Medicare Part D
Concord Medicare Part D: $2,400 Out-of-Pocket Limit in 2027
CONCORD, N.H. — Starting Jan. 1, 2027, people with Medicare Part D drug coverage will hit a firm limit on what they pay out of pocket at the pharmacy counter each year: $2,400. Once you reach that amount in covered drug costs, you pay nothing more for covered prescriptions for the rest of the calendar year. For Concord-area residents choosing coverage during this fall's enrollment window, it's a continuation of the biggest change to how Part D works in decades.
Compare Medicare options near you
Answer 3 quick questions to see Medicare Advantage, Medigap, and Part D listings from licensed insurance partners.
What’s your ZIP code?
Plan availability is set by your county, so we start here.
How old are you?
This helps match you with options you’re eligible for.
Do you have Medicare Parts A & B?
Most Medicare Advantage and Medigap options require both.
These listings are provided by licensed insurance partners.
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.
- Every prescription checked, name by name
- Your pharmacy checked for preferred pricing
Available now — current wait: 0 min
A real person answers. No phone menu, ever.
Want to see more plan options?
Answer a few more questions to continue to additional options from licensed partners.
Continue →Advertising disclosure: MyMedicarePlans.org may be compensated when you contact a partner or licensed agent. Listings are not ranked or endorsed by us, and we do not recommend specific plans. You can also contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.
Speak to a Licensed Insurance Agent
Click to call 855-729-3240Key takeaways
- Starting January 1, 2027, the Medicare Part D yearly out-of-pocket cap is $2,400 (up from $2,100 in 2026), after which covered prescriptions cost nothing for the rest of the year.
- The old "donut hole" coverage gap is gone, replaced by a three-phase design: a deductible of up to $700 in 2027, a standard cost-sharing phase, and a catastrophic phase capped at $2,400.
- This $2,400 cap in 2027 applies to every Part D plan and every Medicare Advantage plan with drug coverage, though premiums, formularies, and pharmacy networks can still differ.
- The Medicare Prescription Payment Plan, continuing in 2027, lets you spread your out-of-pocket drug costs into monthly payments instead of paying it all at the pharmacy, though it doesn't reduce the total amount you owe.
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 Merrimack County
(MA penetration in Merrimack 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.
What's actually changing in 2027
For years, the Part D benefit had a confusing middle stretch called the "coverage gap," or donut hole, where people paid a bigger share of their drug costs after hitting an initial spending limit. That gap was eliminated in 2025. In its place is a cleaner, three-phase design: a deductible (up to $700 in 2027, up from $615 in 2026), a standard cost-sharing phase, and then a catastrophic phase where your out-of-pocket spending caps at $2,400.
According to CMS — Medicare Part D program rules (medicare.gov) — that $2,400 cap applies to every Part D plan and every Medicare Advantage plan that includes drug coverage in 2027. Plans can differ in premiums, formularies, and pharmacy networks, but the cap itself is the same across the board.
Who this matters most to in Concord
Concord is in Merrimack County, and like much of New Hampshire, it's home to a large share of residents on Medicare. The $2,400 ceiling in 2027 will feel most meaningful to people who take expensive brand-name or specialty medications — the kind of drugs that used to push retirees into the old donut hole by mid-year. For someone managing a serious chronic condition, the predictable annual maximum continues into a second year.
For people whose yearly drug spending stays modest, the cap may not come into play. But the new structure still applies, and the deductible and cost-sharing phases still work the same way as before you reach the ceiling.
The Medicare Prescription Payment Plan: spreading costs over the year
New in 2025 and continuing in 2027 is an option called the Medicare Prescription Payment Plan. It doesn't lower what you owe — it lets you spread your out-of-pocket drug costs across monthly payments to your plan instead of paying the full amount at the pharmacy.
A few things to know:
- It's optional and free to join. Every Part D plan must offer it.
- You still pay the same total for the year; the plan just bills you monthly.
- It's most useful for people who face a large drug bill early in the year — for example, a costly prescription in January that would otherwise take a big bite all at once.
- You can opt in before the plan year or any time during the year by contacting your plan.
If your prescription costs are low and steady, the payment plan may not add much value. If you take a high-cost drug, it can smooth the cash-flow shock.
The enrollment calendar
Two windows matter right now:
- Medicare Annual Enrollment Period: Oct. 15 – Dec. 7, 2026. This is when anyone with Medicare can join, switch, or drop a Part D or Medicare Advantage plan for 2027.
- Medicare Advantage Open Enrollment Period: Jan. 1 – March 31. If you're already in a Medicare Advantage plan, you get one chance during this window to switch to a different Medicare Advantage plan or return to Original Medicare (and pick up a Part D plan).
Because formularies, pharmacy networks, and premiums can change each year, CMS encourages beneficiaries to review their plan every fall — even if they're happy with it.
A quick note on higher-income beneficiaries
If your income is above $109,000 as a single filer (or $218,000 for a couple filing jointly) in 2026, you'll pay an income-related surcharge called IRMAA on top of your Part B and Part D premiums. IRMAA is based on your tax return from two years earlier. It doesn't change how the cap ($2,100 in 2026, $2,400 in 2027) works — but it's worth factoring into your overall Medicare budget.
Prescription coverage
How Medicare Part D works in 2027
The old coverage gap (“donut hole”) is eliminated as of 2025 (three phases now). There’s now 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
Does the $2,400 cap include my monthly premium?
What if I take drugs my plan doesn't cover?
If I sign up for the payment plan, do I owe money after Dec. 31?
- CMS — Medicare Part D program rules (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.