Medicare Part D
Part D in Upper Arlington, Ohio: 2027 Update
UPPER ARLINGTON, Ohio — Medicare's prescription drug coverage continues to look different than it did before 2026. There is a hard yearly limit on what you pay out of pocket for covered drugs under Part D: $2,400 in 2027, up from $2,100 in 2026.
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Key takeaways
- In 2027, Medicare Part D will have a hard yearly out-of-pocket cap of $2,400, after which covered drugs cost nothing for the rest of the year.
- The old "donut hole" coverage gap is gone, leaving just three simple phases: deductible (up to $700 in 2027), initial coverage, and catastrophic coverage.
- A free, optional Medicare Prescription Payment Plan lets you spread your drug costs into monthly bills instead of paying it all at the pharmacy, and Medicare.gov has a worksheet to help you decide if it's right for you.
- If your 2024 income was above $109,000 (single) or $218,000 (joint), you'll pay an extra IRMAA charge on top of your Part B and Part D premiums in 2026, and you can request a reconsideration if your income has since dropped.
A big change is coming to Part D on Jan. 1
That change — combined with the end of the old "donut hole" and the option to spread drug costs across the year — continues to reshape how people on Medicare plan for 2027. Here's what Upper Arlington residents should understand before the Annual Enrollment Period closes on December 7, 2026.
The Part D out-of-pocket cap, in plain English
Under the rules from CMS, once your out-of-pocket spending on covered Part D drugs reaches $2,400 in 2027, you pay $0 for the rest of the year on those covered prescriptions. This applies whether you have a stand-alone Part D plan or drug coverage built into a Medicare Advantage plan.
A few things to know:
- The cap counts what you pay — deductibles, copays, and coinsurance on covered drugs.
- It does not count your monthly premium.
- It does not count drugs your plan doesn't cover.
- The Part D deductible can be no higher than $700 in 2027 (it was $615 in 2026), though many plans set it lower.
For people who take expensive medications, this is the most significant change to Part D since the program began.
The coverage gap ("donut hole") is gone
If you've been on Medicare for a while, you probably remember the coverage gap — the middle stretch where your drug costs suddenly jumped after your plan hit a spending threshold.
That phase was eliminated in 2025. In 2027, Part D has just three phases:
1. Deductible phase — you pay full negotiated cost until you meet your plan's deductible (up to $700 in 2027). 2. Initial coverage phase — you pay copays or coinsurance until your out-of-pocket total reaches $2,400. 3. Catastrophic phase — you pay nothing for covered drugs for the rest of the calendar year.
Simpler math, and a real ceiling on what you can spend.
The Medicare Prescription Payment Plan
Even with a $2,400 cap in 2027, hitting that number in January or February can hurt if you take pricey medications. That's where the Medicare Prescription Payment Plan comes in.
It's a free, optional program that lets you spread your out-of-pocket drug costs across the calendar year in monthly bills, instead of paying the full amount at the pharmacy counter. You still owe the same total — but the timing is smoother.
A few points to consider:
- You sign up through your drug plan, not through Medicare directly.
- It works best for people with high drug costs early in the year.
- If you have low, steady drug costs, it may add paperwork without much benefit.
- You can opt in at any time during the year.
Medicare.gov has a worksheet that helps you decide if it makes sense for your situation.
What Upper Arlington residents should do this fall
Upper Arlington is in Franklin County, where Medicare beneficiaries in 2027 can choose from 74 Medicare Advantage plans offered by 12 carriers, alongside stand-alone Part D plans. Availability and formularies are set at the county level, and both change every year — which is exactly why CMS builds in the Annual Enrollment Period.
A practical checklist for this season:
- Read your Annual Notice of Change (ANOC). Your current plan mailed it in September 2026. It shows what's changing for 2027.
- Check your drug list. Even if your plan is staying, its formulary may not cover the same medications the same way.
- Compare on Medicare.gov's Plan Finder. You can enter your prescriptions and see estimated yearly costs under every plan available in your ZIP code.
- Ask about the payment plan. If your drugs are expensive, talk to your plan about enrolling in the Prescription Payment Plan for 2027.
A quick word on IRMAA
If your income is above $109,000 as a single filer (or $218,000 filing jointly) based on your 2024 tax return, you'll pay an income-related monthly adjustment amount (IRMAA) on top of your standard Part B and Part D premiums in 2026. Social Security notifies you by mail. If your income has dropped due to retirement, marriage, or the death of a spouse, you can request a reconsideration.
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 Franklin County
(MA penetration in Franklin 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). There's a hard yearly cap on what you pay out of pocket for covered drugs — $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
Does the $2,400 cap include my monthly premium?
What if I switch plans mid-year? Does my $2,400 reset?
Is the Prescription Payment Plan the same as a payment plan with my pharmacy?
- CMS — Medicare Part D program rules (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.