Medicare Part D
Medicare Coverage Gap Ends for Champaign, Ill.
CHAMPAIGN, Ill. — Starting Jan. 1, 2026, no one with a Medicare Part D drug plan will pay more than $2,100 out of pocket for covered prescriptions in a calendar year. It's the biggest change to Medicare drug coverage in years, and it lands right in the middle of Fall Open Enrollment, which runs through Dec. 7.
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 January 1, 2027, Medicare Part D out-of-pocket drug costs will be capped at $2,400 per year, after which covered prescriptions cost nothing more for the rest of the year.
- The Part D "donut hole" coverage gap is gone for good, leaving just three phases: deductible (up to $700 in 2027), initial coverage, and catastrophic coverage.
- The optional Medicare Prescription Payment Plan lets you spread your out-of-pocket drug costs into monthly bills instead of paying it all at the pharmacy, though you still owe the same total amount.
- Fall Open Enrollment runs through Dec. 7, and any plan changes take effect Jan. 1, 2027, while those who miss this window can still use the Medicare Advantage Open Enrollment Period from Jan. 1 to March 31 with more limited change options.
If you take expensive medications — or you help a parent who does — here's what's actually different for 2027, and the mistakes to avoid before the new rules kick in.
The $2,400 cap, in plain English
For 2027, Medicare Part D has a hard ceiling of $2,400 on what you pay out of pocket for covered prescription drugs during the year, according to CMS. Once you hit that number, you pay nothing more for the rest of the calendar year on covered drugs at your plan's pharmacies.
That cap resets every January.
A few things it does not cover:
- Your monthly Part D premium doesn't count toward the $2,400.
- Drugs that aren't on your plan's formulary (its covered-drug list) don't count.
- Medications paid for outside your plan don't count.
The Part D maximum deductible for 2026 is $615, though many plans set theirs lower. What you pay toward the deductible does count toward the $2,100.
The "donut hole" is gone — for good
For years, Part D had four confusing phases, including the dreaded coverage gap, or "donut hole," where costs would suddenly jump partway through the year. That gap was eliminated in 2025 and stays gone in 2027.
There are now just three phases: 1. Deductible (if your plan has one), up to $700 in 2027. 2. Initial coverage, where you pay a share of the cost. 3. Catastrophic coverage, which starts once you hit $2,400 in 2027 — and from there, you pay nothing more for covered drugs that year.
That's it. No more mid-year price shock.
The Medicare Prescription Payment Plan
Hitting a $2,400 ceiling is a relief, but $2,400 in January or February is still a lot to swing at once. That's where the Medicare Prescription Payment Plan comes in.
It's a free, optional program from Medicare that lets you spread your out-of-pocket drug costs across the calendar year in monthly bills instead of paying the full amount at the pharmacy counter. You still owe the same total — nothing is forgiven — but it's smoothed out.
A few things worth knowing:
- You have to opt in. It doesn't happen automatically.
- You sign up through your Part D plan (not through medicare.gov).
- You can join at any point during the year, but joining earlier in the year spreads costs over more months.
- If you miss a monthly payment, you can be removed from the program, though your drug coverage itself continues.
This program tends to help most if you have one or two high-cost prescriptions early in the year. It may not make sense if your drug costs are low and steady.
What this means during Open Enrollment
Fall Annual Enrollment runs Oct. 15 through Dec. 7. Any change you make takes effect Jan. 1, 2027.
Champaign is in Champaign County, where Medicare beneficiaries can compare stand-alone Part D plans and Medicare Advantage plans that include drug coverage. The 2027 lineup is detailed in each plan's Annual Notice of Change and on Medicare.gov's Plan Finder. The number and mix of plans is set at the county level, so two neighbors on the same block see the same options.
Some common mistakes to avoid this fall:
- Assuming your plan is the same in 2027. Every Part D plan sends an Annual Notice of Change each fall. Read it. Formularies, tiers and pharmacy networks can shift.
- Ignoring your drug list. Even with the $2,400 cap in 2027, a drug that isn't covered by your plan doesn't count toward it. Check that every medication you take is on the 2027 formulary.
- Forgetting about IRMAA. Higher-income beneficiaries pay an added surcharge on Part B and Part D premiums. For 2026, IRMAA begins above $109,000 in income for a single filer (based on your 2024 tax return).
- Waiting until December. Pharmacists and SHIP counselors get swamped near the deadline. Earlier is calmer.
If you missed the fall window, the Medicare Advantage Open Enrollment Period runs Jan. 1 – March 31, but that one has narrower rules about what you can change.
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 Champaign County
(MA penetration in Champaign 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). There's a hard yearly cap on what you pay out of pocket for covered drugs — $2,100 in 2026 and $2,400 in 2027 — 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 apply to Medicare Advantage plans too?
What about insulin and vaccines?
If I sign up for the payment plan, do I pay less overall?
- CMS — Medicare Part D program rules (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.