Medicare Part D
Medicare Part D Payment Plan Option in Perth Amboy, NJ
PERTH AMBOY, N.J. — If you take prescription drugs and have Medicare, the hard yearly limit on what you pay out of pocket under Part D continues into 2027 at a new amount. Here is a plain-language walk-through of how Part D works in 2027, what the cap means, and the three phases your drug costs move through.
Compare Medicare Part D options near you
Answer 3 quick questions to see Medicare 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?
This affects which Medicare Part D options you can choose.
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.
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 855-729-3240
Key takeaways
- The Part D out-of-pocket cap is $2,100 in 2026 and $2,400 in 2027, so once you hit that amount in out-of-pocket drug costs, you pay $0 for covered drugs the rest of the year.
- Part D plans can charge a deductible of up to $615 in 2026 and up to $700 in 2027, but no plan is allowed to charge more, and some charge less or nothing.
- With the old "donut hole" gone, Part D now moves through just three phases each year: deductible, initial coverage, and catastrophic.
- Medicare also offers an optional Prescription Payment Plan that lets you spread your out-of-pocket drug costs into monthly payments across the year instead of paying it all at the pharmacy at once.
The headline change: the Part D out-of-pocket cap
In 2027, no one on a Medicare Part D drug plan will pay more than $2,400 out of pocket for covered prescriptions in the calendar year, according to CMS. Once your out-of-pocket spending on covered drugs hits that number, you pay $0 for the rest of the year on those drugs.
This cap is the successor to a change that began in 2025, when the old "donut hole" coverage gap was eliminated. The cap adjusts each year: it is $2,100 in 2026 and $2,400 in 2027.
The deductible: up to $700 in 2027
Before the plan starts paying its share, you may have to meet a deductible. The maximum Part D deductible is $615 in 2026 and $700 in 2027. Some plans charge less, and some charge nothing at all for certain tiers of drugs — but no Part D plan can charge more than the program maximum as its deductible.
This is a program-level rule set by Medicare, not something a plan can go above.
The three phases of Part D in 2027
With the donut hole gone, Part D now has just three phases each calendar year:
1. Deductible phase. You pay the full negotiated price for your drugs until you meet your plan's deductible (up to $700 in 2027). If your plan has no deductible on your drug's tier, you skip this phase.
2. Initial coverage phase. After the deductible, you pay a copay or coinsurance and your plan pays the rest. You stay in this phase until your out-of-pocket spending reaches the annual cap.
3. Catastrophic phase. Once your out-of-pocket costs hit the annual cap ($2,400 in 2027), you pay nothing for covered Part D drugs for the rest of the year.
That is the whole ladder. No more confusing gap in the middle.
Spreading the cost: the Medicare Prescription Payment Plan
Hitting the annual cap is a relief, but paying a big share of it in January or February can still sting. That is why Medicare offers the Medicare Prescription Payment Plan — an optional program that lets you spread your out-of-pocket drug costs across the calendar year in monthly payments instead of paying the pharmacy in one lump when you fill a prescription.
You do not pay extra to use it — it just smooths the timing. You can sign up through your Part D plan. Medicare.gov has details and a worksheet to help you decide whether it fits your situation.
Higher-income surcharge (IRMAA)
Most people pay only their plan premium for Part D. But if your income is above a set threshold, Medicare adds an income-related monthly adjustment amount (IRMAA) to your Part D premium. For 2026, IRMAA begins for single filers with income above $109,000 (higher thresholds apply for married couples filing jointly). Social Security uses your tax return from two years earlier to decide.
What this means locally in Perth Amboy
Perth Amboy is in Middlesex County, where Medicare beneficiaries can choose from a range of stand-alone Part D drug plans and Medicare Advantage plans that include drug coverage. The rules above — the out-of-pocket cap, the maximum deductible, the three phases — apply to every Part D plan sold in the county, no matter which company offers it. The 2027 lineup is detailed in each plan's ANOC and on Medicare.gov's Plan Finder.
Plan-by-plan details like premiums, formularies (the list of covered drugs), and pharmacy networks still vary, so it is worth comparing options during the Annual Enrollment Period.
Key dates to circle
- October 15 – December 7, 2026: Medicare Annual Enrollment Period. Join, switch, or drop a Part D or Medicare Advantage plan for 2027.
- January 1 – March 31, 2027: Medicare Advantage Open Enrollment Period. If you are already in a Medicare Advantage plan, you get one chance to switch to another MA plan or return to Original Medicare (and pick up a 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 Middlesex County
(MA penetration in Middlesex 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). The hard yearly cap on what you pay out of pocket for covered drugs is $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 Part D premium?
Q: What happens if my drug isn't on my plan's formulary?
Q: I have Extra Help / a Low-Income Subsidy. Do these rules apply to me?
- CMS — Medicare Part D program rules (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.