Yes, the Medicare Part D deductible counts towards your annual out-of-pocket (OOP) maximum for prescription drugs. The out-of-pocket cap is $2,100 in 2026 and $2,400 in 2027, which includes all deductibles, copayments, and coinsurance paid for covered drugs, Humana and UPMC Health Plan.
Key details on Part D OOP limits:
- What Counts: The deductible, 25% cost-sharing (coinsurance/copays), and amounts paid during the initial coverage stage all apply to the annual cap ($2,100 in 2026, $2,400 in 2027).
- What Doesn't Count: Monthly plan premiums do not count towards the cap,
- Coverage Phases: After reaching the cap ($2,100 in 2026 or $2,400 in 2027, which includes the deductible of up to $615 in 2026 or $700 in 2027), you enter the catastrophic stage, where you pay $0 for covered drugs,
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Application: This cap applies to both standalone Part D plans and Medicare Advantage plans with prescription coverage, Humana and Boomer Benefits.
Only covered drugs in your plan's formulary count towards this limit; using out-of-network pharmacies or purchasing non-covered drugs will not help you reach the cap.
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