Medicare Part D

Part D in 2027: Salisbury, NC Guide

# A plain-language guide to Medicare prescription drug…

SALISBURY, N.C. — If you take even one prescription drug, Medicare Part D is worth understanding before the Annual Enrollment Period ends on Dec. 7. And in 2027, the rules remain simpler than they've been in years — but only if you know what to look for.

Here's how Part D works for 2027 coverage, step by step, so you can avoid the most common (and most expensive) mistakes.

The big change: a hard Part D cap

For the second year, there is a firm ceiling on what you'll pay out of pocket each year for covered drugs. The cap is $2,100 in 2026 and $2,400 in 2027.

Once your out-of-pocket spending on covered prescriptions hits $2,100 in 2026 ($2,400 in 2027), you pay $0 for the rest of the calendar year on those drugs. This is a program-wide rule set by Medicare — it applies whether you get Part D through a stand-alone drug plan or bundled inside a Medicare Advantage plan.

For people who take expensive medications — cancer drugs, blood thinners, specialty treatments — this cap can change the math on the whole year.

The three phases of Part D in 2027

Before 2025, Part D had four phases, including the famous "donut hole" coverage gap. That's over. Today, there are three phases, and they happen in order:

1. Deductible phase. You pay the full negotiated price for your drugs until you meet your plan's deductible. The maximum deductible any Part D plan can charge is $615 in 2026 and $700 in 2027. Some plans set it lower, and some drugs may be exempt from the deductible entirely.

2. Initial coverage phase. After the deductible, you pay a share of the drug cost (a copay or coinsurance) and your plan pays the rest. You stay in this phase until your out-of-pocket spending hits the cap ($2,100 in 2026, $2,400 in 2027).

3. Catastrophic phase. Once you hit $2,100 in 2026 ($2,400 in 2027) out of pocket, you pay nothing for covered drugs for the rest of the year.

That's it. No gap, no confusing "true out-of-pocket" math to track on your own.

The Medicare Prescription Payment Plan

Here's a piece of Part D many people don't know about: you can ask to spread your drug costs across the calendar year instead of paying them at the pharmacy.

It's called the Medicare Prescription Payment Plan. You still owe the same total amount, but instead of a $600 hit in January and smaller bills later, your plan bills you in monthly installments. There's no interest and no fee.

This can help if a big cost early in the year would strain your budget. You have to opt in — it isn't automatic. Ask your Part D plan or check medicare.gov for the enrollment form.

Part D and higher incomes (IRMAA)

If your income is above a certain level, you'll pay an extra amount for Part D on top of your plan premium. This is called IRMAA — the Income-Related Monthly Adjustment Amount.

For 2026, IRMAA starts above $109,000 for a single filer (higher thresholds apply for married couples filing jointly). Social Security uses your tax return from two years ago to decide. If your income has dropped since then — say, you retired — you can appeal.

What to check during Annual Enrollment

The Annual Enrollment Period runs Oct. 15 through Dec. 7 every year. This is when you can join, switch, or drop a Part D plan for the following year.

Salisbury is in Rowan County, where several stand-alone Part D plans and Medicare Advantage plans with drug coverage are available. Plan formularies — the list of drugs each plan covers — can change from year to year, along with pharmacy networks and cost-sharing tiers.

Before you renew whatever you had last year, check three things:

• Are all your current prescriptions still on the plan's formulary?
• Is your pharmacy still in the plan's preferred network?
• Has your deductible or tier structure changed?

The Plan Finder tool at medicare.gov lets you enter your drugs and ZIP code and compare what's offered in Rowan County side by side.

The most common Part D mistake

The biggest, most avoidable mistake is not signing up when you first become eligible — and not having other "creditable" drug coverage in the meantime.

If you go 63 days or more without creditable drug coverage after your Initial Enrollment Period, you can face a Part D late enrollment penalty that gets added to your premium for as long as you have Part D. It never goes away.

If you're not sure whether coverage you have now (from an employer, a retiree plan, or the VA) counts as creditable, ask the plan for a written notice. They're required to tell you.