Medicare Part D

Medicare Part D in Roy: $2,100 cap and new phases

ROY, Utah — If you take prescription drugs, Medicare Part D continues to work under the redesign that began in 2026, with updated figures for 2027. There's a firm cap on what you'll pay out of pocket for covered drugs, a set limit on the deductible, and a simpler three-phase design. Here's what Roy residents need to know before the enrollment window closes on December 7.

The Out-of-Pocket Cap: $2,400 in 2027

In 2027, no one with a Medicare Part D plan will pay more than $2,400 out of pocket for covered prescription drugs in a calendar year (the 2026 figure is $2,100). Once you hit that amount, you pay $0 for the rest of the year on covered medications.

This cap is set by Medicare and applies across all Part D plans, whether you get drug coverage through a stand-alone Part D plan or bundled inside a Medicare Advantage plan. For people who take expensive brand-name drugs, this is a meaningful shift — the days of open-ended drug bills are over.

The Deductible: Up to $700 in 2027

Every Part D plan can charge a yearly deductible before coverage kicks in. For 2027, Medicare has set the maximum deductible at $700 (it is $615 in 2026). Some plans charge the full amount, some charge less, and some charge nothing on certain drug tiers. The number varies by plan, but no plan can go above that ceiling.

Once you meet the deductible, you move into the next phase of coverage.

The Three Phases of Part D in 2027

The old "donut hole" coverage gap was eliminated in 2025, so Part D now has just three phases:

1. Deductible phase. You pay the full negotiated price for your drugs until you hit your plan's deductible (up to $700 in 2027).

2. Initial coverage phase. You pay a copay or coinsurance, and your plan pays the rest. You stay in this phase until your out-of-pocket spending reaches $2,400 in 2027.

3. Catastrophic phase. Once you hit the $2,400 cap in 2027, you pay $0 for covered drugs for the rest of the calendar year.

That's it — three phases, one clear ceiling.

Smoothing Your Costs: The Medicare Prescription Payment Plan

If hitting the deductible or a big copay early in the year would strain your budget, Medicare offers an option called the Medicare Prescription Payment Plan. It lets you spread your out-of-pocket drug costs across the calendar year in monthly installments instead of paying all at once at the pharmacy.

It doesn't lower what you owe — it just smooths the payments. Enrollment is free, and you can sign up through your Part D plan.

What This Means Locally

Roy is in Weber County, where Medicare beneficiaries have multiple stand-alone Part D plans and Medicare Advantage plans with drug coverage to choose from during Annual Enrollment. The 2027 lineup is detailed in each plan's Annual Notice of Change and on Medicare.gov's Plan Finder. Plan details — the drugs on the formulary, the pharmacy network, and monthly premiums — vary. The $2,400 cap and $700 maximum deductible for 2027 are program-wide rules and apply no matter which plan you pick.

You can compare plans available in Weber County using the Plan Finder tool at medicare.gov.

Higher-Income Reminder: IRMAA

If your income is above $109,000 as a single filer (or $218,000 filing jointly) based on your 2024 tax return, you'll pay an income-related monthly adjustment amount (IRMAA) on top of your Part D premium. Social Security notifies you if this applies.

Key Deadlines

• Annual Enrollment Period: October 15 – December 7, 2026. This is when you can join, switch, or drop a Part D or Medicare Advantage plan for 2027.
• Medicare Advantage Open Enrollment: January 1 – March 31. If you're already in a Medicare Advantage plan, you get one chance to switch or return to Original Medicare.