Medicare Part D
Medicare Part D in 2027 for Shoreline, WA
# A Plain-Language Guide to Medicare Prescription Drug…
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Click to call 855-729-3240Key takeaways
- In 2027, your out-of-pocket costs for covered Part D drugs are capped at $2,400 for the year.
- The Part D deductible can be no more than $700 in 2027, though many plans set it lower.
- Part D now has just three phases — deductible, initial coverage, and catastrophic — because the coverage gap was eliminated starting in 2025.
- You can spread your drug costs across the year using the Medicare Prescription Payment Plan, an optional, no-interest monthly smoothing option.
SHORELINE, Wash. — If you take prescription drugs and you're on Medicare, 2027 continues some of the friendliest math the program has seen in years. The out-of-pocket cap on covered drugs is $2,400, the coverage gap (the old "donut hole") is gone, and your yearly costs move through just three phases instead of four.
Here's a clear walk-through of how Part D works for 2027, what to watch for, and where to get help without a sales pitch.
What Part D actually is
Part D is Medicare's prescription drug coverage. It's sold by private insurance companies that follow rules set by the Centers for Medicare & Medicaid Services (CMS). You can get it two ways: as a stand-alone drug plan that pairs with Original Medicare, or built into a Medicare Advantage plan.
Shoreline is in King County, where residents typically have a wide selection of stand-alone Part D plans and Medicare Advantage plans that include drug coverage. The exact count changes each year, and you can see current options for your ZIP code at medicare.gov.
The three phases in 2027
Since 2025, Part D has three phases instead of four. Here's how they flow:
1. Deductible phase. You pay the full negotiated price for your drugs until you meet your plan's deductible. In 2027, no plan can charge more than $700 as its deductible. Some plans set a lower deductible, and some waive it entirely 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 spending on covered drugs reaches $2,400.
3. Catastrophic phase. Once you hit $2,400, you're done paying for covered Part D drugs for the rest of the calendar year. That's the cap. No more copays, no more coinsurance on covered medications through December 31.
The old "donut hole" — where costs used to jump in the middle of the year — no longer exists.
The $2,400 cap, in plain English
The cap counts what you pay out of pocket for drugs covered by your plan's formulary. It does not count your monthly premium, and it doesn't count drugs your plan doesn't cover. If you're on an expensive specialty medication, you may reach the cap in the first month or two; if your prescriptions are modest, you may never reach it. Either way, you can't be charged more than $2,400 for covered drugs in 2027.
Smoothing your payments across the year
Continuing in 2027: the Medicare Prescription Payment Plan. This is a free, optional program that lets you spread your drug costs into monthly bills from your plan instead of paying big amounts at the pharmacy counter. There's no interest and no fee. It doesn't lower your total costs — it just spreads them out.
This can be helpful if you're facing a large bill early in the year, since Part D costs used to be front-loaded. You can opt in through your Part D plan; ask them how it works before your next refill.
Common mistakes to avoid
- Skipping Part D when you're first eligible. If you go without creditable drug coverage for 63 days or more after your Initial Enrollment Period, a late-enrollment penalty can be added to your premium — permanently.
- Assuming every drug is covered. Each plan has its own formulary (list of covered drugs). Always check that your medications are on the list before enrolling.
- Ignoring the Annual Notice of Change. Your plan sends this each fall. Formularies, pharmacy networks, and tiers can change from year to year, even if your card looks the same.
- Forgetting IRMAA. Higher-income beneficiaries pay an income-related surcharge on top of their Part D premium. In 2026, IRMAA kicks in above $109,000 in income for a single filer (higher thresholds for couples).
When you can make changes
- Annual Enrollment Period: October 15 – December 7. This is when most people compare plans and switch for the coming year.
- Medicare Advantage Open Enrollment: January 1 – March 31. If you're in a Medicare Advantage plan, you can switch to another MA plan or return to Original Medicare (with a stand-alone Part D plan) during this window.
Other Special Enrollment Periods exist for specific situations, like moving or losing other coverage.
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 King County
(MA penetration in King 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 now a hard yearly cap of $2,400 on what you pay out of pocket for covered drugs 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
Do I still have to worry about the donut hole in 2027?
Does the $2,100 cap include my monthly premium?
What is the Medicare Prescription Payment Plan?
How do I know if my drugs are covered?
- CMS — Medicare Part D program rules (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.
Also for Shoreline
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This page was last updated: October 7, 2026.