Medicare Part D

$2,100 Part D Ceiling Arrives Jan. 1 for Hurst Enrollees

HURST, Texas — Starting Jan. 1, 2027, people with Medicare Part D will have a new, firm ceiling on what they pay out of pocket for covered prescription drugs: $2,400 for the year. Once you hit that number, you pay nothing more for the rest of 2027 on covered medications. This change lands right as the Annual Enrollment Period (Oct. 15 – Dec. 7) is underway.

Here is what is actually changing, in plain English.

The $2,400 cap, explained

The Part D out-of-pocket cap is $2,100 in 2026 and $2,400 in 2027. The 2027 figure reflects the yearly inflation adjustment set by CMS.

A few things to keep in mind:

• The cap applies to covered Part D drugs. If your plan does not cover a drug, that spending does not count toward the cap.
• Your monthly premium does not count toward the $2,100.
• The cap resets every Jan. 1.

The Part D maximum deductible is $615 in 2026 and $700 in 2027, though many plans set a lower deductible.

The coverage gap is gone

The old "donut hole" — the confusing middle stage where costs sometimes spiked — was eliminated in 2025 and remains gone in 2027. Part D now has just three phases:

1. Deductible phase — you pay full negotiated price until you meet the plan's deductible. 2. Initial coverage phase — you pay a copay or coinsurance while the plan pays the rest. 3. Catastrophic phase — once your out-of-pocket spending hits the annual cap ($2,400 in 2027), you pay nothing more for covered drugs the rest of the year.

That's it. No more fourth stage, no more surprise price jumps mid-year.

The Medicare Prescription Payment Plan

Even with the annual cap, hitting that number early in the year can sting if it happens in one trip to the pharmacy. That is what the Medicare Prescription Payment Plan is for.

This is a free, optional program from Medicare that lets you spread your out-of-pocket drug costs across the calendar year in monthly installments instead of paying at the counter. You still owe the same amount overall — it is just billed monthly by your Part D plan rather than charged all at once at the pharmacy.

Who tends to benefit most:

• People who take a high-cost drug early in the year and would otherwise hit the deductible or a big coinsurance charge in January or February.
• People on a fixed monthly budget who prefer predictable bills.

You can opt in through your Part D plan at any time. You do not have to enroll during AEP, but signing up before the year starts means the smoothing kicks in from month one. More detail is at medicare.gov.

What this means for Hurst residents

Hurst is in Tarrant County, where Medicare beneficiaries can compare stand-alone Part D plans and Medicare Advantage plans that include drug coverage during AEP. Plan availability, formularies (the list of covered drugs), and pharmacy networks are set at the county level and vary from plan to plan — so two neighbors on the same street can have very different drug coverage.

Because the $2,100 cap and the three-phase structure are program-level rules, they apply no matter which Part D plan you choose. What differs plan-to-plan is which drugs are covered, at what tier, and at which pharmacies.

That makes this year's plan comparison especially worth doing. Formularies change annually, and your 2025 plan may cover your drugs differently in 2026.

Key dates to circle

• Oct. 15 – Dec. 7, 2026: Medicare Annual Enrollment Period. Change your Part D or Medicare Advantage plan for 2027.
• Jan. 1, 2027: New benefits, formularies, and the $2,400 cap take effect.
• Jan. 1 – Mar. 31, 2027: Medicare Advantage Open Enrollment Period. If you are already in an MA plan, you get one chance to switch or drop back to Original Medicare.

One more figure worth knowing: IRMAA — the income-related surcharge on Part B and Part D premiums — starts above $109,000 in income for a single filer in 2026 (based on your 2024 tax return). Most beneficiaries do not pay it.