Medicare Part D

Part D Drug Cap for 2027: Juneau, Alaska

JUNEAU, Alaska — The Medicare Part D out-of-pocket limit on covered prescription drugs is $2,100 in 2026 and $2,400 in 2027. That is the most anyone with a Part D plan — either a standalone drug plan or a Medicare Advantage plan that includes drug coverage — will have to spend on their share of covered medications in a calendar year, according to the Centers for Medicare & Medicaid Services (CMS).

A Real Ceiling on Drug Costs Starts January 1

For people in Juneau who take expensive medications, that is a meaningful change. And the Annual Enrollment Period, which runs October 15 through December 7, 2026, is when you can review your drug coverage for 2027.

What Actually Changed

The cap ($2,100 in 2026, $2,400 in 2027) replaces the old system that had a "coverage gap" — often called the donut hole — where many people paid a bigger share of their drug costs partway through the year. That gap was eliminated in 2025. Part D now has three phases:

• Deductible phase. You pay full negotiated price until you meet your plan's deductible. The Part D maximum deductible is $700 in 2027.
• Initial coverage phase. You pay a copay or coinsurance for each prescription.
• Catastrophic phase. Once your out-of-pocket spending reaches the annual cap — $2,100 in 2026 and $2,400 in 2027 — you pay nothing for covered drugs for the rest of the calendar year.

The cap resets each January. Only what you pay for drugs on your plan's formulary counts toward the limit — premiums do not count.

The Medicare Prescription Payment Plan

Introduced in 2025 and continuing in 2027, the Medicare Prescription Payment Plan lets you spread your out-of-pocket drug costs across the calendar year in monthly payments instead of paying a large amount at the pharmacy counter.

Here's the basic idea: instead of paying, say, several hundred dollars at once for a refill in February, your plan bills you in monthly installments through December. You still owe the same amount overall — the payment plan does not lower your costs — but it can help with cash flow, especially early in the year when the deductible hits.

This option is voluntary. You have to opt in, and you can do so at any point during the year by contacting your Part D plan. It tends to be most useful for people with high drug costs early in the year. If your prescriptions are inexpensive, signing up may not be worth the paperwork.

How to Decide What This Means for You

If you live in Juneau — which is in Juneau City and Borough for Medicare plan purposes — here are practical steps to take before December 7:

1. Add up what you paid in 2026. If your share of drug costs is approaching the annual cap, the 2027 limit will likely matter to you directly. 2. Check your drugs against next year's formulary. Every Part D plan can change its drug list, tiers, and pharmacy network each year. The cap only helps if your medications are actually covered. 3. Look at the deductible. The Part D maximum deductible is $700 in 2027, but some plans charge less or none for certain drug tiers. 4. Ask about the payment plan. If a big pharmacy bill in January would strain your budget, the smoothing option is worth a call to your plan.

The Alaska Medicare Information Office — the state's SHIP (State Health Insurance Assistance Program) — offers free, unbiased one-on-one counseling and can walk through your specific drug list with you.

A Note on Higher Incomes

If your income is above $109,000 as a single filer (or $218,000 filing jointly) based on your 2024 tax return, you'll pay an income-related monthly adjustment amount, known as IRMAA, on top of your Part D premium in 2026. The cap ($2,100 in 2026, $2,400 in 2027) still applies to you; IRMAA is a separate premium surcharge, not a change to your out-of-pocket drug costs.