The Part D out-of-pocket cap
$2,100 in 2026. After that, covered drugs cost you nothing.
Since 2025, Medicare drug coverage has a yearly limit on what you pay out of pocket for covered drugs. In 2026 it's $2,100. Once you reach it, you pay $0 for covered Part D drugs for the rest of the calendar year.
What counts toward the cap
- What you pay at the pharmacy for drugs on your plan's formulary, including the deductible.
- Payments made on your behalf by certain programs, such as Extra Help and some state and charitable assistance programs.
What doesn't count
- Your monthly premium.
- Drugs not on your plan's formulary (unless you get an exception).
- Drugs bought outside the US.
- Drugs covered under Part B, such as those given in a doctor's office.
Spreading the cost
If you expect to reach the cap early in the year, you can join the Medicare Prescription Payment Plan to pay those costs in monthly amounts instead of all at the pharmacy. It doesn't change the total.
Next year
The cap rises to $2,400 in 2027. It's adjusted each year.
Common questions
Yes. It applies to all Part D coverage, whether in a standalone plan or a Medicare Advantage plan with drug coverage.
Yes, on January 1.
Want help with your own choices?
Every state runs a State Health Insurance Assistance Program (SHIP) with trained counselors who give free, unbiased Medicare help and do not sell plans. Find yours on our Medicare by state pages, or call Medicare at 1-800-MEDICARE (1-800-633-4227) (TTY 1-877-486-2048, 24 hours a day, 7 days a week).
Planning the rest of your coverage in retirement? We can help with life insurance later in life and final expense coverage.
Sources
- Costs for Medicare drug coverage, Medicare.gov. Checked September 29, 2026.
- Medicare costs, Medicare.gov. Checked September 29, 2026.
- CY 2027 Rate Announcement, Centers for Medicare & Medicaid Services. Checked September 29, 2026.
General information about the federal Medicare program, not advice about your situation. Figures are for 2026 unless stated and change every year; last reviewed September 29, 2026. Quote My Policy is a private company. Not connected with or endorsed by the United States government or the federal Medicare program.
Quote My Policy does not sell Medicare plans on this site. For plan-specific help, contact Medicare at 1-800-MEDICARE (1-800-633-4227) (TTY 1-877-486-2048, 24 hours a day, 7 days a week) or your State Health Insurance Assistance Program.