Medicare Part D
Wentzville, MO Medicare Part D in 2027
WENTZVILLE, Mo. — If you take prescription drugs and rely on Medicare, the Part D benefit continues to have a firm yearly ceiling on what you pay out of pocket in 2027, and the old "donut hole" is gone for good.
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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.
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Speak to a Licensed Insurance Agent
Click to call 855-729-3240Key takeaways
- Medicare Part D has a yearly cap on out-of-pocket drug costs — $2,100 in 2026 and $2,400 in 2027 — and once you hit it your plan pays 100% of covered drugs for the rest of the year.
- The old "donut hole" coverage gap was eliminated in 2025 and is gone for good, leaving Part D with three phases: deductible, initial coverage, and catastrophic.
- The maximum Part D deductible any plan can charge is $615 in 2026 and $700 in 2027, and Medicare's optional Prescription Payment Plan lets you spread your out-of-pocket costs into monthly payments instead of one big bill.
- Plan choices and IRMAA income surcharges (which start above $109,000 for single filers in 2026) can change each year, so it helps to review coverage during the Annual Enrollment Period, October 15 through December 7.
Here's a plain-language walk-through of how Part D works heading into 2027, what the cap means, and where to get help close to home.
The Big Change: A Yearly Out-of-Pocket Cap
Starting in 2026, no one with a Medicare Part D plan will pay more than $2,100 out of pocket for covered prescription drugs in a calendar year. Once you hit that number, your plan picks up 100% of the cost of your covered drugs for the rest of the year.
This cap applies whether you get your drug coverage through a stand-alone Part D plan (usually paired with Original Medicare) or through a Medicare Advantage plan that includes drug coverage.
For people who take expensive medications — cancer drugs, blood thinners, insulin, specialty biologics — this is a meaningful shift. Before 2024, there was no annual limit at all.
The Three Phases of Part D
Part D now has three phases instead of the old four. The coverage gap (the "donut hole") was eliminated in 2025 and is not coming back.
1. The Deductible Phase You pay 100% of your drug costs until you meet your plan's deductible. The maximum deductible any Part D plan can charge is $615 in 2026 and $700 in 2027. Some plans set a lower deductible, and some set none at all — that's a plan-by-plan choice.
2. The Initial Coverage Phase Once the deductible is met, 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 $2,100 in 2026 ($2,400 in 2027).
3. The Catastrophic Phase After you hit $2,100 in 2026 ($2,400 in 2027) out of pocket, you pay $0 for the rest of the year on covered drugs from your plan's formulary.
That's the whole structure. No more donut hole math.
The Medicare Prescription Payment Plan
Here's something worth knowing, especially if you take a pricey medication early in the year: Medicare now offers an optional program called the Medicare Prescription Payment Plan.
Instead of paying a big pharmacy bill all at once, you can choose to spread your out-of-pocket drug costs across monthly payments over the calendar year. You still pay the same total — nothing is forgiven — but the cash flow is smoother.
It's voluntary. You opt in through your drug plan. It won't be the right fit for everyone, but for someone facing a $1,500 pharmacy charge in January, it can help.
What Wentzville Residents Should Know Locally
Wentzville is in St. Charles County, and Medicare plan availability is set at the county level. That means the menu of stand-alone Part D plans and Medicare Advantage plans with drug coverage available to you is the same whether you live near Wentzville Parkway, off Highway N, or anywhere else in the county.
The number of plans available in St. Charles County can change each year, and every plan sets its own formulary (the list of covered drugs), pharmacy network, and cost-sharing within the CMS rules. The 2027 lineup is detailed in each plan's Annual Notice of Change and on Medicare.gov's Plan Finder. That's why it pays to review your options during the Annual Enrollment Period, October 15 through December 7, 2026, before your current coverage rolls into the new year.
Higher-Income Rules (IRMAA)
Most people pay only their Part D plan's premium. But if your income is above a certain level, Medicare adds a surcharge called IRMAA (Income-Related Monthly Adjustment Amount) on top of your Part D premium.
For 2026, IRMAA kicks in for single filers with income above $109,000, and at a higher threshold for joint filers. Social Security uses your tax return from two years back to decide. If your income has since dropped — retirement, loss of a spouse, reduced hours — you can ask for a reconsideration.
Key Dates to Remember
- October 15 – December 7: Annual Enrollment Period. Join, switch, or drop a Part D or Medicare Advantage plan.
- January 1 – March 31: Medicare Advantage Open Enrollment. If you're already in a Medicare Advantage plan, you can switch to a different one or return to Original Medicare (with a stand-alone Part D plan).
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. Charles County
(MA penetration in St. Charles 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 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
Q: Does the $2,100 cap include my monthly premium?
Q: What happens if I take a drug my plan doesn't cover?
Q: Can I sign up for the Medicare Prescription Payment Plan mid-year?
- CMS — Medicare Part D program rules (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.