Medicare Part D
$2,100 Part D Cap and Payment Plan Reach Columbia
Columbia, S.C. — Starting Jan. 1, 2027, the Part D out-of-pocket cap that reshaped Medicare's prescription drug program rises to $2,400 for the calendar year. For many older adults in Columbia who take costly drugs, that ceiling — paired with the option to spread those costs across the year — remains a genuine turning point.
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Key takeaways
- Starting Jan. 1, 2027, Part D drug spending is capped at $2,400 out of pocket per year, after which covered drugs cost $0 for the rest of the year.
- As of 2025, the old "donut hole" coverage gap is gone, leaving just three stages: deductible, initial coverage, and catastrophic coverage.
- The Medicare Prescription Payment Plan is a free, optional program that lets you spread your yearly drug costs into monthly bills instead of paying it all at the pharmacy, with no income requirement to join.
- In 2026, the IRMAA income surcharge on Part B and Part D starts for single filers earning more than $109,000, though most people won't have to pay it.
Here is what is changing, what stays the same, and where to get help locally.
The $2,100 cap, explained plainly
For 2027, Medicare sets a hard ceiling of $2,400 on what you pay out of pocket for prescription drugs covered under Part D. Once your covered drug spending reaches that amount, you pay $0 for the rest of the year for those covered drugs. The cap applies whether your Part D coverage comes through a stand-alone drug plan or through a Medicare Advantage plan that includes drugs.
A few details worth knowing:
- The cap only counts spending on drugs your plan covers. Drugs your plan does not cover do not count toward the $2,100.
- Plan premiums do not count toward the cap.
- The Part D deductible can be no higher than $700 in 2027, though many plans set it lower.
This cap is a program-level rule set by CMS under the Inflation Reduction Act. It applies the same way in Columbia as it does anywhere else in the country.
Goodbye, "donut hole"
If you have been on Medicare for a while, you probably remember the coverage gap — the so-called "donut hole" — where your share of drug costs jumped in the middle of the year before catastrophic coverage kicked in.
That phase is gone. As of 2025, Part D has just three stages:
1. Deductible (if your plan has one) 2. Initial coverage, where you pay a share of the cost 3. Catastrophic coverage, where you pay $0 once you hit the annual out-of-pocket limit
In 2027, that limit is $2,400. There is no fourth stage waiting to surprise you.
The Medicare Prescription Payment Plan
The cap helps with the total, but $2,400 in January or February is still a lot to hand over at the pharmacy counter. That's where the Medicare Prescription Payment Plan comes in.
This is a free, optional program. If you opt in, you don't pay the pharmacy directly for your covered drugs. Instead, your Part D plan bills you monthly, spreading your out-of-pocket costs across the remaining months of the year. Your total for the year does not change — it is the same money, just paid in installments.
Who tends to benefit most? People with high drug costs early in the year, or anyone who would rather have a predictable monthly bill than a big pharmacy charge. Anyone with a Part D plan can sign up; there is no income test. You can enroll before the year starts or at any point during the year by contacting your drug plan.
If your drug costs are low and steady, you may not need it at all.
What this means locally
Columbia sits in Richland County, where Medicare beneficiaries can choose among a range of stand-alone Part D drug plans and Medicare Advantage plans that include drug coverage. The $2,100 cap and the payment plan apply to all of them — those are federal rules, not plan features.
That said, plans still differ in which drugs they cover, what tier those drugs fall on, which pharmacies are in-network, and what the monthly premium looks like. Two people in the same Columbia ZIP code taking different medications can have very different experiences under the same plan. This is why comparing plans on your actual drug list matters more than picking based on a name you recognize.
Dates to circle
- Oct. 15 – Dec. 7, 2026: Medicare Annual Enrollment Period. This is when you can join, switch, or drop a Part D or Medicare Advantage plan for 2027.
- Jan. 1, 2027: New coverage — and the $2,400 cap — take effect.
- Jan. 1 – Mar. 31, 2027: Medicare Advantage Open Enrollment. If you are in a Medicare Advantage plan and it isn't working for you, you get one chance to switch to another MA plan or return to Original Medicare.
One more figure to keep in mind: IRMAA, the income-related surcharge on Part B and Part D, kicks in for single filers with income above $109,000 in 2026 (higher thresholds apply for married couples filing jointly). Most people don't pay it, but if your income has changed, it's worth checking.
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 Richland County
(MA penetration in Richland 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 yearly cap on what you pay out of pocket for covered drugs is $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 $2,100 cap include my monthly plan premium?
If I sign up for the payment plan, do I actually save money?
I take just one generic. Do I need to do anything?
- CMS — Medicare Part D program rules (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.