Medicare Part D
Part D $2,400 Cap in 2027 | Spring Hill, TN
SPRING HILL, Tenn. — Starting Jan. 1, 2027, the way Medicare pays for prescription drugs is changing again, and the shift matters for anyone in Spring Hill who takes regular medication. The firm yearly ceiling on what people with a Part D drug plan pay out of pocket, first set at $2,100 in 2026, rises to $2,400 in 2027. Paired with the option to spread those costs across the year in monthly bills, this remains the biggest change to Part D since the program began.
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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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Key takeaways
- In 2027, no one with Medicare Part D will pay more than $2,400 out of pocket for covered prescription drugs in a calendar year. The cap was $2,100 in 2026.
- The old "donut hole" coverage gap is gone; Part D now has three phases instead of four.
- The Medicare Prescription Payment Plan lets you spread your drug costs into monthly installments at no added charge.
- The Annual Enrollment Period runs Oct. 15 through Dec. 7 — the window to join, switch, or drop a Part D plan for 2027.
What the Part D cap actually covers
The out-of-pocket limit applies to what you pay for drugs that are covered by your Part D plan (or the drug portion of a Medicare Advantage plan that includes drug coverage). The cap is $2,100 in 2026 and $2,400 in 2027. Once your deductible, copays, and coinsurance for covered drugs reach that amount, you pay nothing more for those drugs for the rest of the calendar year.
A few things are worth knowing. The cap resets every Jan. 1. It counts only what you spend on covered drugs — cash-pay medications or drugs not on your plan's formulary do not count. And your monthly plan premium is separate; it does not count toward the cap either.
The Part D deductible can be no higher than $615 in 2026 and no higher than $700 in 2027, though many plans set it lower. That deductible spending does count toward your out-of-pocket cap.
The coverage gap is really gone
For years, Part D had a confusing middle stage called the "donut hole" where costs jumped once you hit a spending threshold. That gap was closed in 2025, and 2027 continues the simpler three-phase structure:
1. Deductible phase — you pay the full negotiated price until you meet your plan's deductible. 2. Initial coverage phase — you pay a copay or coinsurance; the plan pays the rest. 3. Catastrophic phase — once you hit the yearly out-of-pocket cap ($2,400 in 2027), you pay nothing more for covered drugs.
That's it. No more surprise price spikes mid-year for people on expensive medications.
The Medicare Prescription Payment Plan
Even with a yearly ceiling ($2,400 in 2027), hitting that number in January or February is hard on a fixed income. That's why Medicare offers the Medicare Prescription Payment Plan, sometimes called "M3P."
Here's how it works: instead of paying the pharmacy when you pick up your medication, you opt in to have your Part D plan bill you monthly for your share of drug costs, spread across the remaining months of the year. There's no interest and no fee. You still pay the same total — it's just smoothed out.
This option is voluntary, and it isn't right for everyone. If your yearly drug costs are low, it can actually feel like more paperwork than it's worth. But if you take one or two expensive drugs and dread the January bill, it's worth asking your plan about signing up. You can enroll before the plan year starts or at any point during the year.
What Spring Hill residents should do this fall
Spring Hill sits in Maury and Williamson counties, and Medicare drug plans are sold and priced at the county level. That means the plans available to you — and their formularies, pharmacy networks, and premiums — depend on which side of the county line your address falls on.
Because plans update their drug lists and pricing every year, the single most useful thing to do during the Oct. 15 – Dec. 7 Annual Enrollment Period is to check that your current plan still covers your specific medications in 2027 at a price you can live with. The Plan Finder at medicare.gov lets you enter your drugs and ZIP code and see how plans compare. Each plan's Annual Notice of Change also spells out what's different next year.
Higher-income households: a quick note on IRMAA
If your income is above $109,000 as a single filer (or $218,000 married filing jointly) based on your 2024 tax return, you'll pay an Income-Related Monthly Adjustment Amount, or IRMAA, on top of your Part D premium in 2026. IRMAA does not affect the cap ($2,100 in 2026, $2,400 in 2027) — it's a separate surcharge tied to income.
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 Maury County
(MA penetration in Maury 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 in 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 $2,100 cap include my monthly Part D premium?
Do I have to sign up for the Medicare Prescription Payment Plan?
What if my drug isn't on my plan's formulary?
When can I change my Part D plan?
- CMS — Medicare Part D program rules (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.
Also for Spring Hill
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This page was last updated: October 7, 2026.