Medicare Part D
Medicare 2027 Drug Changes in Santa Ana, CA
Santa Ana, Calif. — Starting Jan. 1, 2027, Medicare's prescription drug coverage shifts again. The out-of-pocket cap on covered drugs rises to $2,400, the old "donut hole" remains gone, and the payment plan still lets people spread drug costs across the calendar year. If you take even one costly medication, these changes could reshape how you budget in the year ahead.
Compare Medicare Part D options near you
Answer 3 quick questions to see Medicare Part D listings from licensed insurance partners.
What’s your ZIP code?
Plan availability is set by your county, so we start here.
How old are you?
This helps match you with options you’re eligible for.
Do you have Medicare Parts A & B?
This affects which Medicare Part D options you can choose.
These listings are provided by licensed insurance partners.
Will your prescriptions still be covered in 2027?
Part D plans rewrite their drug lists every year — tiers move, pharmacies change, drugs drop off. One call checks your exact medications against the 2027 plans in your area.
- Every prescription checked, name by name
- Your pharmacy checked for preferred pricing
Available now — current wait: 0 min
A real person answers. No phone menu, ever.
Want to see more plan options?
Answer a few more questions to continue to additional options from licensed partners.
Continue →Advertising disclosure: MyMedicarePlans.org may be compensated when you contact a partner or licensed agent. Listings are not ranked or endorsed by us, and we do not recommend specific plans. You can also contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.
Speak to a Licensed Insurance Agent
Click to call 855-729-3240
Key takeaways
- Starting Jan. 1, 2027, the out-of-pocket cap for covered Part D drugs rises to $2,400, up from $2,100 in 2026, and once you hit it you pay nothing more for covered drugs the rest of the year.
- The old "donut hole" coverage gap stage is gone for good, leaving just three stages: deductible (up to $700 max in 2027), initial coverage, and catastrophic coverage.
- The optional, free Medicare Prescription Payment Plan lets you spread your share of drug costs into monthly bills instead of paying a big amount at the pharmacy all at once.
- The Annual Enrollment Period runs Oct. 15 through Dec. 7, giving you a chance to check whether your plan's formulary, pharmacy network, and costs still fit your needs, and Medicare Advantage members get another chance to switch plans or return to Original Medicare from Jan. 1 through March 31.
Here's a plain-language guide to what's new, what stayed, and where to get help before the Annual Enrollment Period closes on Dec. 7.
The Part D out-of-pocket cap, explained
For 2027, no one with a Medicare Part D plan — whether it's a stand-alone drug plan or drug coverage built into a Medicare Advantage plan — will pay more than $2,400 out of pocket for covered prescriptions in a calendar year. Once you hit that limit, you pay nothing more for the rest of the year on drugs your plan covers.
This is the third year of the hard cap. It was set at $2,000 in 2025 and $2,100 in 2026, and it adjusts each year with drug spending trends. The cap only counts what you spend on drugs your plan covers on its formulary at an in-network pharmacy. It does not include your monthly Part D premium.
The maximum Part D deductible is $615 in 2026 and $700 in 2027, though many plans set theirs lower.
The coverage gap is really gone
For years, Part D had a confusing middle stage called the "coverage gap," or donut hole, where people paid a bigger share of drug costs after their plan and they had spent a certain amount together. That stage was eliminated in 2025 and stays gone in 2027.
Part D now has just three phases:
1. Deductible phase — you pay the full negotiated price until you meet the deductible (up to $700 in 2027). 2. Initial coverage phase — you pay a copay or coinsurance, and your plan pays the rest, until your out-of-pocket total hits $2,400. 3. Catastrophic phase — you pay nothing more for covered drugs for the rest of the year.
That's it. No more surprise price jumps in the middle of the year.
The Medicare Prescription Payment Plan
Even with the $2,400 cap, hitting that ceiling early in the year can hurt. A single expensive prescription in January can wipe out a household budget.
That's why Medicare offers the Medicare Prescription Payment Plan. It's optional and free to join. Instead of paying the pharmacy a large amount when you fill a prescription, your plan bills you monthly, spreading your share of drug costs across the remaining months of the year.
A few things to know:
- It doesn't lower what you owe overall — it just smooths the timing.
- You still pay your regular Part D premium separately.
- You can opt in before the plan year starts or at any point during the year.
- If you miss a monthly bill, you can be removed from the program, though you can rejoin later.
This option tends to help people who take high-cost specialty drugs and would otherwise pay hundreds at the pharmacy counter in a single month.
Higher-income enrollees: IRMAA still applies
If your income is above $109,000 as a single filer (or $218,000 for a married couple filing jointly) based on your 2024 tax return, you'll pay an Income-Related Monthly Adjustment Amount, or IRMAA, on top of your regular Part D premium in 2026. This is separate from the cap ($2,100 in 2026, $2,400 in 2027) and applies to Part B premiums as well.
Social Security notifies you by mail if IRMAA applies to you. If your income has dropped due to a life event — retirement, the death of a spouse, divorce — you can ask Social Security to reconsider.
What Santa Ana residents can do during AEP
Santa Ana is in Orange County, where Medicare beneficiaries have a wide range of stand-alone Part D and Medicare Advantage plans to choose from. For 2027, CMS Landscape files list 92 Medicare Advantage plans from 16 carriers in the county, compared with 104 plans from 17 carriers in 2026. Because plans can change their formularies, pharmacy networks, and cost-sharing from one year to the next, the Annual Enrollment Period — Oct. 15 through Dec. 7 — is the time to check that your current plan still fits your prescriptions and your budget.
If you're in a Medicare Advantage plan, you also have the Medicare Advantage Open Enrollment Period from Jan. 1 through March 31 to switch to another Advantage plan or return to Original Medicare.
A good annual checkup:
- Log in to your Medicare account and review your current drug list.
- Use the Plan Finder tool at Medicare.gov to compare plans side by side using your specific medications and pharmacies.
- Ask whether the Prescription Payment Plan makes sense for how you fill prescriptions.
By the numbers
Medicare Part B premium, 2006–2026
The standard monthly Part B premium has climbed from $88.50 in 2006 to $202.90 in 2026. Hover any point for that year’s premium.
Source: CMS. Standard premium shown; in some hold-harmless years many existing enrollees paid less. Confirm at Medicare.gov.
By the numbers
How people get Medicare in Orange County
(MA penetration in Orange County)
MA penetration from CMS enrollment data; Medigap share is an estimate. U.S. average is about 54% Medicare Advantage. These are area-level figures, not plan-specific.
Prescription coverage
How Medicare Part D works in 2027
The old coverage gap (“donut hole”) is eliminated as of 2025 (three phases now). For 2027, there's a hard yearly cap of $2,400 on what you pay out of pocket for covered drugs, and you can spread those costs across the year with the Medicare Prescription Payment Plan.
Try it
How the 2026 Part D drug cap works
Slide to your estimated yearly prescription costs and see how the new $2,100 out-of-pocket cap protects you. This illustrates the standard Part D benefit; your plan may structure costs differently.
Once your out-of-pocket spending on covered drugs reaches $2,100, you pay nothing more for the rest of 2026. Confirm details at Medicare.gov.
Explore
When can you enroll? An interactive year
Enrollment windows are federal and the same nationwide. Confirm your personal dates at Medicare.gov or 1-800-MEDICARE.
Good to know
Frequently asked questions
Does the $2,100 cap include my monthly premium?
If I sign up for the payment plan, do I save money?
What if my drug isn't on my plan's formulary?
- CMS — Medicare Part D program rules (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.