Medicare Part D Costs 2026 vs 2027: Premium, Deductible, Cap

Medicare Part D costs are four separate numbers, and the one most people ask about, the monthly premium, is usually the smallest. The deductible, the copays and coinsurance you pay at the pharmacy, and the yearly out-of-pocket cap decide what a year of prescriptions really costs.

This guide gives every 2026 figure, every 2027 figure CMS has already published, and the two programs that can cut your bill to almost nothing.

Key Takeaways

• The average stand-alone Part D premium is $36 a month in 2026 (KFF, June 2026), but 28% of stand-alone enrollees without Extra Help pay $0 and 20% pay $100 or more.
• The 2026 deductible is capped at $615 and the out-of-pocket limit is $2,100. For 2027 CMS has set them at $700 and $2,400.
• The 2027 base premium is $41.33, up 6%, and the stand-alone premium subsidy ends after 2026, so many plan premiums will rise more than 6%.
• Higher earners pay an IRMAA surcharge of $14.50 to $91.00 a month on top of the plan premium in 2026.
• Extra Help brings the premium and deductible to $0 with copays of $5.10 or less for generics if your 2026 income is under $23,940 single or $32,460 married.

What does Medicare Part D cost in 2026?

Medicare Part D costs in 2026 break into a monthly premium, a deductible of up to $615, copays or coinsurance at the pharmacy, and a $2,100 yearly out-of-pocket cap, according to Medicare.gov. The premium is set by each private plan. KFF’s June 2026 analysis found the enrollment-weighted average stand-alone plan premium is $36 a month, down 7% from $39 in 2025, while the drug portion of a Medicare Advantage premium averages $8. After the deductible, the standard benefit charges 25% coinsurance until your out-of-pocket spending on covered drugs reaches $2,100, and then you pay $0 for the rest of the calendar year. Higher earners pay an income-related surcharge of $14.50 to $91.00 a month, and people who enroll late pay a permanent penalty of 1% of the $38.99 national base premium per uncovered month. Extra Help removes the premium and deductible entirely for enrollees with limited income and resources.

Those four numbers interact. A plan with a $0 premium can carry the full $615 deductible and coinsurance on every brand-name drug, while a $126 premium plan may reduce the deductible and charge lower brand coinsurance. Which one is cheaper depends on what you take, which is why the Medicare Plan Finder asks for your drug list before it shows prices.

Part D is the drug half of the Medicare cost picture. For the hospital and doctor side, see our guides to the 2026 Part B premium and the Medicare deductibles for Parts A, B, and D.

How much is the Part D premium, and why do plans range from $0 to $126?

The average stand-alone Part D premium is $36 a month in 2026, per KFF’s June 11, 2026 brief; CMS’s earlier September 26, 2025 projection was $34.50. Averages hide the spread. Among stand-alone enrollees who do not receive Extra Help, 28% pay $0, another 25% pay under $10, and 20% pay $100 or more. Among the 72% who pay anything at all, the average is $57 a month.

KFF reports the cheapest national plan, Wellcare Value Script, averages just under $6 and holds one-third of all stand-alone enrollment, 6.1 million people. At the other end, AARP Medicare Rx Preferred averages $126 and Humana Premier Rx averages $120.

The expensive plans typically pair a lower deductible with lower brand-name cost sharing: KFF’s plan data shows Humana Premier Rx charges a flat $45 copay for preferred brands, and AARP Medicare Rx Preferred charges 17% coinsurance against the 25% median.

Medicare Advantage tells a different story. Plans use rebate dollars to lower or erase the drug premium, so 79% of Advantage enrollees without Extra Help pay nothing for drug coverage and the average drug portion is $8. If you are weighing the two routes, our comparison of Medicare Advantage vs Original Medicare covers the trade-offs beyond price.

What is the Part D deductible in 2026 and 2027?

No Medicare drug plan may charge a deductible above $615 in 2026, and for 2027 CMS has set the standard deductible at $700, an $85 increase.

Both figures come from the CMS April 2026 Rate Announcement, which updates the deductible each year by the growth in per-person drug spending and rounds to the nearest $5. CMS’s spending index for 2027 is 13.65%; after rounding to the nearest $5, the deductible rises 13.8%.

The standard deductible is a ceiling, and most plans sit right at it. KFF found that in 2026, 78% of stand-alone enrollees are in plans charging the full $615, 18% face a partial deductible, and only 4% pay none. The zero-deductible plans charge an average premium of $127 a month, against $22 for plans with the full deductible.

