Medicare Part D

How Medicare Part D phases work in Tualatin for 2026

For people on Medicare in Tualatin, 2026 brings a clearer, more predictable prescription drug benefit. Part D still has a deductible, still moves through phases as you fill prescriptions, but there is now a firm annual limit on what you pay out of pocket for covered drugs. Here is how the pieces fit together this year.

The 2026 out-of-pocket cap: $2,100

The biggest change most people feel is the annual cap. Once your out-of-pocket spending on covered Part D drugs reaches $2,100 in 2026, you pay $0 for the rest of the calendar year on those drugs. This cap applies whether you have a stand-alone Part D plan or drug coverage built into a Medicare Advantage plan.

The cap counts what you pay — deductibles and copays or coinsurance on covered drugs. It does not count your monthly premium, and it does not count drugs your plan does not cover.

The Part D deductible

Every Part D plan can set a deductible, up to a maximum of $615 in 2026. Some plans use the full amount, some set it lower, and some do not charge a deductible at all. During the deductible phase, you pay the full negotiated price for your covered drugs until you meet that plan's deductible.

Because the maximum is set by Medicare each year, no Part D plan in the country can charge a deductible higher than $615 in 2026.

The three phases of Part D in 2026

Since 2025, Part D has had three phases instead of four. The coverage gap — the "donut hole" that used to sit in the middle — is gone. Here is what remains:

1. Deductible phase. You pay the full cost of your covered drugs until you meet your plan's deductible (up to $615). If your plan has no deductible, you skip straight to the next phase.

2. Initial coverage phase. You pay a copay or coinsurance for each prescription, and your plan pays the rest. You stay in this phase until your out-of-pocket spending on covered drugs reaches $2,100.

3. Catastrophic phase. Once you hit the $2,100 cap, you pay $0 for covered Part D drugs for the rest of the year.

Your counter resets every January 1.

Smoothing costs with the Medicare Prescription Payment Plan

Even with the $2,100 cap, a big prescription bill early in the year can sting. The Medicare Prescription Payment Plan is a free, optional program that lets you spread your out-of-pocket drug costs across monthly payments to your plan instead of paying the pharmacy all at once.

You still pay the same total for the year — nothing is forgiven — but the monthly billing can be easier to manage. You can opt in through your Part D or Medicare Advantage drug plan.

What this looks like in Tualatin

Tualatin is in Washington County, where Medicare beneficiaries can choose from stand-alone Part D plans and Medicare Advantage plans that include drug coverage. The rules above — the $2,100 cap, the $615 maximum deductible, the three phases — apply the same way across every ZIP code in the county. What varies from plan to plan is the specific deductible, the drug list (called a formulary), preferred pharmacies, and copays.

If your income is higher than $109,000 as a single filer (or $218,000 filing jointly), you may also pay an income-related monthly adjustment amount, or IRMAA, on top of your Part D premium. Social Security notifies you if this applies.

Key dates to remember

• Annual Enrollment Period: October 15 – December 7. This is when you can join, switch, or drop a Part D or Medicare Advantage plan for the following year.
• Medicare Advantage Open Enrollment: January 1 – March 31. If you are already in a Medicare Advantage plan, you can switch to another one or return to Original Medicare with a Part D plan.

Reviewing your plan each fall is worth the time. Formularies and pharmacy networks change from year to year, and so do the medications you take.