What is the Medicare Part D cap?

Beginning January 1, 2026, people with Part D plans through traditional Medicare and Medicare Advantage plans with prescription drug coverage won’t pay more than $2,100 over the calendar year in out-of-pocket costs for their prescription medications. All prescription medications, including specialty medications, covered by Part D plans are included under this cap.

It does not apply to costs for drugs that are not covered under a Part D plan, nor does it cover drugs covered under Medicare Part B, such as injectables and infused drugs. It also does not apply to your monthly Part D plan premiums.

The cap applies to all Medicare beneficiaries with Part D prescription drug coverage, regardless of income level.

The cap is adjusted each year. For 2027, it rises to $2,400.