Medicare Part D
Bismarck Medicare: 2027 Part D Drug Cap
BISMARCK, N.D. — The Part D out-of-pocket cap that took effect January 1, 2026 continues into 2027, with the ceiling rising to $2,400 for the year. Once you reach that amount, your Part D plan picks up the rest of your covered drug costs for the calendar year. The cap is the biggest change to Medicare drug coverage in nearly two decades, and the 2027 figure takes effect right after the Annual Enrollment Period (October 15 – December 7, 2026) wraps up.
Compare Medicare options near you
Answer 3 quick questions to see Medicare Advantage, Medigap, and 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?
Most Medicare Advantage and Medigap options require both.
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 855-729-3240Key takeaways
- For 2027, Medicare drug plans have a firm out-of-pocket cap of $2,400 per year, and once you hit it, your plan covers the rest of your covered drug costs for that year.
- The cap covers costs like your deductible (up to $700 in 2027) and pharmacy cost-sharing, but it does not include your monthly Part D premium, and the old coverage gap ("donut hole") was already eliminated in 2025.
- The optional Medicare Prescription Payment Plan lets you spread your out-of-pocket drug costs into monthly installments instead of paying a big amount at the pharmacy all at once.
- The $2,100 cap and payment plan option apply nationwide under both Original Medicare with a stand-alone Part D plan and Medicare Advantage plans with drug coverage, though formularies, pharmacy networks, and premiums still vary by plan, and IRMAA surcharges begin above $109,000 in income for a single filer in 2026.
What the Part D cap actually means
The cap applies to what you spend out of pocket on covered Part D drugs — things like your deductible and the share you pay at the pharmacy. It does not include your monthly Part D premium.
Under Medicare's rules for 2027:
- The out-of-pocket cap is $2,100 in 2026 and $2,400 in 2027.
- The maximum Part D deductible any plan can charge is $615 in 2026 and $700 in 2027 (many plans set it lower).
- After you hit the yearly out-of-pocket cap ($2,100 in 2026, $2,400 in 2027), you pay $0 for covered drugs for the rest of the year.
For people who take expensive brand-name medications, that ceiling can be reached early in the year — and then costs stop. For people with modest drug spending, the cap may not come into play at all, but the deductible and cost-sharing rules still apply.
The "donut hole" is gone
If you've had Medicare for a while, you may remember the coverage gap — the middle stretch where you paid more out of pocket after your plan hit a spending limit. That gap was eliminated in 2025.
In 2027, Part D still has just three phases:
1. Deductible phase — you pay the full negotiated price until you meet your plan's deductible (up to $700 in 2027). 2. Initial coverage phase — you pay a copay or coinsurance; the plan pays the rest. 3. Catastrophic phase — once your out-of-pocket spending hits the yearly cap ($2,400 in 2027), you pay nothing more for covered drugs that year.
No more donut hole math. No more sticker shock in the middle of the year.
The Medicare Prescription Payment Plan: spreading costs out
Here's the piece a lot of people miss. Even with the yearly cap ($2,400 in 2027), hitting that ceiling in January or February can still be a rough month at the pharmacy counter.
To help, Medicare offers the Medicare Prescription Payment Plan — an optional program that lets you spread your out-of-pocket drug costs across the calendar year in monthly installments instead of paying it all at the pharmacy up front.
A few key points:
- It's free to join. There's no fee or interest.
- You still owe the same total amount — it's just billed monthly by your plan.
- You have to opt in. Your Part D or Medicare Advantage drug plan can tell you how to sign up, and you can join before the year starts or during the year.
- It tends to help most if you have high drug costs early in the year.
If you're on a fixed income and one big pharmacy bill would strain your budget, this is worth asking about.
What Bismarck-area readers should know about plan choices
Bismarck is in Burleigh County, where Medicare beneficiaries can choose between Original Medicare with a stand-alone Part D drug plan, or a Medicare Advantage plan that includes drug coverage. The number of available plans and carriers changes each year, and CMS publishes the current options at Medicare.gov's Plan Finder.
Whichever route you're on, the yearly out-of-pocket cap and the payment plan option apply — they're set at the federal program level, not by ZIP code. But specific drug formularies, pharmacy networks, and premiums do vary by plan, so it's worth comparing during Annual Enrollment. Your current plan's 2027 details are in its ANOC and on Medicare.gov's Plan Finder.
Deadlines to keep on your calendar
- October 15 – December 7, 2026: Annual Enrollment Period. You can join, switch, or drop a Part D or Medicare Advantage plan for 2027.
- January 1, 2027: New coverage starts. The $2,400 cap begins.
- January 1 – March 31, 2027: Medicare Advantage Open Enrollment. If you're in a Medicare Advantage plan and want to switch to a different one — or back to Original Medicare with a drug plan — you have one more window.
One note on higher earners: IRMAA surcharges (income-related premium adjustments for Part B and Part D) begin above $109,000 in income for a single filer in 2026. If your income has changed, it's worth checking whether that affects you.
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 Burleigh County
(MA penetration in Burleigh 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 — $2,400 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?
If I sign up for the Prescription Payment Plan, do I pay less overall?
Do I need to do anything to get the $2,100 cap?
- CMS — Medicare Part D program rules (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.