Medicare Part D
Oswego NY Medicare Part D Guide for 2027
OSWEGO, N.Y. — If you take prescription drugs and have Medicare, the yearly out-of-pocket limit at the pharmacy is $2,100 in 2026 and $2,400 in 2027, and the old "donut hole" is gone for good.
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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.
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Click to call 855-729-3240Key takeaways
- The Part D out-of-pocket cap is $2,100 in 2026 and $2,400 in 2027 for covered prescription drugs, and the old "donut hole" coverage gap is gone.
- Once you hit the yearly cap, your plan pays 100% of covered drug costs for the rest of the year, and this applies to both stand-alone Part D plans and Medicare Advantage plans with drug coverage.
- Part D now works in three phases—deductible (up to a $615 maximum in 2026 and $700 in 2027), initial coverage, and catastrophic—instead of the old four-phase system.
- Medicare offers a free Prescription Payment Plan that lets you spread out-of-pocket drug costs into monthly payments over the year, though it doesn't lower the total amount you owe.
Here's a plain-language look at how Medicare Part D works heading into 2027, and what it means for people here in Oswego.
The big change: a yearly out-of-pocket cap
Starting in 2026, no one with a Medicare Part D plan will pay more than $2,100 out of pocket for covered prescription drugs in a calendar year. Once you hit that number, your plan picks up 100% of the cost of covered drugs for the rest of the year.
That cap replaces a much messier system where high-cost drug users could face thousands of dollars in yearly bills. It applies whether you have a stand-alone Part D plan or a Medicare Advantage plan that includes drug coverage.
Source: CMS — Medicare Part D program rules (medicare.gov).
The three phases of Part D
Since 2025, Part D has had three phases instead of four. The old "coverage gap" (donut hole) is gone. Here's how the year plays out:
1. Deductible phase. You pay the full negotiated price of your drugs until you meet your plan's deductible. In 2026, the maximum deductible a plan can charge is $615. Some plans set a lower deductible, and some cover certain drug tiers before the deductible is met.
2. Initial coverage phase. After the deductible, you pay a copay or coinsurance for each prescription, and your plan pays the rest. You stay in this phase until your out-of-pocket spending reaches $2,100 in 2026 ($2,400 in 2027).
3. Catastrophic phase. Once you hit the cap ($2,100 in 2026, $2,400 in 2027), you pay $0 for covered drugs for the rest of the year.
That's it — three phases, one cap.
Spreading costs out: the Medicare Prescription Payment Plan
If a big drug bill early in the year would be hard to handle, Medicare offers a free option called the Medicare Prescription Payment Plan. Instead of paying the pharmacy at the counter, you can choose to spread your out-of-pocket drug costs into monthly payments over the calendar year.
It doesn't lower what you owe — it just smooths the timing. You can opt in through your Part D or Medicare Advantage drug plan. This is especially worth knowing about if you take one or two high-cost specialty drugs.
A local snapshot: Oswego and drug coverage
Oswego sits in Oswego County, and Medicare plan availability — including stand-alone Part D plans and Medicare Advantage plans with drug coverage — is set at the county level. That means everyone in the county sees the same menu of plan options when they shop on Medicare.gov.
The rules described above, though, are federal. The cap ($2,100 in 2026, $2,400 in 2027), the $615 maximum deductible, and the three-phase structure apply to every Part D plan in the country, including the ones offered here.
Higher-income surcharges (IRMAA)
Most people pay only their plan's premium. But if your income is above a set threshold, Medicare adds an extra monthly amount called IRMAA (Income-Related Monthly Adjustment Amount) on top of your Part B and Part D premiums.
For 2026, IRMAA kicks in above $109,000 in income for a single filer (higher for married couples filing jointly). Social Security uses your tax return from two years ago to decide. If your income has dropped since then — say, because you retired — you can ask Social Security to reconsider.
Key dates to remember
- October 15 – December 7: Medicare Annual Enrollment Period. This is when you can join, switch, or drop a Part D or Medicare Advantage plan for the following year.
- January 1 – March 31: Medicare Advantage Open Enrollment Period. If you're already in a Medicare Advantage plan, you can switch to another one or return to Original Medicare (and add a Part D plan).
Outside those windows, you generally need a Special Enrollment Period — for example, if you move or lose other drug coverage.
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 Oswego County
(MA penetration in Oswego 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 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 include my monthly premium?
What happens if my drug isn't on my plan's formulary?
I take only one generic drug. Do I still need Part D?
- CMS — Medicare Part D program rules (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.