Medicare Part D: Prescription Drug Coverage
Medicare Part D provides insurance for outpatient prescription medications. You can buy a standalone plan alongside Original Medicare or get coverage through a Medicare Advantage plan.
Standard Part D Costs and Caps
The maximum allowable annual deductible for Part D is $615 in 2026. CMS has finalized that this deductible limit will rise to $700 in 2027.
The national base beneficiary premium is $38.99 monthly in 2026 and increases to $41.33 in 2027. Actual monthly premiums vary depending on your insurer and medication list.
The Part D coverage gap, formerly called the donut hole, was permanently eliminated in 2025. Coverage now features only three stages: Deductible, Initial Coverage, and Catastrophic Coverage.
Total out-of-pocket spending on covered drugs is capped at $2,100 in 2026. CMS has finalized an increased spending cap of $2,400 for 2027.
Once your qualifying drug purchases reach that annual cap, you enter the Catastrophic phase and pay $0 for covered medications for the rest of the calendar year.
A temporary federal premium stabilization demonstration program ends after 2026. Standalone drug plans may experience wider premium shifts heading into 2027 as a result.
Key Protections: Insulins, Vaccines, and New 2027 Programs
Federal law caps covered insulin products at $35 per month per prescription. Recommended adult vaccines, including shingles and RSV, cost $0 under Part D.
Starting in 2027, the Medicare GLP-1 Bridge Program gives qualifying Part D enrollees access to certain GLP-1 weight loss medications for a $50 monthly copayment.
This $50 GLP-1 copay does not count toward your Part D annual out-of-pocket spending cap.
For Original Medicare enrollees, the 2027 Medicare ACCESS Model will cover home support, virtual visits, wearable devices, and lifestyle coaching for chronic conditions at low or no cost.
