Medicare Part D
$2,100 Part D Cap Arrives Jan 1 for Draper Residents
DRAPER, Utah — Starting January 1, 2027, the amount you pay out of pocket for prescription drugs under Medicare Part D will be capped at $2,400 for the year. Once your covered drug spending hits that number, you pay nothing for covered prescriptions the rest of the calendar year.
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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, Medicare Part D out-of-pocket drug costs will be capped at $2,400 per year, after which covered prescriptions cost nothing for the rest of the year.
- The old Part D "coverage gap" that made drugs cost more mid-year has been phased out and formally ended in 2025.
- A free, optional Medicare Prescription Payment Plan lets you spread your yearly drug costs into monthly payments instead of paying it all at the pharmacy at once.
- The $2,100 cap is a federal rule that applies to all Part D and Medicare Advantage drug plans, but higher earners (over $109,000 as a single filer in 2026) may still owe a separate IRMAA surcharge on their premiums.
Draper seniors: a $2,100 ceiling on drug costs starts Jan. 1
This is one of the biggest changes to Medicare drug coverage in years, and it lands right in the middle of the Annual Enrollment Period (October 15 – December 7, 2026). If you take expensive medications — or worry that you might someday — this is the year to understand how your plan actually works.
What's new for 2027
Three program-level facts to keep in mind, straight from Medicare's Part D rules:
- The out-of-pocket cap is $2,400. This applies to what you pay for covered Part D drugs in 2027. It resets each January.
- The maximum Part D deductible is $700 in 2027. Individual plans can set a lower deductible, but none can charge more than this.
- The coverage gap — the old "donut hole" — is gone. Part D now has three simple phases: deductible, initial coverage, and catastrophic (where you pay nothing more for the year).
Together, these changes mean there is a hard ceiling on what a Medicare drug plan can cost you in a year for covered medications. Before 2024, there was no cap at all.
Goodbye, donut hole
For years, the "coverage gap" was the confusing middle stretch where beneficiaries suddenly paid more for drugs after hitting a spending threshold. It was phased out under the Inflation Reduction Act and formally ended in 2025.
In 2027, the structure is cleaner:
1. Deductible phase — you pay full negotiated price until you meet your plan's deductible (up to $700 in 2027). 2. Initial coverage phase — you pay a copay or coinsurance until your out-of-pocket total reaches $2,400. 3. Catastrophic phase — you pay nothing for covered drugs for the rest of the year.
That's it. No more gap, no more re-entering a different cost tier mid-year.
The Medicare Prescription Payment Plan
Here's the part many people miss: even with the $2,400 cap, you could still owe a big chunk in a single month — say, if a costly prescription is filled in January.
That's where the Medicare Prescription Payment Plan comes in. It's a free, optional program that lets you spread your Part D out-of-pocket costs across the calendar year in monthly payments instead of paying at the pharmacy counter.
A few things to know:
- You still owe the same total amount — this doesn't reduce your costs; it smooths them out.
- You can opt in before the year starts or during the year.
- Your Part D plan bills you monthly; the pharmacy is paid up front.
If you've ever been surprised by a large January pharmacy bill, this is worth asking about.
What Draper residents should check during AEP
Draper is in Salt Lake County, where Medicare beneficiaries choose among a range of stand-alone Part D plans and Medicare Advantage plans that include drug coverage. For 2027, the county has 37 Medicare Advantage plans from 8 carriers. The $2,400 cap applies across all of them — it's a federal rule, not a plan feature.
But plans still differ in:
- Which drugs are on the formulary
- Which pharmacies are in-network (including mail order)
- The deductible amount (up to $700 in 2027)
- Monthly premiums
Because those pieces vary, the same medication can cost different amounts under different plans — even though the annual ceiling is the same. The Plan Finder tool at Medicare.gov lets you enter your specific prescriptions and ZIP code to compare.
Also worth noting: if your income is above $109,000 as a single filer (2026), an IRMAA surcharge may be added to your Part B and Part D premiums. That's separate from the $2,100 cap.
Key dates
- October 15 – December 7, 2026: Annual Enrollment Period. Any change you make takes effect January 1, 2027.
- January 1 – March 31, 2027: Medicare Advantage Open Enrollment. If you're already in a Medicare Advantage plan, you can switch to another MA plan or return to Original Medicare (and pick up a Part D plan).
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 Salt Lake County
(MA penetration in Salt Lake 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's a hard yearly cap of $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?
What if my drug isn't on my plan's formulary?
Do I have to sign up for the payment plan?
- CMS — Medicare Part D program rules (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.