The Medicare Part D out-of-pocket cap is $2,400 in 2027, up from $2,100 in 2026.
Once your own spending on covered Part D drugs reaches that figure, you pay nothing more for them for the rest of the year. The cap counts your deductible and coinsurance, but not your monthly plan premium, and it applies only to drugs your plan actually covers.
| Parameter | 2026 | 2027 |
|---|---|---|
| Out-of-pocket cap | $2,100 | $2,400 |
| Maximum plan deductible | $615 | $700 |
| Coinsurance after the deductible | 25% | 25% |
| National base beneficiary premium | $38.99 | $41.33 |
Source: CMS Part D redesign instructions and the CY2027 bid announcement
Through The YearHow the cap works through the year
You pay your plan deductible first, which can be no more than $700 in 2027. After that you pay 25% of the cost of each covered drug until your own spending reaches $2,400. From that point your share of covered Part D drugs is nothing for the rest of the calendar year, and the counter resets on 1 January.
Before the Part D redesign there was no ceiling at all, which is why someone on an expensive specialty drug could pay many thousands a year indefinitely.
What Is ExcludedWhat the cap does not cover
Your monthly plan premium is separate and does not count toward the $2,400. Neither does a drug your plan leaves off its formulary, which is the most common reason someone spends past the cap and is surprised. Check your plan’s drug list before assuming a medication counts.
If you qualify for Extra Help, your costs are lower still and the standard figures above do not describe what you pay.
Next StepsWhat to do next
Price your actual medication list rather than the average. Two plans with the same deductible can put the same drug on different tiers, which changes how fast you reach the cap. Medicare Plan Finder prices your own list against every plan in your county.
If a large bill lands in January, ask about the Medicare Prescription Payment Plan, which spreads your share across monthly instalments instead of all at once at the pharmacy.
More QuestionsPeople also ask
Does the deductible count toward the $2,400 cap?
Yes. Money you pay toward the deductible is out-of-pocket spending, so it moves you toward the cap.
Do plan premiums count toward the cap?
No. Premiums are never counted. Only what you pay for the drugs themselves does.
Does the cap apply to Medicare Advantage drug coverage?
Yes. A Medicare Advantage plan that includes Part D drug coverage is subject to the same cap.
This page explains officially published figures. It is not an insurance quote and not an eligibility determination. Only HealthCare.gov, Medicare.gov, Social Security or the carrier can determine your eligibility and your actual price.
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. Not connected with or endorsed by the U.S. government or the federal Medicare program.