Medicare Part D
Why the Medicare donut hole is gone for Euless in 2026
EULESS, Texas — Starting Jan. 1, 2026, the way you pay for prescription drugs under Medicare looks different than it did just two years ago. The Part D out-of-pocket cap rises to $2,100, the old "donut hole" is gone for good, and a payment plan lets you spread drug costs across the year. If you take expensive medications — or worry you might someday — these are the changes worth understanding before Annual Enrollment ends Dec. 7.
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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.
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Click to call 855-729-3240Key takeaways
- In 2026, once you spend $2,100 out of pocket on covered Part D drugs, you pay $0 for the rest of the calendar year.
- The Part D coverage gap (the "donut hole") no longer exists; there are now three payment phases instead of four.
- The Medicare Prescription Payment Plan lets you spread your yearly drug costs into monthly bills at no extra charge.
- The Part D deductible can be no higher than $615 in 2026, and Annual Enrollment runs Oct. 15 through Dec. 7.
What the $2,100 cap actually means
The out-of-pocket cap is a hard ceiling on what you personally pay for covered prescription drugs under Part D in a calendar year. In 2026, that ceiling is $2,100, up from $2,000 in 2025. Once you hit it, you pay nothing more for your covered drugs through Dec. 31.
A few important details:
- Only what you pay counts toward the cap — your deductible, copays, and coinsurance for Part D drugs.
- Your monthly Part D premium does not count.
- Drugs that are not on your plan's formulary (the covered drug list) generally don't count either.
- The cap resets every Jan. 1.
This is the biggest financial protection Medicare has ever built into Part D, and it applies whether you have a stand-alone Part D plan or drug coverage through a Medicare Advantage plan.
Why the "donut hole" is gone
For years, Part D worked in four confusing stages, including the notorious coverage gap where beneficiaries suddenly paid a larger share of drug costs. That gap was eliminated starting in 2025. In 2026, Part D has just three phases:
1. Deductible phase — you pay full negotiated price until you meet the deductible (no more than $615 in 2026; some plans set it lower or at $0). 2. Initial coverage phase — you pay a copay or coinsurance; the plan pays the rest. 3. Catastrophic phase — once your out-of-pocket spending reaches $2,100, you pay nothing for covered drugs the rest of the year.
Fewer phases, one clear ceiling. That's the design.
The Medicare Prescription Payment Plan, explained
Even with a $2,100 cap, hitting that number in January or February can hurt. That's where the Medicare Prescription Payment Plan comes in. It's a free, optional program that lets you pay your out-of-pocket drug costs in level monthly installments across the calendar year instead of at the pharmacy counter.
How it works in plain terms:
- You still owe the same total for the year — the payment plan does not lower your drug costs.
- Instead of paying the pharmacy, you pay $0 at pickup and get a monthly bill from your Part D plan.
- You can opt in before the year starts or any month during the year by contacting your plan.
- There are no fees or interest.
This option tends to help most if you have high drug costs early in the year or take a specialty medication. It may not help — and could even feel like a hassle — if your drug costs are low and spread out.
What Euless readers should keep in mind locally
Euless is in Tarrant County, where a wide range of stand-alone Part D and Medicare Advantage plans with drug coverage are offered. The federal rules above apply to every one of those plans, but formularies, pharmacy networks, and premiums vary. That's why the same medication can cost different amounts under different plans — even though the $2,100 cap is universal.
The most common mistake we see this time of year: assuming your current plan will treat your drugs the same way next year. Plans can change their formulary, tiers, and preferred pharmacies every January. Before Dec. 7, use the Plan Finder at medicare.gov to check that your specific prescriptions are still covered the way you expect.
Common mistakes to avoid
- Skipping the annual review. Even if you love your plan, its 2026 formulary may not match your 2025 one.
- Confusing the cap with a subsidy. The $2,100 cap doesn't lower drug prices — it stops your out-of-pocket spending once you hit that number.
- Ignoring IRMAA. Higher-income beneficiaries (above $109,000 for a single filer in 2026) pay an income-related surcharge on Part B and Part D premiums.
- Waiting too long to opt into the payment plan. You can join any month, but joining later in the year spreads your costs over fewer months.
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 Tarrant County
(MA penetration in Tarrant 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 2026
The old coverage gap (“donut hole”) is eliminated as of 2025 (three phases now). There’s now a hard yearly cap of $2,100 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 apply to all my medications?
Do I have to sign up for the Medicare Prescription Payment Plan?
When can I change my Part D or Medicare Advantage plan for 2026?
Where can I get free help sorting through my options?
- CMS — Medicare Part D program rules (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.
Also for Euless
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This page was last updated: September 2026.