Paying an extra $105 a month to avoid a $615 deductible costs $1,260 a year, so it only pays off if the plan also lowers your copays substantially.

Medicare Advantage drug deductibles have climbed fast. KFF reports the average drug deductible in Advantage plans rose from $64 in 2024 to $371 in 2026, and 82% of Advantage enrollees now face one. That shift matters if you assumed Advantage meant little or no drug deductible; that was mostly true two years ago, and it mostly is not now.

How does the $2,100 out-of-pocket cap work?

Medicare Part D’s out-of-pocket maximum works in three stages, per Medicare.gov: you pay 100% of drug costs in the deductible stage, 25% coinsurance (or a flat copay) in the initial coverage stage until your spending on covered drugs reaches $2,100, and $0 for covered drugs in the catastrophic stage through December 31. Since 2025, this three-stage design has been the biggest change to Part D in a generation.

Some amounts count toward the $2,100 even though you did not pay them: Extra Help payments and contributions from State Pharmaceutical Assistance Programs. The manufacturer discount on brand-name drugs does not count. CMS’s guidance for the redesigned benefit says those discounts “do not count toward the enrollee’s incurred costs,” a change from the old coverage-gap discount that did count before 2025.

Premiums do not count either, and neither do drugs bought with a discount card instead of your plan. Medicare.gov’s drug-cost help page says TrumpRx and other discount cards are not creditable coverage, and drugs bought with them instead of your plan do not count toward your deductible or the cap.

Your plan may not use 25% coinsurance on every tier. KFF found the median coinsurance for preferred brands is 25% in stand-alone plans and 21% in Advantage plans, and for non-preferred drugs it is 34% and 38%.

Generics usually carry flat copays. Specialty-tier drugs, which KFF reports CMS defined for 2026 as those costing more than $950 a month, carry the highest coinsurance, which is exactly where the $2,100 cap does the most work.

Medicare Part D costs in 2027: what changes on January 1

CMS has published three of the 2027 numbers. On July 28, 2026 it set the national base beneficiary premium at $41.33, up from $38.99, and the national average bid at $296.05, up from $239.27.

In April 2026 it set the standard deductible at $700 and the out-of-pocket threshold at $2,400. The 2027 IRMAA brackets and Extra Help income limits arrive later: CMS released the 2026 IRMAA amounts on November 14, 2025, and Extra Help limits follow the federal poverty guidelines early in the new year.

The $36 and $34.50 averages in this guide describe the premium plan sponsors actually charge. The $38.99 and $41.33 figures are a different number: the national base beneficiary premium Medicare uses to calculate late enrollment penalties and the IRMAA surcharge amounts, not what most enrollees pay. The table below keeps the two on separate rows so they are not confused.

Part D cost item	2026	2027	Source
National base beneficiary premium	$38.99	$41.33	CMS, July 28, 2026
Average stand-alone plan premium	$36 (KFF) / $34.50 (CMS projection)	Published with the plan landscape in mid-to-late September 2026	KFF June 2026; CMS Sept 2025
Maximum deductible	$615	$700	CMS Rate Announcement, April 2026
Out-of-pocket cap	$2,100	$2,400	CMS Rate Announcement, April 2026
Coinsurance after deductible (standard benefit)	25%	25%	CMS Rate Announcement, April 2026
Extra Help copay, generic (100% to 150% of poverty)	$5.10	$5.80	CMS Rate Announcement, April 2026
Extra Help copay, brand (100% to 150% of poverty)	$12.65	$14.40	CMS Rate Announcement, April 2026
Premium Stabilization Demonstration subsidy	$10 a month per stand-alone plan	Ends after 2026	CMS, July 28, 2026
IRMAA surcharge range	$14.50 to $91.00	Expected November 2026	Medicare.gov fact sheet

The deductible and the cap are both indexed to a 13.65% increase because the law ties them to the growth in average Part D spending per person, which CMS measured at 9.37% for the year ending July 2026, compounded with a 3.92% correction for prior-year revisions.

Rounding to the nearest $5 and $50 is why the deductible shows up as 13.8% and the cap as 14.3%. The base premium rises only 6% because the Inflation Reduction Act caps its annual increase at 6% through 2029.

Will your premium go up in 2027 when the subsidy ends?

Probably, and by more than 6% for many stand-alone plans. The CMS July 28, 2026 fact sheet says the Part D Premium Stabilization Demonstration will end after 2026 because plan sponsors now have “sufficient experience under the redesigned Part D benefit.”

In 2026 the demonstration paid participating stand-alone plans a uniform $10 monthly reduction on the base premium and limited any plan’s year-over-year premium increase to $50, per the CMS July 28, 2025 fact sheet.

