Medicare Part D Calculator 2027: $2,400 Out-of-Pocket Cap

How to use this calculator

Choose the year and your plan’s deductible. Many plans use the standard amount; some charge less or none.
Enter the monthly full price of your drugs, before insurance. In Medicare Plan Finder, it’s the total drug cost for each prescription.
Add your insulin prescriptions separately, because insulin has its own $35 limit.
Pick a month for the payment plan to see your costs spread into monthly bills.

Calcvera’s Part D calculator uses Medicare’s standard drug benefit for 2027 and 2026, and nothing you enter leaves your browser. Your plan’s copays may differ, so compare your own plans in Plan Finder before you choose.

Medicare Part D costs for 2027

Standard Part D benefit	2026	2027
Deductible (most a plan can charge)	$615	$700
Your share after the deductible	25%	25%
Out-of-pocket cap	$2,100	$2,400
After you reach the cap	$0	$0
Covered insulin, per product per month	$35	$35
Recommended adult vaccines	$0	$0
Yearly full drug price that reaches the cap (standard deductible)	$6,555	$7,500

The deductible and the cap rise each year with Part D spending. CMS set the 2027 amounts in its 2027 rate announcement.

How the $2,400 out-of-pocket cap works

A year of Part D coverage has three stages:

Deductible: you pay the full price of covered drugs until you’ve paid up to $700.
Initial coverage: you pay 25% of the price (or your plan’s copays) and the plan pays the rest.
Catastrophic coverage: once your own payments reach $2,400, you pay $0 for covered drugs until December 31.

Under the standard benefit, you reach the cap once your drugs’ full price for the year is about $7,500: the $700 deductible plus 25% of the next $6,800. Learn the term in our glossary.

Worked example

Drugs with a full price of $1,000 a month, standard plan, 2027. In January you pay the $700 deductible plus 25% of the remaining $300: $775. From February you pay 25% of $1,000, or $250 a month. By the end of July you’ve paid $2,275, so in August you pay only $125 and reach the cap. From then on, covered drugs cost $0. Total for the year: $2,400.

With the payment plan from January, you pay nothing at the pharmacy. Instead your plan bills you $200 in January ($2,400 ÷ 12), $75 in February and $100 in March, rising to about $261 a month by the end of the year. The total is the same $2,400, but no month is higher than $261.

Part D costs at different drug prices

2027, standard benefit with the $700 deductible, no insulin:

Monthly full price	Your cost for the year	Reach the cap in	January at the pharmacy	Biggest bill with the payment plan
$100	$825	Not reached	$100	$131
$200	$1,125	Not reached	$200	$200
$300	$1,425	Not reached	$300	$264
$500	$2,025	Not reached	$500	$418
$750	$2,400	October	$713	$332
$1,000	$2,400	August	$775	$261
$1,500	$2,400	May	$900	$224
$2,000	$2,400	April	$1,025	$212

The payment plan lowers the biggest monthly payment only when costs are high early in the year. With low drug costs, it can do the opposite: at $100 a month, the largest bill would be $131 instead of $100.

The Medicare Prescription Payment Plan

The Medicare Prescription Payment Plan lets you pay your Part D drug costs in monthly bills from your plan instead of all at once at the pharmacy. It’s free to join, with no interest or fees, and every Part D and Medicare Advantage drug plan must offer it.

First month: the bill is the smaller of your costs that month and ($2,400 − what you’ve already paid this year) ÷ the months left, counting the current month.
Later months: any costs not billed yet, plus new costs, divided by the months left in the year.
Who it helps: people who would hit the deductible and much of the cap in the first few months, especially with expensive drugs.
How to join: contact your plan, before or during the year. It doesn’t change your total costs, and you can leave it.

The rules are in 42 CFR 423.137. If you get Extra Help with drug costs, your copays are already low and the payment plan usually doesn’t help.

