Medicare Part D

$2,400 Part D Ceiling in Citrus Heights, CA 2027

CITRUS HEIGHTS, Calif. — Starting January 1, 2027, the hard yearly ceiling on what you pay out of pocket for prescription drugs under Part D rises to $2,400, up from $2,100 in 2026. For seniors in Citrus Heights who have juggled high pharmacy bills — especially those on brand-name or specialty medications — the cap, combined with an optional monthly payment plan, is designed to make drug costs more predictable this Annual Enrollment Period.

Here is what the change actually means, and how to think about it as you review your 2027 coverage before the December 7 deadline.

The Part D out-of-pocket cap, in plain English

In 2027, once your out-of-pocket spending on covered Part D drugs reaches $2,400 in a calendar year, you pay nothing more for the rest of the year on those drugs. That's the entire cap — not per drug, not per month.

What counts toward the cap:

• Your deductible payments
• Copays and coinsurance at the pharmacy for covered drugs

What does not count:

• Your monthly Part D premium
• Drugs not on your plan's formulary
• Over-the-counter medications

The Part D maximum deductible is $700 in 2027 (it was $615 in 2026), and specific plans may set it lower. After you meet the deductible, you share costs with your plan until you hit the yearly ceiling.

The "donut hole" is gone

If you remember the old Medicare coverage gap — that stretch where drug costs jumped and many people stopped filling prescriptions — it's officially history. As of 2025, Medicare simplified Part D into three phases: deductible, initial coverage, and catastrophic. There is no longer a fourth "gap" phase.

For 2027, that structure continues, with the $2,400 cap sitting at the top. Once you cross it, you're in catastrophic coverage and owe nothing more for covered drugs that year.

The Medicare Prescription Payment Plan

Even with a cap, $2,400 in a single January is a lot for anyone on a fixed income. That's where the Medicare Prescription Payment Plan comes in — a free, optional program that lets you spread your out-of-pocket drug costs across the calendar year in monthly installments instead of paying the pharmacy all at once.

A few things to know:

• You still pay the same total amount; it's spread out, not reduced.
• You must opt in through your Part D or Medicare Advantage drug plan.
• It tends to help most if you have high drug costs early in the year.
• If your drug costs are low and steady, it may not be worth the paperwork.

You can sign up before the plan year starts or at any point during the year.

What this means locally

Citrus Heights is in Sacramento County, where residents choose from a range of stand-alone Part D plans and Medicare Advantage plans that include drug coverage. For 2027, Sacramento County has 23 Medicare Advantage plans from 10 carriers. The cap and the payment plan apply to all Part D coverage nationwide — so no matter which plan a Sacramento County resident picks, the ceiling is the same.

What can differ from plan to plan is the deductible amount, the formulary (which drugs are covered and at what tier), preferred pharmacies, and monthly premium. That's why a plan comparison during the Annual Enrollment Period matters, especially if your prescriptions changed this year.

Key dates to circle

• Annual Enrollment Period: October 15 – December 7, 2026 (for 2027 coverage)
• Medicare Advantage Open Enrollment: January 1 – March 31, 2027 (one switch allowed if you're already in an MA plan)
• IRMAA note: Higher-income beneficiaries pay a Part D surcharge; in 2026, those adjustments begin above $109,000 in income for a single filer.