The 2027 Part D out-of-pocket cap is $2,400
Every Medicare drug plan has the same yearly limit on what you pay for covered drugs. For 2027 it is $2,400, up from $2,100 in 2026. When your out-of-pocket spending on covered drugs reaches that amount, you move into catastrophic coverage and pay $0 for covered Part D drugs for the rest of the calendar year.
See the numbers
| Item | 2026 | 2027 | Status |
|---|---|---|---|
| Out-of-pocket cap | $2,100 | $2,400 | final |
| Maximum deductible | $615 | $700 | final |
The Part D out-of-pocket cap rises from $2,100 in 2026 to $2,400 in 2027, and the highest deductible a plan may charge rises from $615 to $700.
Source: Medicare.gov — How much does Medicare drug coverage cost?
The cap applies to Part D coverage whether you have a stand-alone drug plan with Original Medicare or a Medicare Advantage plan that includes drug coverage. It resets each January.
What counts toward the cap, and what doesn't
Does it count toward the 2027 Part D cap?
| Cost | Counts? |
|---|---|
| Your deductible for covered drugs | Yes |
| Copays and coinsurance for covered drugs | Yes |
| Payments made for you through Extra Help | Yes |
| Your monthly plan premium | No |
| Drugs your plan doesn't cover | No |
| The Medicare GLP-1 Bridge copay | No |
The most common surprise is the premium. You keep paying your monthly premium after you reach the cap, so a plan with a low premium and high drug costs can still cost more over a year than a plan with a higher premium and lower copays.
Drugs that aren't on your plan's formulary (its covered-drug list) don't count either. That is why the first check during Open Enrollment is whether each plan still covers every drug you take in 2027.
The deductible: up to $700 in 2027
A plan can make you pay the full cost of your drugs until you meet its deductible. For 2027, no Medicare drug plan may charge a deductible above $700, up from $615 in 2026. Many plans charge less, and some charge none, especially for lower-cost generic tiers.
Insulin is the exception. You pay no more than $35 for a one-month supply of each covered insulin, and no deductible applies to it.
How your costs move through the year
- Deductible. You pay for covered drugs until you meet your plan's deductible, up to $700 in 2027.
- Initial coverage. You pay your plan's copays or coinsurance. Everything you pay for covered drugs keeps counting toward the cap.
- Catastrophic coverage. Once you reach $2,400, you pay $0 for covered drugs for the rest of the year.
If you take an expensive brand-name drug, you may reach the cap in the first few months of the year. The Medicare Prescription Payment Plan lets you spread those costs into monthly payments across the year instead of paying them up front. You can ask your plan to sign you up.
GLP-1 Bridge copays sit outside the cap
The Medicare GLP-1 Bridge runs July 1, 2026 through December 31, 2027. Eligible people with Part D can get certain GLP-1 drugs for weight loss for a $50 copay with prior authorization. CMS says no part of that copay counts toward your Part D deductible or the out-of-pocket cap. See does Medicare cover Ozempic and Wegovy.
Using the cap when you compare plans
The cap is the same in every plan, so it won't separate one plan from another. What differs is how fast you reach it, which depends on covered-drug spending, the deductible, drug tiers and pharmacy network. Premiums do not count toward reaching the cap. Comparing the total yearly cost of your own prescriptions is the only reliable way to see which plan is cheapest for you.
For the other 2027 changes, see what's changing in Medicare for 2027. If one of your drugs is getting a Medicare-negotiated price, see which drugs get lower Medicare prices in 2027. For premiums, see will Part D premiums go up in 2027.
The drug cap and your medical costs are separate
The Part D limit applies to qualifying out-of-pocket spending for covered Part D drugs. It does not place a single limit on every Medicare expense. Medical services, plan premiums and prescriptions outside Part D coverage require separate review. In a Medicare Advantage plan, distinguish the medical out-of-pocket maximum from the Part D drug limit.
Use your Explanation of Benefits to track progress
After the pharmacy bills your plan, review the drug Explanation of Benefits. It identifies the prescriptions processed, coverage stage and amounts counted toward the annual threshold. Compare it with pharmacy receipts if something looks wrong. A cash purchase or coupon transaction should not be assumed to count merely because you paid for a prescription.
Ask the plan about a missing claim, a coverage decision or an amount that appears incorrect. Keep receipts and written responses. If a medication is not covered, ask about the coverage-determination or exception process before assuming the price you pay will be credited toward the cap.
Budgeting when expensive prescriptions arrive early in the year
The annual protection does not mean every month's payment is equal. Someone who uses an expensive covered drug early can face substantial initial cost sharing, while someone with inexpensive generics may never reach the limit. Ask for a month-by-month estimate as well as the annual total.
The Medicare Prescription Payment Plan changes when eligible out-of-pocket drug costs are paid; it does not reduce the drug price or turn an uncovered drug into a covered one. Ask your plan how enrollment and billing work, and compare that option with any available financial assistance before deciding.
What to bring to an annual drug review
Bring the exact medication names, strengths, quantities, refill schedule and preferred pharmacies, along with any Extra Help notice. Include drugs your doctor expects to start or stop if those changes are known. This lets the comparison show how your own costs may develop instead of assuming every enrollee pays the cap.
Keep paying required premiums after reaching catastrophic coverage. Continue checking the formulary and coverage rules for any newly prescribed medicine. Reaching the annual threshold does not make every future prescription covered regardless of the plan's rules.
Quick questions
Does the 2027 Part D cap include my premium?
No. The cap counts what you pay for covered drugs. Monthly premiums are separate and continue after you reach the cap.
Does the Part D cap apply in a Medicare Advantage plan?
Yes, if your Medicare Advantage plan includes drug coverage. The same $2,400 limit applies in 2027.
Does the GLP-1 Bridge copay count toward the cap?
No. CMS says no part of the $50 GLP-1 Bridge copay counts toward your Part D deductible or out-of-pocket cap.
How The Jordan Insurance Agency helps
The Jordan Insurance Agency is an independent agency based in Charlotte, North Carolina. We enter your prescriptions into each plan available in your county and show you what you would pay over the full year, including how fast you would reach the cap.
There is no fee for our help. Carriers pay the agent, so your premium is the same whether you enroll with us or on your own.
Next steps: read what's changing in Medicare for 2027 and which drugs get lower Medicare prices in 2027.
2027 Part D limits checked October 16, 2026. Sources: Medicare.gov — How much does Medicare drug coverage cost?, Medicare.gov — Insulin, CMS — Medicare GLP-1 Bridge.
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