What counts toward the cap

Counts: the deductible and your coinsurance or copays for drugs your plan covers, including insulin, and amounts paid for you by Extra Help or a family member.
Doesn’t count: premiums, the IRMAA surcharge, a late enrollment penalty, drugs your plan doesn’t cover, and drugs you buy outside your plan, for example with a discount card.

Premiums aren’t capped

You keep paying your Part D premium all year, even after you reach the cap. Higher earners also pay an extra Part D amount, which the IRMAA calculator estimates, and joining late can add a permanent penalty: see the Medicare late enrollment penalty calculator. Premiums vary by plan, so compare them alongside drug costs during open enrollment, from October 15 to December 7. Our Medicare open enrollment checklist walks through it.

Formulas used

Each month: insulin = $35 × prescriptions Then: deductible = full price, until the deductible is met Then: 25% × full price Stop when your year-to-date costs reach the cap (then $0) Payment plan, first month = min(costs this month, (cap − costs before joining) ÷ months left) Payment plan, later months = (unbilled costs + new costs) ÷ months left

The calculator assumes the same drugs every month and the standard benefit. Plans can use copays and drug tiers instead of 25% coinsurance, may not cover every drug, and set their own premiums, so your plan’s costs can differ. It doesn’t model Extra Help copays or a deductible that applies only to some drug tiers.

Frequently asked questions

What is the Medicare Part D out-of-pocket maximum for 2027?

$2,400, up from $2,100 in 2026. Once your own costs for covered drugs reach $2,400, you pay nothing more for covered Part D drugs for the rest of 2027. Premiums don’t count toward it.

What is the Part D deductible for 2027?

Up to $700, up from $615 in 2026. Plans can set a lower deductible or none, and some don’t apply it to cheaper generic drugs. Insulin and recommended vaccines are never subject to it.

Do Part D premiums count toward the $2,400 cap?

No. Only what you pay for covered drugs counts: the deductible and your coinsurance or copays. Your monthly premium, any IRMAA surcharge and a late enrollment penalty keep being charged after you reach the cap.

What happens when I reach the out-of-pocket cap?

You pay $0 for drugs your plan covers for the rest of the calendar year. The count starts again on January 1.

How does the Medicare Prescription Payment Plan work?

Instead of paying at the pharmacy, you get a monthly bill from your plan that spreads your drug costs over the rest of the year. It has no interest or fees and doesn’t lower your total costs. It helps most if you have high costs early in the year. You can sign up with your plan at any time during the year.

Is insulin still $35 a month in 2027?

Yes. Each covered insulin product costs no more than $35 for a month’s supply, with no deductible, and those payments count toward the cap.

Does the cap apply to Medicare Advantage plans with drug coverage?

Yes. The out-of-pocket cap applies to Part D drug coverage whether it comes from a stand-alone drug plan or a Medicare Advantage plan that includes drug coverage.

Sources

Announcement of CY 2027 Medicare Advantage capitation rates and Part C and Part D payment policies (Part D parameters) — Centers for Medicare & Medicaid Services
42 CFR 423.137: Medicare Prescription Payment Plan — eCFR (National Archives)
Medicare Prescription Payment Plan — Centers for Medicare & Medicaid Services
What’s the Medicare Prescription Payment Plan? (fact sheet) — Medicare.gov
Costs for Medicare drug coverage — Medicare.gov
Medicare Plan Finder — Medicare.gov

Key terms

About this calculator. Calcvera’s Medicare Part D Calculator 2027 is written and maintained by Hassan Arslan and was last reviewed on October 22, 2026. Rules and figures are checked against “Announcement of CY 2027 Medicare Advantage capitation rates and Part C and Part D payment policies (Part D parameters)”, “42 CFR 423.137: Medicare Prescription Payment Plan” and the other sources listed above. Results are estimates for education — not financial, tax or legal advice. Found an error? Tell us and we'll fix it. See our methodology and editorial policy.

Medicare Part D Calculator 2027

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