Medicare Part D
Part D in Mcallen: 2027 cap & end of donut hole
McALLEN, Texas — If you take prescription drugs and have Medicare, 2027 continues one of the biggest changes to Part D in years. There's a yearly limit on what you pay out of pocket, a set cap on the deductible, and a simpler three-phase structure now that the old "donut hole" is gone.
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Speak to a Licensed Insurance Agent
Click to call 855-729-3240Key takeaways
- The Part D yearly out-of-pocket cap is $2,100 in 2026 and $2,400 in 2027; once you hit it, you pay nothing for covered drugs the rest of the year.
- Part D deductibles can vary by plan, but no plan can charge more than $615 in 2026 or $700 in 2027.
- The old "donut hole" coverage gap is gone, leaving three simple phases: deductible, initial coverage, and catastrophic.
- If a big drug bill in one month is tough on your budget, CMS offers an optional Medicare Prescription Payment Plan that spreads your out-of-pocket drug costs into monthly installments without lowering your total cost.
Here's a plain-language walk-through of how Part D works heading into 2027, and where McAllen readers can go for personal help.
What Part D is, in one minute
Part D is Medicare's prescription drug coverage. You can get it two ways: as a stand-alone drug plan added to Original Medicare, or built into a Medicare Advantage plan. Either way, private insurers run the plans under rules set by the Centers for Medicare & Medicaid Services (CMS).
McAllen is in Hidalgo County, where a range of stand-alone Part D plans and Medicare Advantage plans with drug coverage are offered each year. The number of plans available shifts annually, so it's worth checking the Plan Finder at medicare.gov during open enrollment.
The 2027 out-of-pocket cap: $2,400
Part D has a firm annual limit on what you pay out of pocket for covered drugs. The cap is $2,100 in 2026 and $2,400 in 2027. Once your out-of-pocket spending on covered prescriptions reaches that amount, you pay nothing for the rest of the calendar year on those drugs.
This cap applies to every Part D plan. It does not include your monthly premium, and it only counts spending on drugs your plan covers.
The deductible: up to $700 in 2027
Each Part D plan can set its own deductible, but in 2026 no plan can charge more than $615. Some plans charge less, and some charge nothing at all for certain drug tiers. During the deductible phase, you generally pay the full negotiated price for your drugs until you meet that amount.
The three phases of Part D in 2027
Since 2025, the coverage gap (the old "donut hole") is gone. Part D now has three phases:
1. Deductible phase. You pay the full cost of your drugs until you meet the plan's deductible (up to $615 in 2026, up to $700 in 2027). 2. Initial coverage phase. You pay a copay or coinsurance for each prescription, and the plan pays the rest. This continues until your out-of-pocket spending reaches the yearly cap ($2,100 in 2026, $2,400 in 2027). 3. Catastrophic phase. Once you hit the cap, you pay nothing for covered drugs for the remainder of the year.
That's a meaningful change for people who take high-cost medicines, because in past years there was no ceiling on out-of-pocket drug spending.
The Medicare Prescription Payment Plan
If paying a large drug bill in a single month is hard on your budget, CMS offers an optional program called 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 at the pharmacy counter.
It doesn't lower your total costs — it just smooths them out. You can sign up through your Part D plan. It's worth a look if you have a costly medication early in the year.
A note on higher-income enrollees (IRMAA)
Most people pay the standard Part D premium set by their plan. If your income is above $109,000 as a single filer (or $218,000 filing jointly) based on your most recent IRS return on file, you may owe an extra amount called the Income-Related Monthly Adjustment Amount, or IRMAA. Medicare bills this surcharge separately.
Key dates to remember
- Annual Enrollment Period: October 15 – December 7, 2026. This is when you can join, switch, or drop a Part D or Medicare Advantage plan for 2027.
- Medicare Advantage Open Enrollment: January 1 – March 31, 2027. If you're already in a Medicare Advantage plan, you can make a one-time change during this window.
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 Hidalgo County
(MA penetration in Hidalgo 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”) has been eliminated since 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 yearly cap include my monthly premium?
What if my drug isn't on my plan's formulary?
I already hit big drug costs last year. Does that carry over?
- CMS — Medicare Part D program rules (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.