Remove the $10 subsidy and add the $2.34 base premium increase, and a plan that changed nothing else would cost roughly $12 more a month in 2027. Plans that were holding increases under the $50 limit can raise premiums further, and plans can exit entirely.

KFF counted 360 stand-alone plans in 2026, 22% fewer than 2025 and about half the 2024 count, so a 2027 shakeout on top of that is realistic.

You will know your own number soon. Plans must mail the Annual Notice of Change by September 30, and CMS says it will publish the full 2027 plan landscape in mid-to-late September.

Medicare Open Enrollment runs October 15 to December 7, 2026, and every stand-alone plan and Advantage drug plan is on the table during that window. Our Medicare program guide tracks the enrollment dates and the hub of related decisions.

How much extra do higher earners pay for Part D?

If your modified adjusted gross income from two years ago is above $109,000 for a single filer or $218,000 for a joint return, you pay an income-related monthly adjustment amount, or IRMAA, on top of your plan premium in 2026.

The 2026 Medicare costs fact sheet lists five surcharge tiers from $14.50 to $91.00 a month. Medicare bills the surcharge directly, and Social Security deducts it from your benefit if you receive one.

2024 income, single filer	2024 income, joint filer	2026 Part D monthly surcharge
$109,000 or less	$218,000 or less	$0 (plan premium only)
$109,001 to $137,000	$218,001 to $274,000	$14.50 + plan premium
$137,001 to $171,000	$274,001 to $342,000	$37.50 + plan premium
$171,001 to $205,000	$342,001 to $410,000	$60.40 + plan premium
$205,001 to $499,999	$410,001 to $749,999	$83.30 + plan premium
$500,000 or more	$750,000 or more	$91.00 + plan premium

Married people filing separately with income above $109,000 pay $83.30, and $91.00 at $391,000 or more. The surcharge applies even in a $0-premium plan and even inside a Medicare Advantage plan.

If your income dropped after 2024 because of retirement, a divorce, or a death, you can ask Social Security to use a more recent year. Our Medicare IRMAA guide walks through the appeal form and the life events that qualify.

What is the Part D late enrollment penalty?

The late enrollment penalty is a permanent monthly charge for going 63 or more days without Part D or other creditable drug coverage after your Initial Enrollment Period ends. Medicare.gov calculates it as 1% of the national base beneficiary premium, $38.99 in 2026, multiplied by the number of full uncovered months, rounded to the nearest 10 cents. Because the base premium changes yearly, so does the penalty.

Medicare.gov’s own example: someone who waited 14 months pays 14% of $38.99, which is $5.46, rounded to $5.50 a month in 2026. At the 2027 base premium of $41.33 the same 14-month penalty becomes $5.80. Wait five years and the penalty is 60% of the base premium, about $24.80 a month in 2027, for as long as you have drug coverage.

Two groups are exempt. Anyone with creditable coverage from an employer, a union, TRICARE, the VA, or the Indian Health Service accrues no penalty, and anyone who qualifies for Extra Help pays no penalty at all. Medicare.gov’s advice for people who take no drugs is to join a low-premium plan anyway, because the penalty is calculated on months without coverage, not on how much you spend.

Extra Help: how to pay $0 premium and $0 deductible

Extra Help, formally the Part D Low-Income Subsidy, is the single biggest lever on Part D costs. Medicare.gov lists the 2026 terms: it pays the full premium in benchmark plans, sets the deductible at $0, caps copays at $5.10 for generics and $12.65 for brand-name drugs, and waives the late enrollment penalty.

Once total drug costs, including amounts Extra Help pays, reach $2,100, you pay $0. Medicare.gov adds that people with full Medicaid who are also in the QMB program pay no more than $4.90 per covered drug.

Extra Help in 2026 (Medicare.gov)	Individual	Married couple living together
Yearly income limit	$23,940	$32,460
Resource limit (savings, investments; home and one car excluded)	$18,090	$36,100
Plan premium	$0 in a benchmark plan
Plan deductible	$0
Copay per generic	Up to $5.10 (rising to $5.80 in 2027)
Copay per brand-name drug	Up to $12.65 (rising to $14.40 in 2027)
After $2,100 in total drug costs	$0 per drug

You qualify automatically if you have full Medicaid, get help from a Medicare Savings Program with your Part B premium, or receive SSI. Everyone else applies through Social Security, online or at 1-800-772-1213, and the same application can start a Medicare Savings Program application in your state.

