Medicare Part D
Medicare's 2027 Drug Cap in Nashua, N.H.
NASHUA, N.H. — Medicare Part D now has a firm dollar limit on what enrollees pay out of pocket for prescription drugs each year. Starting January 1, 2027, that ceiling rises from the 2026 amount of $2,100 to $2,400, according to CMS. Once you hit it, you pay nothing for covered Part D drugs for the rest of the calendar year.
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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.
- Every prescription checked, name by name
- Your pharmacy checked for preferred pricing
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Key takeaways
- Starting January 1, 2027, the yearly out-of-pocket cap for Part D drugs rises to $2,400 from $2,100 in 2026, and once you hit it you owe nothing for covered drugs the rest of the year.
- The Medicare Prescription Payment Plan (M3P) is a free, optional way to spread your drug costs into monthly bills instead of paying large amounts at the pharmacy, though the total you owe stays the same.
- The Annual Enrollment Period runs October 15 to December 7, and reviewing your plan's Annual Notice of Change and comparing total yearly costs on the Plan Finder can help since formularies, networks, and premiums may have changed for 2027.
- For 2026, higher-income single filers with income above $109,000 (based on 2024 tax returns) pay an extra IRMAA surcharge, so it's worth checking if a recent income change affected your bracket.
Nashua seniors will see a hard ceiling on drug costs starting Jan. 1
That's a meaningful change for anyone in Nashua who takes expensive medications — and it's one of the biggest reasons the fall Annual Enrollment Period (October 15 – December 7) matters this year. The drug plan you're in on January 1 is the one that will carry you through 2027.
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.
What actually changes in 2027
Three things are worth knowing as you sort through mail from insurers this fall:
- The out-of-pocket cap is $2,400 in 2027. This applies to what you spend on covered Part D drugs. Premiums don't count toward it.
- The Part D deductible can be up to $700 in 2027. Plans can charge less, but not more.
- The "donut hole" is gone. The old coverage gap was eliminated in 2025. Part D now has three phases: deductible, initial coverage, and catastrophic (where you pay nothing once you reach the cap).
These are program-wide rules set by Medicare. Individual plans still design their own formularies and cost-sharing within those rules, so two plans that both follow the 2027 cap can look very different month to month.
The Medicare Prescription Payment Plan: spreading costs across the year
One feature that got less attention when it launched in 2025 is the Medicare Prescription Payment Plan, sometimes called "M3P" or drug cost smoothing. It's optional and free to join.
Here's the idea: instead of paying a large amount at the pharmacy counter in, say, February, you can ask your Part D plan to bill you monthly across the rest of the calendar year. You still owe the same total — the 2027 cap is still $2,400 — but the hit to your checking account is spread out.
This tends to help people who:
- Take a high-cost drug early in the year and would otherwise front-load their spending.
- Live on a fixed monthly income and prefer predictable bills.
It doesn't help everyone. If your drug costs are low and steady, smoothing may just add a bill to track. You can opt in before the plan year starts or any time during the year by contacting your Part D plan directly.
Why AEP matters more than usual this year
Nashua is in Hillsborough County, where residents choose among a range of stand-alone Part D plans and Medicare Advantage plans that include drug coverage. Insurers have been adjusting formularies, pharmacy networks, and premiums in response to the cap and other Part D changes. The 2027 lineup is detailed in each plan's ANOC and on Medicare.gov's Plan Finder.
That means the plan that worked well for you in 2026 may look different in 2027 — even if the name on the card is the same. A few practical steps during AEP (Oct. 15 – Dec. 7):
1. Read the Annual Notice of Change your current plan mailed you in September. Focus on drug tier changes and pharmacy network changes. 2. Use the Plan Finder at medicare.gov to enter your specific drugs and compare total estimated yearly cost — not just premium. 3. If you're happy with your plan after reviewing, you don't have to do anything. Coverage renews automatically.
If you miss AEP, you'll get another window through the Medicare Advantage Open Enrollment Period, January 1 – March 31, but that one is more limited — it doesn't let you switch stand-alone Part D plans.
A quick word on IRMAA
Higher-income beneficiaries pay an extra amount on top of Part B and Part D premiums, called IRMAA. For 2026, the surcharge begins for single filers with income above $109,000 (based on your 2024 tax return). It's worth checking if a recent income change — a Roth conversion, a home sale, a retirement — pushed you into or out of an IRMAA bracket.
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 in 2027 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
Does the 2027 out-of-pocket cap include my monthly premium?
What if I take only one or two low-cost generics?
Is the Prescription Payment Plan automatic?
- CMS — Medicare Part D program rules (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.