Medicare Part D
The End of the Coverage Gap: Medicare Part D in Fayetteville
# How Medicare Part D Works in 2027: The Deductible, the $2,400 Cap, and the Three…
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Click to call 855-729-3240Key takeaways
- In 2027, once you spend $2,400 out of pocket on covered drugs, you pay $0 for the rest of the year, and this cap applies to both stand-alone drug plans and Medicare Advantage plans with drug coverage.
- Part D plans can charge a yearly deductible of up to $700 before your regular cost-sharing starts in 2027.
- The old "donut hole" coverage gap is gone, so Part D now has just three phases: deductible, initial coverage, and catastrophic.
- You can choose to spread your drug costs into monthly payments through the Medicare Prescription Payment Plan, which every Part D plan must offer and which does not change your total costs.
FAYETTEVILLE, N.C. — If you take prescription drugs and have Medicare, 2027 continues some of the friendliest Part D rules the program has seen in years. There's a hard yearly limit on what you pay out of pocket at the pharmacy, the old "donut hole" is gone, and you have the option to spread your drug costs across the year in even monthly payments.
Here's a plain-English guide to how Part D works in 2027, and where to go for help in Fayetteville.
The big number: $2,100 out-of-pocket cap
In 2027, once your out-of-pocket spending on covered prescription drugs reaches $2,400, you pay $0 for the rest of the calendar year on those drugs. That's the single most important change to understand.
This cap applies whether you get your Part D coverage through a stand-alone Prescription Drug Plan (often called a PDP) or through a Medicare Advantage plan that includes drug coverage (an MA-PD). The cap resets each January 1.
Only your out-of-pocket costs for covered drugs count toward the $2,400. Your monthly premium does not.
The deductible: up to $700 in 2027
Part D plans can charge a yearly deductible before cost-sharing kicks in. In 2027, the maximum allowed deductible is $700. Some plans charge the full amount, some charge less, and some charge nothing at all — that's a plan-by-plan detail you'll see when you compare options on Medicare.gov.
Until you meet your plan's deductible, you generally pay the full negotiated price for your drugs.
The three phases of Part D in 2027
The old "coverage gap" (the donut hole) was eliminated in 2025. So in 2027, Part D has just three phases:
1. Deductible phase. You pay 100% of the drug cost until you reach the plan's deductible (up to $700 in 2027).
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 total out-of-pocket spending reaches $2,400.
3. Catastrophic phase. Once you hit $2,400 out of pocket, you pay $0 for covered drugs for the rest of the year.
That's it. No more gap, no more confusing math about what "counts" — just three straightforward steps.
The Medicare Prescription Payment Plan
If a $2,400 bill early in the year would be hard to absorb, there's a tool worth knowing about: the Medicare Prescription Payment Plan. It lets you spread your out-of-pocket drug costs across the calendar year in monthly installments, instead of paying big amounts at the pharmacy counter.
You don't pay more overall — it's the same money, just smoothed out. It's optional, and you have to opt in. Every Part D plan is required to offer it. You can sign up before the year starts or at any point during the year.
What about higher-income retirees?
Most people pay the standard Part D premium set by their plan. But if your income is above $109,000 as a single filer (or $218,000 filing jointly) based on your 2024 tax return, you'll pay an extra amount called IRMAA — the Income-Related Monthly Adjustment Amount — on top of your Part D premium. Social Security notifies you if this applies.
Plan availability in Cumberland County
Fayetteville is in Cumberland County, where Medicare beneficiaries can choose from a range of stand-alone Part D drug plans and Medicare Advantage plans with built-in drug coverage. For 2027, Cumberland County has 55 Medicare Advantage plans from 8 carriers, and you can see current options for your ZIP code on Medicare.gov's Plan Finder.
The rules above — the $2,400 cap, the $700 maximum deductible, the three phases, and the payment plan option — apply to every Part D plan nationwide in 2027, no matter which one you pick.
Dates to remember
- October 15 – December 7, 2026: Medicare Annual Enrollment Period. You can join, switch, or drop a Part D or Medicare Advantage plan. Changes take effect January 1, 2027.
- January 1 – March 31, 2027: Medicare Advantage Open Enrollment. If you're already in a Medicare Advantage plan, you get one chance to switch to a different MA plan or return to Original Medicare with a stand-alone Part D plan.
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 Cumberland County
(MA penetration in Cumberland 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?
What happens if my drug isn't on my plan's formulary?
Do I have to sign up for the Prescription Payment Plan?
- CMS — Medicare Part D program rules (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.