cap is set by Medicare and applies to all Part D plans.

What the yearly cap actually covers

The cap applies to what you spend out of pocket on covered Part D drugs — deductibles, copays, and coinsurance. Monthly plan premiums don't count toward the cap. Drugs your plan doesn't cover don't count either, which is one reason it's worth checking each year that your medications are on your plan's formulary.

The cap resets every January 1, along with the deductible.

The Medicare Prescription Payment Plan

Introduced in 2025 and continuing in 2027, the Medicare Prescription Payment Plan lets you spread your out-of-pocket drug costs across the calendar year in monthly payments instead of paying a large amount at the pharmacy counter. It doesn't change what you owe overall — it just smooths it out. There's no fee to use it, and any Part D or Medicare Advantage plan with drug coverage must offer it. You can sign up through your plan.

This option can be especially helpful if you have an expensive medication early in the year that would otherwise eat up your deductible in a single fill.

Part D availability in Columbia

Columbia is in Boone County, where Medicare beneficiaries choose Part D coverage either as a standalone prescription drug plan added to Original Medicare, or as part of a Medicare Advantage plan that includes drug coverage. Availability, formularies, and pharmacy networks vary by plan, so the right fit depends on the specific drugs you take and the pharmacies you use.

The Medicare Plan Finder at medicare.gov lets you enter your ZIP code and your medications to compare covered drugs and estimated yearly costs across the plans offered in Boone County.

When you can enroll or switch

• Annual Enrollment Period: October 15 – December 7. This is when most people join, drop, or change a Part D or Medicare Advantage plan for the following year.
• Medicare Advantage Open Enrollment: January 1 – March 31. If you're already in a Medicare Advantage plan, you can switch to another Medicare Advantage plan or return to Original Medicare (and add a standalone Part D plan).
• Special Enrollment Periods may apply if you move, lose other coverage, or qualify for Extra Help.

A note on higher-income surcharges

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 Income-Related Monthly Adjustment Amount (IRMAA) on top of your Part D premium in 2026. Social Security notifies you if this applies, and you can appeal if your income has dropped due to a life event.