Is there a cap on what I pay for prescriptions?
Yes. Part D has a yearly cap on what you pay for covered drugs: $2,400 in 2027, up from $2,100 in 2026.
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Goes deeper on: How does a Medicare Advantage plan work? (Medicare Clarity Guide)
The short version
- The yearly cap is $2,400 in 2027. It was $2,100 in 2026.
- The highest deductible a plan can have is $700 in 2027. It was $615 in 2026. Some plans set it lower or have none.
- The old coverage gap is gone. The cap replaced it.
- Both figures can change from one year to the next, so check the year you're in.
The cap and the deductible are different numbers
| Part D | 2026 | 2027 |
|---|---|---|
| Yearly cap on what you pay for covered drugs | $2,100 | $2,400 |
| Standard deductible | $615 | $700 |
The figures come from the CMS 2027 Rate Announcement, published April 6, 2026.
The deductible is what you pay before your plan starts sharing the cost. The cap is the ceiling for the year. A ceiling isn't a bill, so don't read $2,400 as what you will pay. It's the most you'd pay for covered drugs in 2027. Your monthly plan premium is separate and doesn't count toward it.
If you get Extra Help, Medicare.gov says that in 2027, once total drug costs reach $2,400, "you'll pay $0 for each covered drug." Extra Help is explained in What is Extra Help, and do I qualify?.
Does the donut hole still exist?
No. The old coverage gap, often called the donut hole, is gone. The yearly cap has replaced it.
How prescriptions fit into a Medicare Advantage plan is in step 4 of our Medicare guide.
Your next step
A licensed support agent can explain what the cap means for your drug plan.
No obligation. You can request help from one of our licensed support agents at any time.
See My Personalized OptionsWords on this page
- Deductible
- What you pay yourself first, before the plan starts paying its share.
- Extra Help
- A Medicare program that helps people with limited income and savings pay for drugs.
- Medicare Advantage
- A private plan you can choose instead. It bundles coverage and has a yearly out-of-pocket limit.
- Part D
- Medicare's coverage for prescription drugs. It's its own plan, or built into some Medicare Advantage plans.
Sources
All 2 checked October 7, 2026.