Medicare Part D
How Part D changes in 2026 affect Logan Medicare users
LOGAN, Utah — If you take prescription drugs and have Medicare, 2027 brings another adjustment to Part D. The out-of-pocket ceiling at the pharmacy is moving up from its 2026 level — and the old "donut hole" remains gone for good.
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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
- The Part D out-of-pocket cap is $2,100 in 2026 and $2,400 in 2027. Once you hit that cap, you pay $0 for covered drugs the rest of the year.
- The old "donut hole" coverage gap was eliminated in 2025, leaving Part D with three phases: deductible, initial coverage, and catastrophic.
- The Part D maximum deductible is $615 in 2026 and $700 in 2027. Only what you personally pay (plus most manufacturer discounts) counts toward the annual out-of-pocket cap.
- The optional, free Medicare Prescription Payment Plan lets you spread your out-of-pocket drug costs into monthly payments instead of paying it all at once at the pharmacy.
Here's a plain-language walkthrough of how Part D works in 2027, what the numbers mean, and where to go for help.
The headline change: a $2,100 out-of-pocket cap
In 2027, the most you'll pay out of pocket for covered prescription drugs under Part D is $2,400 for the year (up from $2,100 in 2026). Once your out-of-pocket spending on covered drugs hits that cap, you pay $0 for the rest of the calendar year on those drugs.
This cap applies whether your drug coverage comes through a stand-alone Part D plan or a Medicare Advantage plan that includes drug coverage. It resets every January 1.
For people in Logan who take expensive medications — think insulin, blood thinners, cancer drugs, or specialty biologics — this is a meaningful change from prior years, when there was no annual limit at all.
The three phases of Part D in 2027
The old "coverage gap" (the donut hole) was eliminated in 2025. That means Part D now has three phases instead of four:
1. Deductible phase. You pay the full negotiated price of your drugs until you meet your plan's deductible. In 2027, plans can charge a deductible up to $700 (up from $615 in 2026), though some plans set it lower or waive it for certain drug tiers.
2. 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 costs reach $2,400 in 2027.
3. Catastrophic phase. Once you hit $2,400 in 2027, you pay nothing for covered drugs for the rest of the year.
Only what you pay counts toward the $2,400 cap in 2027 — not what your plan pays. Manufacturer discounts on brand-name drugs generally also count toward it.
Spreading costs out: the Medicare Prescription Payment Plan
Hitting the deductible in January can sting, especially if you fill a pricey prescription early in the year. That's where the Medicare Prescription Payment Plan comes in.
This is a free, optional program that lets you spread your out-of-pocket drug costs across monthly payments instead of paying the pharmacy all at once. You still pay the same total amount over the year — it's just smoothed out.
You can sign up through your Part D plan. It's worth asking about if you expect high drug costs early in 2027.
What about higher-income enrollees?
Most people pay only their plan's premium for Part D. But if your income is above certain thresholds, you'll pay an extra amount called IRMAA (Income-Related Monthly Adjustment Amount) on top of your premium.
For 2026, IRMAA surcharges for Part D start when a single filer's income is above $109,000 (based on your 2024 tax return). Married couples filing jointly have a higher threshold. Social Security notifies you if it applies, and there's an appeal process if your income has dropped.
Coverage where you live
Logan is in Cache County, where Medicare beneficiaries can choose from multiple stand-alone Part D drug plans and Medicare Advantage plans that include drug coverage. Plan availability, formularies (the list of covered drugs), and pharmacy networks are set at the county level, so what your neighbor picks may not be right for you.
The best way to compare what's available in Cache County is the Plan Finder tool at medicare.gov, which lets you enter your specific medications and see how each plan would handle them.
Key dates to remember
- October 15 – December 7: Medicare Annual Enrollment Period. You can join, switch, or drop a Part D or Medicare Advantage plan. Changes take effect January 1.
- January 1 – March 31: Medicare Advantage Open Enrollment. If you're already in a Medicare Advantage plan, you can switch to another one or return to Original Medicare (and add a Part D plan).
If you miss these windows, you generally have to wait until the next one unless you qualify for a Special Enrollment Period.
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 Cache County
(MA penetration in Cache 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 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 out-of-pocket cap include my monthly premium?
What if my drug isn't on my plan's formulary?
I have Extra Help (LIS). Does any of this change for me?
- CMS — Medicare Part D program rules (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.