Medicare Part D
Nashua NH: Part D Cap & Payment Plan 2027
NASHUA, N.H. — In 2027, Medicare Part D will cap what you pay out of pocket for covered prescription drugs at $2,400 for the year, up from $2,100 in 2026. For Nashua residents who take expensive medications, this remains one of the biggest shifts in how Medicare drug coverage works — and this fall's Annual Enrollment Period, which runs October 15 through December 7, is when you can review how your plan will handle it.
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Key takeaways
- In 2027, Medicare Part D caps your yearly out-of-pocket drug costs at $2,400 (up from $2,100 in 2026), and once you hit that amount you pay nothing for covered prescriptions for the rest of the year.
- The old "donut hole" coverage gap is gone, leaving three simple phases: a deductible (no more than $700 in 2027), initial coverage, and catastrophic coverage.
- The Medicare Prescription Payment Plan lets you spread out big drug costs into monthly payments instead of one large bill, though it may not help people with low, steady drug costs.
- During Annual Enrollment (October 15 – December 7), check your plan's Annual Notice of Change, confirm your drugs and pharmacy are still covered, and note that in 2026 the IRMAA income surcharge starts above $109,000 for single filers.
Here is a plain-language look at what is changing, what is staying, and where to get help.
What the new Part D cap actually does
In 2027, once your out-of-pocket spending on covered Part D drugs reaches $2,400, you pay nothing for the rest of the calendar year on those covered prescriptions. The cap resets each January.
This replaces the old system, where people with high drug costs could keep paying — sometimes thousands more — into what was called "catastrophic coverage." Under the new rules, the ceiling is firm and predictable.
A few things to keep in mind:
- Only what you pay toward covered Part D drugs counts toward the $2,100 in 2026 ($2,400 in 2027).
- Premiums do not count toward the cap.
- Drugs not on your plan's formulary generally do not count either.
The "donut hole" is gone
The coverage gap — the confusing middle stage many people called the donut hole — was eliminated in 2025. Part D now has three phases:
1. Deductible phase — you pay full negotiated price until you meet your plan's deductible. In 2027, no Part D plan can charge a deductible higher than $700. 2. Initial coverage phase — you pay a copay or coinsurance, and the plan pays the rest. 3. Catastrophic phase — once you hit the $2,400 out-of-pocket cap, you pay nothing more for covered drugs that year.
That's it. No more sudden jump in prices partway through the year.
The Medicare Prescription Payment Plan
Hitting a $2,400 cap is still $2,400 — and for someone on a costly specialty drug, most of that can land in a single month early in the year. To help with that, Medicare offers the Medicare Prescription Payment Plan, sometimes called "smoothing."
Here's how it works:
- You opt in through your Part D plan (it's voluntary and free to join).
- Instead of paying the pharmacy at pickup, your plan bills you monthly.
- Your total for the year is the same — it's just spread out.
This can be a real help if a big pharmacy bill in January or February would strain your budget. It can also be the wrong fit for people with low, steady drug costs, because it adds a monthly bill you didn't have before. Medicare.gov has a worksheet to help you decide.
What Nashua residents should check this fall
Nashua is in Hillsborough County, where Medicare beneficiaries choose among stand-alone Part D drug plans and Medicare Advantage plans that include drug coverage. Availability, formularies, and pharmacy networks are set at the county level, and they change every year.
During Annual Enrollment (October 15 – December 7), it's worth doing three things:
1. Read your plan's Annual Notice of Change (ANOC). It arrives in September and spells out what's different for 2027. 2. Check that your drugs are still on the formulary and at what tier. 3. Confirm your pharmacy is still in-network — including any mail-order option you use.
The Plan Finder tool at medicare.gov lets you enter your prescriptions and ZIP code to compare what's offered in Hillsborough County.
A quick word on IRMAA
If your income is higher, you may pay an income-related surcharge on top of your Part B and Part D premiums. In 2026, the IRMAA surcharge begins above $109,000 for a single filer (higher thresholds apply for joint filers). Social Security uses your tax return from two years earlier to determine this. If your income has dropped since then — because of retirement or another life change — you can ask Social Security to reconsider.
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 Hillsborough County
(MA penetration in Hillsborough 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). In 2027 there is 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
Q: Does the $2,400 cap include my monthly premium?
Q: If I'm in the payment plan and switch plans mid-year, what happens?
Q: I take only one low-cost generic. Do I still need to pay attention?
- CMS — Medicare Part D program rules (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.