Medicare Part D
Hanahan, SC: Part D Cap & Phases in 2027
HANAHAN, S.C. — If you take prescription drugs and use Medicare, 2027 brings an updated out-of-pocket limit worth understanding before you pick up your next refill. Medicare Part D — the part of Medicare that helps pay for prescription drugs — works in three phases, with a firm yearly limit on what you pay out of pocket at the pharmacy counter.
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Will your prescriptions still be covered in 2027?
Part D plans rewrite their drug lists every year — tiers move, pharmacies change, drugs drop off. One call checks your exact medications against the 2027 plans in your area.
- Every prescription checked, name by name
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Click to call 855-729-3240Key takeaways
- In 2027, Medicare Part D has three phases: a deductible phase, an initial coverage phase, and a catastrophic phase where you pay nothing for covered drugs.
- The yearly out-of-pocket spending cap for covered Part D drugs is $2,100 in 2026 and $2,400 in 2027; once you hit it, you stop paying for covered prescriptions until January.
- The Part D maximum deductible is $615 in 2026 and $700 in 2027, though some plans set it lower or cover some drugs before the deductible is met.
- If a big pharmacy bill would be hard to pay in one month, you can opt into the Medicare Prescription Payment Plan through your Part D plan to spread costs across the year, though this does not lower your total costs.
A calmer year for prescription costs is coming
Hanahan is in Berkeley County, where residents get their Part D coverage the same way people do across the country: either through a stand-alone Part D plan added to Original Medicare, or built into a Medicare Advantage plan that includes drug coverage. The rules below are set by Medicare and apply no matter which plan you choose.
The three phases of Part D in 2027
Since 2025, the old "donut hole" coverage gap is gone. Part D now moves through three phases in a calendar year:
1. The deductible phase. You pay the full negotiated price for your drugs until you meet your plan's deductible. In 2026, no Part D plan can set a deductible higher than $615. Some plans set it lower, and some drugs may be covered before you meet it.
2. The initial coverage phase. After the deductible, 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 the yearly cap.
3. The catastrophic phase. Once you hit the cap, you pay $0 for covered Part D drugs for the rest of the calendar year. Your plan and Medicare cover the cost from that point forward.
The Part D out-of-pocket cap
This is the headline figure for 2027: your out-of-pocket spending on covered Part D drugs is capped at $2,400 for the year (up from $2,100 in 2026). Once you reach it, you're done paying for covered prescriptions until January.
A few things to keep in mind:
- The cap applies to what you pay for covered drugs — deductibles, copays, and coinsurance count toward it.
- Monthly plan premiums do not count toward the cap.
- Drugs that aren't on your plan's formulary (its list of covered drugs) don't count either.
- The cap resets every January 1.
The Medicare Prescription Payment Plan
If paying a large amount at the pharmacy in a single month would be a hardship, Medicare offers an optional program called the Medicare Prescription Payment Plan. Instead of paying the pharmacy directly, you can choose to spread your Part D costs across the calendar year in monthly bills from your plan.
It doesn't lower your total costs — it just smooths them out. You have to opt in through your Part D plan, and it's worth asking about if you take an expensive drug early in the year.
Common mistakes to avoid
A few slip-ups trip people up every year:
- Skipping Part D when you're first eligible. If you go without creditable drug coverage for too long, a late enrollment penalty can be added to your premium for as long as you have Part D.
- Assuming every plan covers every drug. Formularies differ. Check that your specific medications are covered before you enroll.
- Ignoring the Annual Enrollment Period. Between October 15 and December 7, you can switch Part D or Medicare Advantage plans for the following year. If you're already in a Medicare Advantage plan, there's also a Medicare Advantage Open Enrollment Period from January 1 through March 31.
- Forgetting about IRMAA. Higher-income beneficiaries pay an extra amount on top of their Part D premium. In 2026, this surcharge begins for single filers with income above $109,000 (based on your tax return from two years earlier).
What to do before January
Take a few minutes to:
1. List every prescription you take, including the dose. 2. Sign in at medicare.gov and use the Plan Finder to compare how different Part D or Medicare Advantage drug plans would handle your list. 3. If costs may be tight early in the year, ask about the Medicare Prescription Payment Plan. 4. If your income has dropped, look into Extra Help (the Low-Income Subsidy), which can further reduce Part D costs.
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 Berkeley County
(MA penetration in Berkeley 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 is 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 $2,100 cap include my monthly premium?
What happens to the "donut hole" I've heard about?
If I hit the $2,100 cap in June, do I really pay nothing for the rest of the year?
- CMS — Medicare Part D program rules (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.