Medicare Part D
$2,400 Part D Cap in Williamsport, Pa.
WILLIAMSPORT, Pa. — Starting Jan. 1, 2027, no one with a Medicare Part D drug plan will pay more than $2,400 out of pocket for covered prescriptions in a calendar year. It's one of the biggest shifts in how Medicare pays for drugs in years, and for people who take expensive medicines, it changes the math on what a year of treatment can cost.
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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.
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Speak to a Licensed Insurance Agent
Click to call 855-729-3240Key takeaways
- Starting Jan. 1, 2027, Medicare Part D out-of-pocket costs for covered prescriptions are capped at $2,400 per calendar year, and once you hit that limit you pay nothing for covered drugs the rest of the year.
- The cap only counts your deductible and pharmacy cost-sharing for covered drugs, not your monthly premium or drugs your plan doesn't cover.
- The optional, free Medicare Prescription Payment Plan lets you spread your out-of-pocket drug costs into monthly bills instead of paying it all at the pharmacy at once.
- The Annual Enrollment Period runs Oct. 15 through Dec. 7, and Medicare Advantage members get another chance to switch plans or return to Original Medicare from Jan. 1 through March 31.
Here in Williamsport — part of Lycoming County — pharmacists and Medicare counselors are already fielding questions about the new cap, the end of the old "donut hole," and a new option that lets you spread your drug costs across the year.
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 Lycoming County
(MA penetration in Lycoming 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.
What's changing in 2027
Three things stand out for the new plan year:
- A hard out-of-pocket cap on what you pay for covered Part D drugs: $2,100 in 2026 and $2,400 in 2027.
- The coverage gap is gone. The old "donut hole" ended in 2025. Part D now has just three phases: deductible, initial coverage, and catastrophic.
- The maximum Part D deductible a plan can charge is $615 in 2026 and $700 in 2027. Plans can set it lower, but not higher.
Once you hit the cap, you pay nothing for the rest of the year on covered drugs from your plan's formulary. That's a real change from the old system, where high-cost drugs could keep hitting your wallet for months.
How the $2,100 cap actually works
The cap counts what you pay for covered prescriptions — your deductible and your share of the cost at the pharmacy. It does not count your monthly premium, and it does not count drugs your plan doesn't cover.
If you take a single high-cost medication, you could reach the limit fairly early in the year. After that, covered refills should cost you nothing out of pocket for the rest of 2027. If you take mostly low-cost generics, you may never come close to the cap — and that's fine. The cap is a ceiling, not a target.
Two reminders worth repeating:
- The cap resets every Jan. 1.
- It applies to Part D drug coverage, whether you get it through a stand-alone drug plan or built into a Medicare Advantage plan with drug coverage.
The Medicare Prescription Payment Plan
Here's the part a lot of Williamsport readers have been asking about: what if you hit a huge bill in January and can't cover it all at once?
Medicare's answer is the Medicare Prescription Payment Plan, which continues in 2027. It's optional and free to join. Instead of paying your full share at the pharmacy counter, your Part D plan bills you monthly, spreading your out-of-pocket costs across the rest of the calendar year.
A few things to know:
- It doesn't lower what you owe overall — it just changes when you pay.
- You sign up through your Part D plan, not through Medicare directly.
- Once you enroll, the pharmacy charges you $0 at pickup, and your plan sends you a monthly bill.
- You can join at any time during the year.
For someone facing a big first-of-the-year drug bill, this can be the difference between filling a prescription and walking away from the counter.
Enrollment dates you can't miss
The Annual Enrollment Period runs Oct. 15 through Dec. 7 each year. That's your window to join, switch, or drop a Part D or Medicare Advantage plan for the coming year.
If you're already in a Medicare Advantage plan, you get a second window — the Medicare Advantage Open Enrollment Period, Jan. 1 through March 31 — to switch to a different Advantage plan or return to Original Medicare.
Williamsport is in Lycoming County, and Pennsylvania seniors here typically have a wide range of stand-alone Part D and Medicare Advantage options to compare. The specific plans available, their premiums, and their drug lists change every year, which is why it's worth reviewing your coverage during AEP even if you were happy last year.
A note on higher-income enrollees
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 IRMAA surcharge on top of your Part B and Part D premiums in 2026. The $2,100 out-of-pocket cap still applies to you — IRMAA affects premiums, not the cap.
Prescription coverage
How Medicare Part D works in 2027
The old coverage gap (“donut hole”) was eliminated as of 2025 (three phases now). The yearly out-of-pocket cap on 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 premium?
What happens if my drug isn't on my plan's formulary?
Do I have to sign up for the payment plan?
- CMS — Medicare Part D program rules (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.