Prescription costs
Part D cost cap
Medicare drug coverage (Part D) has a yearly limit on what you pay out of pocket for covered drugs. Once your costs reach $2,100 in 2026, or $2,400 in 2027, you pay nothing more for covered drugs for the rest of the year. It applies to anyone with a Medicare drug plan or a Medicare Advantage plan with drug coverage.
How to apply
- By phone
- 1-800-633-4227
Applying is free. Nobody should charge you to apply.
Apply on the official siteWho may qualify
| Who the limit covers | People with Medicare drug coverage, through a drug plan or a Medicare Advantage plan with drug coverage |
|---|
Source: Medicare.gov (source 1)
What you may get
| Yearly limit on what you pay for covered drugs (2026) | $2,100 Source: Medicare.gov (source 1) |
|---|---|
| Yearly limit on what you pay for covered drugs (2027) | $2,400 |
| After you reach the limit | You pay $0 for covered drugs for the rest of the calendar year Source: Medicare.gov (source 1) |
| Highest deductible a plan may charge (2026) | $615 Source: Medicare.gov (source 1) |
| Highest deductible a plan may charge (2027) | $700 |
| What you pay between the deductible and the limit | Generally 25% of the cost of covered generic and brand-name drugs Source: Medicare.gov (source 1) |
| What counts toward the limit | What you pay for covered drugs, plus certain payments made for you, such as through Extra Help Source: Medicare.gov (source 1) |
Dates, renewals and waiting lists
| Open Enrollment, to join or switch drug plans | October 15 to December 7 each year |
|---|---|
| When a plan change made in Open Enrollment starts | January 1, 2027 |
Good to know
- Your plan sends an Explanation of Benefits the month after you fill a prescription. It shows your coverage stage and what has counted toward your out-of-pocket costs.
- What a State Pharmaceutical Assistance Program pays for you may also count toward the limit.
- Your monthly premium depends on the plan you choose, and people with higher incomes may pay more.
- With Extra Help, you pay no more than $5.80 for a generic drug and $14.40 for a brand-name drug in 2027, and $0 once your costs reach $2,400.
Source: Medicare.gov (source 1)
What people get wrong
MythDiscount cards count toward my yearly limit.
Not true. When you use a discount card, including TrumpRx, instead of your Medicare plan, what you pay doesn't count toward your deductible or yearly out-of-pocket limit.
MythThe Medicare Prescription Payment Plan lowers what I pay.
No. It spreads your out-of-pocket costs across the year in monthly amounts, but it doesn't save you money or lower your drug costs.
MythWaiting to join a drug plan until I need one won't cost me anything.
Not true. If you go 63 days or more in a row without Medicare drug coverage or other creditable drug coverage after you're first eligible, a late enrollment penalty may be added to your premium for as long as you have drug coverage. People with Extra Help don't pay it.
Sources
- Medicare.gov, How much does Medicare drug coverage cost? (official government site). Checked Oct 28, 2026.
- Centers for Medicare & Medicaid Services, Announcement of CY 2027 Medicare Advantage Capitation Rates and Part C and Part D Payment Policies (Table V-2) (official government site). Checked Oct 28, 2026.
- Centers for Medicare & Medicaid Services, Medicare & You 2027 (the official Medicare handbook) (official government site). Checked Oct 28, 2026.
- Medicare.gov, Help with drug costs (official government site). Checked Oct 28, 2026.
- Medicare.gov, Contact Medicare (official government site). Checked Oct 28, 2026.
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