Medicare Part D

Medicare Part D in 2027 — Asheboro, NC

ASHEBORO, N.C. — On Jan. 1, 2027, the Medicare Part D cap on what you pay out of pocket for covered prescription drugs rises to $2,400 for the year. Once you hit that number at the pharmacy counter, your covered medications cost you nothing for the rest of 2027. The cap carries forward one of the biggest Part D changes in years, and it lands right as the Annual Enrollment Period (Oct. 15 – Dec. 7) is underway.

Here's a plain-English look at what's different, what's staying the same, and where Asheboro readers can get help.

The Part D cap, in plain terms

For years, there was no limit on what someone could spend out of pocket for Part D drugs in a single year. People with cancer treatments, expensive injectables, or brand-name specialty drugs could easily spend many thousands of dollars.

That changes in 2026. Under the Inflation Reduction Act, Medicare caps annual out-of-pocket spending on covered Part D drugs at $2,100 in 2026 ($2,400 in 2027). The cap applies whether you have a stand-alone Part D plan or drug coverage built into a Medicare Advantage plan.

A few things to keep in mind:

• The cap ($2,100 in 2026, $2,400 in 2027) only counts what you pay for covered drugs. Premiums don't count toward it, and neither do drugs your plan doesn't cover.
• Your plan's deductible still applies at the start of the year. For 2026, the maximum Part D deductible is $615.
• After the deductible, you pay coinsurance or copays until you hit the yearly cap. Then you're done paying for covered drugs for the rest of the year.

The "donut hole" is gone

If you've been on Medicare for a while, you probably remember the coverage gap — the "donut hole" — where costs spiked after your plan had spent a certain amount on your drugs.

That phase went away in 2025. Part D now has just three phases: the deductible, the initial coverage phase, and the catastrophic phase (where you pay nothing once you hit the cap). It's simpler, and for people on costly medications, it's a real relief.

The Medicare Prescription Payment Plan

Hitting the yearly cap in January or February is still a big bill if it lands all at once. That's 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 installments instead of paying the pharmacy in full each time.

A few points worth knowing:

• It's free to sign up, and every Part D plan and Medicare Advantage plan with drug coverage must offer it.
• You don't save money overall — you still owe the same total. It just smooths the payments.
• You can opt in before the year starts or any month during the year. If a big prescription is coming, that's a good time to look at it.
• You pay Medicare's billing partner monthly, not the pharmacy.

It won't be the right choice for everyone. If your drug costs are modest and steady, paying at the pharmacy may be simpler. If you take a high-cost drug and expect to hit the cap early, the payment plan can prevent a painful one-month hit.

What this means locally

Asheboro is in Randolph County, where Medicare beneficiaries can choose between Original Medicare with a stand-alone Part D plan, or a Medicare Advantage plan that bundles drug coverage. The cap ($2,100 in 2026, $2,400 in 2027) and the payment plan apply to both routes — this is a program-level rule, not a plan-specific perk.

If you're comparing coverage during AEP, the Medicare Plan Finder at medicare.gov lets you enter your prescriptions and see estimated yearly costs under each plan available in Randolph County.

A quick note on IRMAA

Higher-income beneficiaries pay a surcharge called IRMAA on top of their Part B and Part D premiums. For 2026, IRMAA starts kicking in above $109,000 in income for a single filer (higher for joint filers). Social Security uses your tax return from two years earlier to decide. If your income has dropped since then — say, you retired — you can ask for a reconsideration.