Medicare Part D
$2,400 Part D Cap Comes to Burleson in 2027
BURLESON, Texas — Starting January 1, 2026, a long-awaited change kicks in for anyone on Medicare's prescription drug coverage: no one enrolled in a Part D plan will pay more than $2,100 out of pocket for covered medications in a calendar year. For Burleson residents who have watched drug prices climb, it's one of the most meaningful shifts Medicare has seen in years.
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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
- Your pharmacy checked for preferred pricing
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Speak to a Licensed Insurance Agent
Click to call 855-729-3240Key takeaways
- Starting January 1, 2027, Part D drug plans have a hard yearly cap of $2,400 in out-of-pocket costs, after which covered drugs cost nothing for the rest of the year.
- The old "donut hole" coverage gap is gone, replaced since 2025 by three simple phases: deductible (up to $615 in 2026, and up to $700 in 2027), initial coverage, and catastrophic.
- The optional, free Medicare Prescription Payment Plan lets you spread your drug costs into monthly bills instead of paying it all at the pharmacy at once.
- These rules apply to every Part D and Medicare Advantage drug plan, so when comparing plans during Annual Enrollment, it's more useful to check your medications' formulary and tier than to look for the cap itself.
Here's a plain-language look at what's changing, what stays the same, and where to get help.
The Part D cap, in plain English
The out-of-pocket cap is a hard ceiling. The Part D out-of-pocket cap is $2,100 in 2026 and $2,400 in 2027. Once your covered drug costs — the deductible and your share of prescriptions — reach the cap in a year, you pay nothing more for covered drugs the rest of that year through your Part D plan.
A few points worth knowing:
- The cap applies to covered drugs on your plan's formulary. Drugs your plan doesn't cover don't count toward it.
- Monthly premiums do not count toward the $2,100 in 2026 ($2,400 in 2027).
- The cap resets each January 1.
This ceiling applies whether your Part D coverage comes as a stand-alone drug plan or as part of a Medicare Advantage plan that includes drugs.
The "donut hole" is officially gone
For years, the coverage gap — the so-called donut hole — was one of the most confusing parts of Medicare. It's now history. Since 2025, Part D has just three phases:
1. Deductible phase — you pay full negotiated price until you meet your plan's deductible (up to $615 in 2026, and up to $700 in 2027). 2. Initial coverage phase — you pay a share of the cost (a copay or coinsurance) for each prescription. 3. Catastrophic phase — once you reach the out-of-pocket limit for the year ($2,100 in 2026, $2,400 in 2027), you pay nothing more for covered drugs the rest of the year.
No more surprise jump in prices halfway through the year. That alone makes budgeting easier for people on fixed incomes.
The Medicare Prescription Payment Plan: spreading the cost
Even with the cap ($2,100 in 2026, $2,400 in 2027), some folks hit big drug bills early in the year — for example, if an expensive medication is filled in January. That's where the Medicare Prescription Payment Plan comes in.
This is a free, optional program offered through your Part D plan. Instead of paying the pharmacy at pickup, you can spread your out-of-pocket drug costs across the remaining months of the calendar year in monthly bills from your plan.
A few things to keep in mind:
- It does not lower what you owe overall — it just smooths the timing.
- You have to opt in. It isn't automatic.
- You can sign up before the plan year starts or any time during the year.
- Your plan sends you a monthly bill; the pharmacy still gets paid up front.
For someone in Burleson facing a $600 refill in January, this can be the difference between a hard month and a manageable one.
What this looks like in Burleson
Burleson sits in Johnson County, and Medicare plan availability is set at the county level. That means the same menu of Part D and Medicare Advantage plans offered across Johnson County is what's available to Burleson residents. Every one of those plans has to honor the new cap ($2,100 in 2026, $2,400 in 2027) and offer the payment plan option — those are federal rules, not perks a plan can add or drop.
If you're comparing options during this fall's Annual Enrollment Period, focus less on whether a plan has the cap (they all do) and more on whether your specific medications are on the plan's formulary and what tier they fall into.
Key dates to circle
- October 15 – December 7, 2026: Medicare Annual Enrollment Period. Changes take effect January 1, 2027.
- January 1 – March 31, 2027: Medicare Advantage Open Enrollment Period, if you're already in an Advantage plan and want to switch or return to Original Medicare.
If your income was above $109,000 as a single filer (or $218,000 filing jointly) on your most recent tax return Medicare has on file, you may also owe an IRMAA surcharge on top of your Part D premium in 2026.
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 Johnson County
(MA penetration in Johnson 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”) is eliminated as of 2025 (three phases now). There’s now a hard yearly cap of $2,100 in 2026 ($2,400 in 2027) on what you pay out of pocket for covered drugs, 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?
If I take one very expensive drug, can I hit $2,100 in a single month?
Do I have to sign up for the payment plan every year?
- CMS — Medicare Part D program rules (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.