KFF counted 13.6 million Extra Help enrollees in 2026, up 0.5 million from 2025, and 88 stand-alone benchmark plans available at no premium, between 1 and 4 per state.

The income limits are 150% of the federal poverty level, which means many people who do not think of themselves as low-income qualify, especially retirees living on Social Security alone. Our guides to Extra Help for Medicare and the Medicare Savings Programs cover what counts as income, what counts as a resource, and how to apply for both at once.

Two worked examples: what Part D really costs per year

Two examples show what Part D actually costs per year: about $804 for three generics with no brand-name drugs, and about $2,364 for one $1,000-a-month brand-name drug that hits the $2,100 cap in July. The figures are GrantsHubUSA arithmetic on the 2026 standard benefit and KFF’s premium averages; real plans vary, so treat them as ranges, not quotes.

Example 1: three generics, no brand-name drugs

A retiree in a $22-a-month plan with the full $615 deductible fills three generics that cost about $15 each per month. The deductible stage lasts until $615 of drug costs, so roughly the first 14 months at $45 a month, which means this person never leaves the deductible stage in a calendar year.

Yearly cost: $264 in premiums plus $540 at the pharmacy, about $804. Some plans exempt preferred generics from the deductible and charge a flat copay, which would cut the pharmacy side further.

Example 2: one brand-name drug at $1,000 a month

The same $22 plan. January: the $615 deductible plus 25% of the remaining $385, or $96, for a $711 out-of-pocket month. February through June: 25% of $1,000, or $250 a month, for a running total of $1,961.

In July another $139 brings the total to $2,100, catastrophic coverage begins, and the drug costs $0 from August through December. Yearly cost: $2,100 at the pharmacy plus $264 in premiums, about $2,364, for a drug with a $12,000 list price.

Example 2 shows why the cap matters more than the premium. Before 2024 that same person would have faced 5% coinsurance with no ceiling. It also shows why the Medicare Prescription Payment Plan exists: it lets you spread the $2,100 across 12 monthly bills of about $175 instead of paying $711 in January. Medicare.gov is clear that the payment plan does not lower your costs; it only changes the timing.

How can you lower Medicare Part D costs before Open Enrollment?

Start with the Plan Finder, not the premium. Enter your exact drugs and pharmacy at Medicare.gov/plan-compare and sort by total yearly cost. Because the $6 plan and the $126 plan differ in deductible and copay design, they can produce very different totals for the same drug list, and the direction is not always the one you expect.

Then work the list Medicare.gov publishes on its drug-cost page:

• Apply for Extra Help if your income is under $23,940 single or $32,460 married. It is the only step that removes the premium, the deductible, and the penalty at once.
• Check a State Pharmaceutical Assistance Program. Many states run one, and Medicare.gov says their payments may count toward your $2,100 cap.
• Ask about generics and preferred pharmacies. Medicare.gov notes that mail order is sometimes cheaper, and many plans charge less at preferred-network pharmacies.
• Use the $35 insulin cap and free vaccines. Every Part D plan caps a month’s supply of covered insulin at $35 and covers adult vaccines at no cost under the Inflation Reduction Act.
• Look up manufacturer assistance programs through the Plan Finder’s pharmaceutical assistance search for high-cost brand drugs.
• Consider the Medicare Prescription Payment Plan if a single expensive fill early in the year would strain your budget.

If you get drug coverage inside a Medicare Advantage plan, compare the drug side separately. The plan’s network and out-of-pocket cap for medical care are one decision, and its formulary and drug deductible are another. Our guide to Medicare HMO vs PPO plans covers the medical side of that comparison.

The bottom line on Medicare Part D costs

In 2026, expect a premium anywhere from $0 to $126 a month with an average of $36, a deductible of up to $615, and a hard $2,100 ceiling on what you spend at the pharmacy for covered drugs. In 2027 the deductible becomes $700, the ceiling $2,400, and the base premium $41.33, while the subsidy that kept stand-alone premiums flat disappears.

Higher earners add $14.50 to $91.00 a month, late enrollees add 1% of the base premium per uncovered month, and Extra Help erases the premium and deductible for anyone under the income and resource limits.

The plan landscape for 2027 posts in mid-to-late September, Annual Notices of Change arrive by September 30, and Open Enrollment opens October 15. Run your drug list through the Plan Finder in that window every year, because the cheapest plan for your prescriptions in 2026 is not guaranteed to be the cheapest in 2027.

Related reading

• Medicare Advantage vs Medigap: which supplement route costs less
• Medicare Part A premium and hospital costs in 2026