Medicare Part D
Medicare's 2027 Part D Drug Cap: Lacey, WA Guide
LACEY, Wash. — Starting Jan. 1, 2027, Medicare Part D will cap what you pay out of pocket for covered prescription drugs at $2,400 for the year. Once you hit that number at the pharmacy counter, your covered prescriptions cost you $0 for the rest of the calendar year. For Lacey residents who take expensive medications — cancer pills, blood thinners, insulin, autoimmune drugs — this is one of the biggest changes to Medicare in a generation.
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Key takeaways
- Starting Jan. 1, 2027, Medicare Part D will cap yearly out-of-pocket costs for covered prescription drugs at $2,400, up from $2,100 in 2026.
- Once you reach that cap, covered prescriptions cost $0 for the rest of the calendar year, and the old "donut hole" coverage gap no longer exists.
- The Medicare Prescription Payment Plan is a free, optional program offered through every Part D plan that lets you spread drug costs into monthly payments instead of paying it all at the pharmacy, and you sign up directly with your plan, not Medicare.
- The Annual Enrollment Period runs Oct. 15 through Dec. 7, and if you're on Medicare Advantage and want to switch after Jan. 1, the Medicare Advantage Open Enrollment Period runs Jan. 1 through March 31.
Here is what is actually changing, and how to think through your choices during this fall's Annual Enrollment Period, which runs Oct. 15 through Dec. 7, 2026.
The $2,400 cap, in plain English
Before 2025, there was no ceiling on what a Medicare Part D enrollee could spend on drugs in a year. People with serious conditions sometimes paid many thousands of dollars.
In 2026, the cap is $2,100. For 2027, the cap adjusts to $2,400, according to CMS Part D program rules published at medicare.gov.
A few things to keep straight:
- The cap applies to your out-of-pocket spending on drugs covered by your Part D plan.
- It resets every Jan. 1.
- Premiums do not count toward the cap.
- Drugs your plan does not cover do not count toward the cap.
- The maximum Part D deductible is $615 in 2026 and $700 in 2027, though many plans set theirs lower.
The "donut hole" is gone
If you or a family member has been on Medicare for a while, you may remember the dreaded coverage gap — the "donut hole" — where costs jumped in the middle of the year after a certain spending threshold.
That phase was eliminated as of 2025. Part D now has just three phases:
1. Deductible (if your plan has one) — you pay full negotiated cost until you meet it. 2. Initial coverage — you pay a copay or coinsurance; the plan pays the rest. 3. Catastrophic coverage — once your out-of-pocket spending hits the annual cap ($2,400 in 2027), you pay $0 for covered drugs the rest of the year.
No more middle stage where costs suddenly spike.
The Medicare Prescription Payment Plan
Here is the part a lot of Lacey readers are asking about: even with a $2,400 cap, what if you hit a big pharmacy bill in January? The cap protects your annual total, but a single fill can still be a shock.
That is what the Medicare Prescription Payment Plan is for. It is a free, optional program — available through every Part D plan — that lets you spread your out-of-pocket drug costs across the calendar year in monthly payments instead of paying at the pharmacy counter.
A few things to know:
- You still pay the same total amount over the year — this is smoothing, not a discount.
- You have to opt in. Your plan will not enroll you automatically.
- You can sign up before the year starts or any month during the year.
- If you have very low drug costs, this program probably will not help you and may not be worth the paperwork.
- If you take a high-cost drug early in the year, it can prevent a big January or February bill.
You sign up directly with your Part D or Medicare Advantage plan, not with Medicare itself.
How Lacey residents can decide during AEP
Lacey is in Thurston County, where Medicare beneficiaries have a range of stand-alone Part D plans and Medicare Advantage plans with drug coverage to choose from. Because the cap ($2,100 in 2026, $2,400 in 2027) and the payment plan apply to every Part D plan by law, your decision is less about whether you get these protections and more about which plan fits your specific drug list and pharmacies.
A practical way to think about it:
- Make a current list of your medications, doses, and preferred pharmacy.
- Use the Plan Finder at medicare.gov to see how each plan covers those specific drugs.
- Check whether your pharmacy is "preferred" under a plan — that often affects your copays.
- If you know you will hit the $2,400 cap early in the year, ask about the Prescription Payment Plan before Jan. 1.
- Watch for IRMAA surcharges if your income (as a single filer, 2026) is above $109,000 — higher earners pay more for Part B and Part D.
If you are already on a Medicare Advantage plan and want to switch after Jan. 1, the Medicare Advantage Open Enrollment Period runs Jan. 1 through March 31.
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 Thurston County
(MA penetration in Thurston 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). For 2027 there is a hard yearly cap of $2,400 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 signed up for the payment plan in 2026, do I need to re-enroll for 2027?
What if I cannot afford my share of drug costs even with the cap?
- CMS — Medicare Part D program rules (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.