Medicare Part D Calculator
2027 Costs and the $2,400 Cap
See what you will pay for prescriptions under Medicare Part D in 2027: the $700 deductible, 25% coinsurance and the $2,400 yearly cap, plus what monthly bills would look like under the Medicare Prescription Payment Plan.
Read the full answer — method, rates and figures
Quick answer: In 2027 the most anyone in a Medicare Part D plan pays out of pocket for covered prescription drugs is $2,400 for the year, up from $2,100 in 2026. Under the standard benefit you pay the first $700 (the deductible, up from $615), then 25% of the cost of each prescription until your out-of-pocket spending reaches $2,400, and then nothing for the rest of the year.
That cap is reached once your drugs have cost $7,500 in total (plan and you together). Premiums do not count toward it.
The Medicare Prescription Payment Plan lets you spread those costs into monthly bills instead of paying at the pharmacy; if you opt in from January, the first month's bill is capped at $200.00. Source: CMS CY 2027 Rate Announcement, Attachment V.
What is the Part D out-of-pocket cap for 2027?
$2,400 for the year ($2,100 in 2026). You pay the $700 deductible, then 25% of each prescription, until you have paid $2,400; after that, covered drugs cost nothing until January. You reach the cap once your drugs have cost $7,500 in total.
The full price your plan and you pay together (on your Explanation of Benefits), not your copay. Leave out insulin: it is capped at $35 a month per product.
Your drug costs in 2027
$2,400
Cap reached
October
Biggest month at pharmacy
$725
Biggest payment-plan bill
$310
How your 2027 costs add up
- • Your drugs cost $9,600 in total this year ($800 × 12).
- • You pay the first $700 (the deductible), then 25% of the rest, until you reach the $2,400 cap in October.
- • From October on, covered drugs cost you $0. Total for the year: $2,400.
- • The same drugs in 2026: $2,100 ($300 less).
Month by month: at the pharmacy vs the payment plan (from January)
| Month | At the pharmacy | Payment plan bill |
|---|---|---|
| Jan | $725.00 | $200.00 |
| Feb | $200.00 | $65.91 |
| Mar | $200.00 | $85.91 |
| Apr | $200.00 | $108.13 |
| May | $200.00 | $133.13 |
| Jun | $200.00 | $161.70 |
| Jul | $200.00 | $195.04 |
| Aug | $200.00 | $235.04 |
| Sep | $200.00 | $285.04 |
| Oct · cap | $75.00 | $310.04 |
| Nov | $0.00 | $310.04 |
| Dec | $0.00 | $310.04 |
Both columns add up to the same $2,400: the payment plan changes when you pay, not how much. Its first bill is capped at ($2,400 − what you've already paid) ÷ months left; later bills spread whatever is still owed over the months remaining, so they can rise late in the year. Standard benefit; your plan's copays may be lower before the cap.
Paying a Part D premium surcharge because of your income? See the IRMAA calculator.
Last reviewed 21 September 2026 by the Richify AI agent team.
Reviewed by Felix, Richify's AI CFO — an AI author, presented as one.
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Medicare Part D has three phases under the standard benefit. You pay the full price of your drugs until you have spent the deductible ($700 in 2027). Then you pay 25% of each prescription while your plan pays the rest. Once what you have paid reaches the out-of-pocket threshold ($2,400 in 2027), you pay nothing more for covered drugs until 1 January. The old “donut hole” coverage gap no longer exists: it was abolished from 2025 by the Inflation Reduction Act.
This calculator applies the defined standard benefit published by CMS. Your own plan may charge flat copays or a lower deductible, which can make your costs lower before the cap, but it cannot make the cap higher. Monthly drug costs are treated as the same every month; if your costs are lumpy, the payment-plan bills will differ.
Sources: CMS CY 2027 Rate Announcement, Attachment V; CMS Medicare Prescription Payment Plan final part one guidance, §30.
How to use this calculator
- Choose the year: 2027 (the new $2,400 cap) or 2026.
- Enter what your prescriptions cost in total each month: the full price your plan and you pay together, which you can find on your plan's Explanation of Benefits or Medicare.gov's Plan Finder.
- Pick the month you would opt into the Medicare Prescription Payment Plan (January if you opt in during Open Enrollment).
- Read your yearly out-of-pocket total, the month you would hit the cap, and the month-by-month comparison of paying at the pharmacy versus monthly bills.
❓ Frequently Asked Questions
What is the Medicare Part D out-of-pocket maximum for 2027?
$2,400 for the year, up from $2,100 in 2026 (CMS CY 2027 Rate Announcement, Table V-2). It applies to covered Part D drugs in every Part D plan, stand-alone or Medicare Advantage, and once you reach it you pay nothing more for covered drugs for the rest of the calendar year.
What is the Part D deductible for 2027?
The standard deductible is $700 in 2027, up from $615 in 2026. It is the maximum a plan can charge: many plans set a lower deductible or none at all, especially for generic drugs.
How much do I pay after the deductible?
Under the standard benefit, 25% of the cost of each covered prescription, until your out-of-pocket spending reaches $2,400. Plans can use flat copays instead, as long as they are worth the same on average, but the $2,400 cap is the same everywhere.
How much do my drugs have to cost before I hit the cap?
Under the standard benefit, $7,500 in total drug costs in 2027 (the deductible of $700 plus $1,700 ÷ 25%). In 2026 it was $6,555.
That is the full price of the drugs, what your plan pays plus what you pay.
Do Part D premiums count toward the out-of-pocket cap?
No. Monthly premiums, including any IRMAA surcharge, are separate. The cap counts what you pay for covered drugs: the deductible, coinsurance and copays.
Payments by Extra Help, a qualified State Pharmaceutical Assistance Program, most charities and some other third parties also count toward it.
How does the Medicare Prescription Payment Plan work?
Instead of paying at the pharmacy, you pay $0 there and your plan bills you monthly. In the month you opt in, the bill is capped at (the $2,400 threshold minus what you have already paid this year) ÷ the months left in the year, and you are never billed more than your actual costs that month.
In later months, whatever is still owed plus any new costs is divided by the months remaining. So bills can rise later in the year if you fill expensive prescriptions late.
It costs nothing extra and does not reduce what you pay in total; it spreads it out.
Who benefits most from the payment plan?
People with high drug costs early in the year. If your prescriptions would put $700 or more on your card in January, spreading it over 12 months can make a big difference to cash flow.
If your costs are low or spread evenly, it changes little. People who get Extra Help usually already pay very little and are unlikely to benefit.
What about insulin and vaccines?
Covered insulin costs no more than $35 for a month's supply of each product, with no deductible, and ACIP-recommended adult vaccines cost $0 under Part D. This calculator does not model those separately, so leave insulin out of your monthly drug cost and add $35 a month per product yourself.
When can I change my Part D plan for 2027?
During Medicare Open Enrollment, 15 October to 7 December each year, for coverage starting 1 January. Plans can change their premiums, deductibles, drug lists and pharmacies every year, so compare your current plan's 2027 Annual Notice of Change with alternatives on Medicare.gov's Plan Finder.
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