Medicare Part D
North Las Vegas, Nev. Medicare Part D in 2027
North Las Vegas, Nev. — Starting Jan. 1, 2027, no one with a Medicare Part D drug plan will pay more than $2,400 out of pocket for their covered prescriptions all year. The out-of-pocket cap, the biggest shift to Medicare drug coverage in a generation, moves up from $2,100 in 2026 — and it lands right as North Las Vegas residents are making choices during the fall Annual Enrollment Period, which ends Dec. 7.
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Key takeaways
- Starting Jan. 1, 2027, Medicare Part D out-of-pocket drug costs will be capped at $2,400 for the year (up from $2,100 in 2026), after which covered drugs cost $0 for the rest of the year.
- The Annual Enrollment Period, when people can review or change their coverage, ends Dec. 7.
- The old coverage gap, or "donut hole," was eliminated in 2025, leaving Part D with just three phases: deductible, initial coverage, and catastrophic coverage.
- A free, optional Medicare Prescription Payment Plan lets people spread their out-of-pocket drug costs into monthly installments instead of paying it all at the pharmacy at once.
Here is what is actually changing, in plain language.
The Part D cap: what it means
Under Medicare Part D program rules, once your out-of-pocket spending on covered prescription drugs hits the annual cap, you pay $0 for those covered drugs for the rest of the calendar year. The cap is $2,100 in 2026 and $2,400 in 2027. This is a hard ceiling set by Medicare, and it applies whether you get your Part D coverage as a stand-alone drug plan or built into a Medicare Advantage plan.
A few things worth knowing:
- The annual cap counts only what you pay for covered drugs — deductibles, copays, and coinsurance. Monthly premiums do not count.
- The cap resets each January.
- Drugs your plan does not cover (its formulary) still do not count toward the annual cap.
For 2026, the maximum Part D deductible a plan can charge is $615, though many plans set theirs lower.
The "donut hole" is gone
If you have been on Medicare a while, you probably remember the coverage gap — the so-called "donut hole" — where your share of drug costs jumped in the middle of the year before catastrophic coverage kicked in.
That gap was eliminated in 2025. Part D now has just three phases: the deductible, the initial coverage phase, and catastrophic coverage (where you pay $0 after hitting the annual cap). It is a much simpler picture than the one many longtime enrollees learned to navigate.
The Medicare Prescription Payment Plan
Even with an annual ceiling, a big pharmacy bill in January can still sting. That is where the Medicare Prescription Payment Plan comes in. It is 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 full amount at the pharmacy counter.
A few points to keep in mind:
- You still owe the same total — the payment plan does not lower your costs. It just smooths them out.
- You sign up through your Part D or Medicare Advantage drug plan, not at the pharmacy.
- It tends to help most if you have a high-cost medication early in the year.
- You can join anytime during the year, though signing up before you fill a big prescription gives you the most benefit.
If you are unsure whether this program fits your situation, you can call your plan or 1-800-MEDICARE (1-800-633-4227) for a walk-through.
What this looks like in North Las Vegas
North Las Vegas is in Clark County, where Medicare beneficiaries choose among a wide selection of stand-alone Part D drug plans and Medicare Advantage plans that include drug coverage. For 2027, Clark County has 57 Medicare Advantage plans from 10 carriers, down from 74 plans and 12 carriers in 2026; Kaiser Permanente and Molina Healthcare of Nevada are not offering plans in the county next year. The $2,400 cap and the payment plan apply to all plans — those are federal rules, not plan features.
That said, plans still differ on which drugs they cover, which pharmacies are in network, and what you pay before hitting the cap. So the cap does not remove the need to compare plans; it just changes the math at the top end.
Deadlines to have on your calendar
- Oct. 15 – Dec. 7: Medicare Annual Enrollment Period. Changes made now take effect Jan. 1, 2027.
- Jan. 1 – March 31: Medicare Advantage Open Enrollment Period. If you are already in a Medicare Advantage plan, you get one chance to switch to another Advantage plan or drop back to Original Medicare with a stand-alone drug plan.
One more figure worth flagging: IRMAA, the income-related surcharge that some higher earners pay on top of standard Part B and Part D premiums, begins above $109,000 in income for a single filer in 2026 (based on your 2024 tax return). It is not a penalty — just a sliding scale tied to income.
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 Clark County
(MA penetration in Clark 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”) was eliminated in 2025 (three phases now). The hard yearly cap on what you pay out of pocket for covered drugs is $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 include my monthly plan premium?
If I sign up for the Prescription Payment Plan, will I pay less overall?
What if my drug is not on my plan's list of covered medications?
- CMS — Medicare Part D program rules (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.