Medicare Part D

Part D's 2027 Drug Cap in Chula Vista, CA

CHULA VISTA, Calif. — Starting Jan. 1, 2027, the Part D out-of-pocket cap moves up. No matter how expensive your medications are, you will not pay more than $2,400 out of pocket for covered Part D drugs next year. The cap landed in 2025, and it adjusts again as Annual Enrollment runs through Dec. 7.

Here is what Chula Vista readers need to know before they pick a 2027 drug plan or a Medicare Advantage plan that includes drug coverage.

The Part D out-of-pocket cap, explained

For 2026, once your out-of-pocket spending on covered Part D drugs hits $2,100, you pay $0 for the rest of the calendar year on those covered drugs. That cap is set by Medicare and applies across all Part D plans, whether you get drug coverage through a stand-alone Part D plan or built into a Medicare Advantage plan.

A few important details:

• The cap counts what you pay at the pharmacy for covered drugs. Monthly plan premiums do not count toward it.
• The cap resets each Jan. 1.
• If a medication isn't on your plan's formulary (its list of covered drugs), what you pay for it typically won't count toward the cap.

The Part D deductible can be up to $700 in 2027. Plans can charge less, but no Part D plan can charge more than that as a deductible.

The "donut hole" is gone

For years, people on Medicare dreaded the coverage gap — the "donut hole" — where costs jumped in the middle of the year. That gap was eliminated in 2025, and it stays gone in 2027.

Part D now has just three phases:

1. Deductible phase — you pay full negotiated price until you meet the plan's deductible (up to $700 in 2027). 2. Initial coverage phase — you pay a copay or coinsurance until your out-of-pocket total reaches $2,400. 3. Catastrophic phase — you pay nothing for covered drugs the rest of the year.

That is a much simpler structure than what Medicare used just two years ago.

The Medicare Prescription Payment Plan

Even with the $2,400 cap, a big pharmacy bill in January or February can still sting. That is where the Medicare Prescription Payment Plan comes in. It's a free option offered by every Part D plan that lets you spread your yearly drug costs into monthly payments instead of paying all at once at the counter.

Key points:

• It does not lower your drug costs — it just smooths them across the year.
• You still pay $0 at the pharmacy for covered drugs; the plan bills you monthly instead.
• You can sign up before the year starts or any time during the year by contacting your Part D plan.
• It tends to help most if you have high drug costs early in the year.

If your drug costs are low and steady, you may not need it. If you take one or two expensive medications, it is worth a look.

What Chula Vista residents should check during AEP

Chula Vista is in San Diego County, where a wide range of stand-alone Part D and Medicare Advantage plans are available for 2026. Plans change each year — formularies, pharmacy networks, and costs can all shift — so the plan that worked in 2025 may not be your best fit in 2026.

Before Dec. 7, it's worth doing three things:

1. Read your plan's Annual Notice of Change (ANOC), mailed in September, to see what's different for 2027. 2. Log in to the Plan Finder at medicare.gov and enter your medications and preferred pharmacies to compare total yearly costs. 3. Check whether your drugs are still on the formulary and whether your pharmacy is still in network.

If your income is higher, remember that IRMAA surcharges on Part B and Part D premiums start above $109,000 for single filers in 2026 (higher for married couples filing jointly).

Key 2027 dates

• Oct. 15 – Dec. 7, 2026: Medicare Annual Enrollment Period. Changes take effect Jan. 1, 2027.
• Jan. 1 – March 31, 2027: Medicare Advantage Open Enrollment. If you are already in a Medicare Advantage plan, you can switch once or drop back to Original Medicare.