Medicare Supplement
Part D's $2,100 Drug Cap Arrives in Casper January 2026
CASPER, Wyo. — Starting January 1, 2026, Medicare beneficiaries will hit a new, lower ceiling on what they pay out of pocket for prescription drugs: $2,100 for the year. It's the biggest change to Part D in a generation, and it lands right in the middle of Medicare's Annual Enrollment Period, which runs through December 7.
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Click to call 855-729-3240Key takeaways
- Starting January 1, 2026, Medicare Part D has a new $2,100 yearly cap, so once you hit that amount in out-of-pocket drug costs, you pay $0 for covered drugs for the rest of the year, and the cap resets each January.
- This $2,100 cap applies to everyone with Part D drug coverage, whether it's a standalone plan or built into a Medicare Advantage plan.
- The free, optional Medicare Prescription Payment Plan lets you spread your out-of-pocket drug costs into monthly bills instead of paying it all at the pharmacy at once, though you still owe the same total amount.
- The Annual Enrollment Period runs through December 7, so it's a good time to check your plan's Annual Notice of Change, review your drugs on the Plan Finder at medicare.gov, and confirm your pharmacy is still in-network before choosing a plan for 2026.
For older adults in Casper juggling several prescriptions — or bracing for one expensive specialty drug — the math is about to look very different.
What the $2,100 cap actually means
Under the 2026 Part D rules, once your out-of-pocket spending on covered prescription drugs reaches $2,100, you pay $0 for the rest of the calendar year on those covered drugs. The cap resets each January.
A few things to know:
- The cap applies to covered Part D drugs. Medications not on your plan's formulary don't count toward it.
- Premiums do not count toward the cap.
- The Part D deductible can be no higher than $615 in 2026 (plans can set it lower).
- The old "donut hole" coverage gap was eliminated in 2025. Part D now has three phases: deductible, initial coverage, and catastrophic (where the cap kicks in).
This is a program-wide change set by CMS. It applies whether you get your drug coverage through a standalone Part D plan or built into a Medicare Advantage plan.
The Medicare Prescription Payment Plan: spreading costs across the year
Hitting $2,100 in January is still a real cash-flow problem for someone on a fixed income. That's what the Medicare Prescription Payment Plan is designed to address.
It's a free, optional program. Instead of paying the pharmacy in full when you pick up an expensive prescription, your plan bills you monthly, spreading your out-of-pocket costs across the remaining months of the year. You still owe the same total — it's smoothed out, not reduced.
You can opt in before the plan year starts or any month during the year through your Part D or Medicare Advantage plan. It tends to help most if you have a large drug cost early in the year.
What Casper residents should check during AEP
Casper is in Natrona County, where Medicare Advantage and standalone Part D plan availability is set at the county level. Every fall, plans can change their formularies, pharmacy networks, and cost-sharing tiers — so the plan that worked well for you in 2025 may treat your prescriptions differently in 2026.
Before December 7, it's worth doing three things:
1. Read your plan's Annual Notice of Change (ANOC), mailed in September. 2. Run your current drug list through the Plan Finder at medicare.gov to see how each available plan would price your medications next year. 3. Confirm your regular pharmacy is still in-network.
If you're in a Medicare Advantage plan, you also have the Medicare Advantage Open Enrollment Period from January 1 to March 31 to make a one-time switch.
A word on higher-income enrollees (IRMAA)
If your 2024 income was above $109,000 as a single filer (or $218,000 filing jointly), you'll likely pay an income-related monthly adjustment on top of your standard Part B and Part D premiums in 2026. This is called IRMAA. Social Security notifies you by mail; you can appeal if you've had a qualifying life event like retirement or the death of a spouse.
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 Natrona County
(MA penetration in Natrona 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.
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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 list?
Do I have to sign up for the payment plan?
- CMS — Medicare basics (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.