Medicare Part D
Kearney Medicare Part D 2027: cap & donut hole
KEARNEY, Neb. — Starting Jan. 1, 2027, the way Medicare pays for prescription drugs continues to look different than anything older adults in Buffalo County saw before 2025. The yearly cap on out-of-pocket drug costs rises to $2,400, the old "donut hole" stays gone, and a monthly payment option is available for people whose drug bills hit hard early in the year.
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Key takeaways
- Starting Jan. 1, 2027, Medicare Part D drug costs are capped at $2,400 out of pocket per year, and once you hit that amount you pay nothing more for covered drugs the rest of the year.
- The old "donut hole" coverage gap, eliminated in 2025, stays gone in 2027, 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 payments instead of paying it all at the pharmacy, though you still owe the same total amount.
- These rules apply to all Part D and Medicare Advantage drug plans, but plans still differ on covered drugs, pharmacy networks, and costs before the cap, so it helps to compare your medications using Medicare.gov's Plan Finder or a SHIP counselor before the Dec. 7, 2026 enrollment deadline.
Here's a plain-language guide to what's changing — and where Kearney-area residents can get personal help before the Dec. 7, 2026 enrollment deadline.
The out-of-pocket cap, explained simply
In 2027, no one with Medicare Part D drug coverage will pay more than $2,400 out of pocket for covered prescriptions in a calendar year. Once your spending on covered drugs reaches that number, you pay nothing more for the rest of the year on those drugs. The cap was $2,100 in 2026.
This cap applies whether you get your drug coverage through a standalone Part D plan or bundled into a Medicare Advantage plan that includes drugs. It replaces the old system, where a person with expensive medications could easily spend many thousands of dollars a year.
The Part D maximum deductible is $700 in 2027, and plans can charge less. After the deductible, you're in the standard cost-sharing phase — and once your out-of-pocket spending hits $2,400, you're done paying for the year.
The "donut hole" is really gone
For years, Kearney retirees learned to dread the "coverage gap," the middle stretch where drug costs suddenly jumped. That phase was eliminated in 2025 and stays gone in 2027.
Part D now has just three phases: the deductible, the initial coverage phase where you and your plan share costs, and the catastrophic phase once you hit the $2,400 cap — where you pay nothing more for covered drugs.
That's a real structural change, not a marketing line. It's written into federal law through the Inflation Reduction Act and administered by the Centers for Medicare & Medicaid Services (CMS).
The Medicare Prescription Payment Plan
Even with a $2,400 ceiling, some folks still face a rough January — especially anyone starting the year with a high-cost prescription. That's where the Medicare Prescription Payment Plan comes in.
This is a free, optional program that lets you spread your out-of-pocket drug costs across the calendar year in monthly payments instead of paying the full amount at the pharmacy counter. You don't save money overall — you owe the same total — but the bill is smoothed out.
To use it, you sign up through your Part D or Medicare Advantage drug plan. You can join before the plan year starts or any month during the year. If a large prescription hits at the pharmacy, ask the pharmacist about it — they're required to flag people who might benefit.
What this means locally
Kearney is in Buffalo County, where drug coverage is offered through both standalone Part D plans and Medicare Advantage plans that include drugs. The number of plans available in Buffalo County changes each year, and CMS publishes the full county-level list each fall on Medicare.gov.
The rules above — the $2,400 cap, the eliminated coverage gap, and the payment plan option — apply to every Part D and Medicare Advantage drug plan available here. They are program-level protections, not features of any one plan.
That said, plans still differ in which drugs they cover, which pharmacies are in network, and what you pay before you hit the cap. That's why comparing your specific medications on Medicare.gov's Plan Finder — or with a SHIP counselor — matters so much during open enrollment.
Key dates for 2027 coverage
- Oct. 15 – Dec. 7, 2026: Medicare Annual Enrollment Period. This is when you can join, switch, or drop a Part D or Medicare Advantage plan for 2027.
- Jan. 1, 2027: New coverage begins; the $2,400 cap takes effect.
- Jan. 1 – March 31, 2027: 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.
One more figure worth knowing: IRMAA, the income-related surcharge some higher earners pay on top of standard Part B and Part D premiums, begins above $109,000 in income for a single filer in 2026 (higher for married couples).
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 Buffalo County
(MA penetration in Buffalo 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
Do I need to do anything to get the $2,100 cap?
Does the $2,100 cap include my monthly premium?
What if my drug isn't on my plan's list?
- CMS — Medicare Part D program rules (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.