Medicare Part D
Updated September 2026 · 2026 figures from CMS and Medicare.gov
Medicare Part D is prescription drug coverage, sold by private insurers. In 2026 the deductible can't be more than $615, and once you've paid $2,100 out of pocket for covered drugs, you pay nothing more for them for the rest of the year.
How to get Part D
- A standalone Part D plan alongside Original Medicare (and a Medigap policy, if you have one).
- A Medicare Advantage plan with drug coverage (MA-PD).
Part D costs in 2026
| Stage | What you pay |
|---|---|
| Deductible | Up to $615 (many plans have lower or no deductible) |
| Initial coverage | Copays or coinsurance set by your plan (standard coinsurance: 25%) |
| Catastrophic coverage | $0 for covered drugs once your out-of-pocket spending reaches $2,100 |
The old "donut hole" coverage gap no longer exists. Premiums vary by plan and area; people with higher incomes also pay a Part D IRMAA (see the IRMAA brackets). Covered insulin costs no more than $35 a month, and recommended adult vaccines are free.
Spreading drug costs over the year
The Medicare Prescription Payment Plan lets you pay your out-of-pocket drug costs in monthly installments across the year instead of all at once at the pharmacy. Ask your plan to sign you up; it doesn't lower the total, but it smooths it.
Part D late enrollment penalty
If you go 63 days or more in a row without Part D or other creditable drug coverage after your Initial Enrollment Period, you'll pay a penalty for as long as you have Part D. It equals 1% of the national base beneficiary premium for each full month you went without coverage, rounded to the nearest $0.10, and it's recalculated every year. Employer, union, VA and TRICARE drug coverage usually counts as creditable — your plan must tell you each year.
Extra Help
People with limited income and resources can get Extra Help (the Low-Income Subsidy), which lowers or removes Part D premiums and deductibles and reduces copays. You qualify automatically if you have Medicaid, SSI or a Medicare Savings Program; otherwise apply through Social Security.
Choosing a Part D plan
- List every drug you take, with dose and frequency.
- Use the plan finder on Medicare.gov to compare total yearly cost (premium plus copays), not just the premium.
- Check each plan's formulary (drug list), tiers and preferred pharmacies.
- Re-check every year during Open Enrollment (October 15 – December 7): plans change formularies and prices every January.
Frequently asked questions
What is the Part D out-of-pocket maximum for 2026?
$2,100 for covered drugs. After that you pay nothing for covered drugs for the rest of 2026.
What is the maximum Part D deductible for 2026?
$615.
Is there still a Part D donut hole?
No. The coverage gap was eliminated when the out-of-pocket cap began in 2025.
How is the Part D late penalty calculated?
1% of the national base beneficiary premium for each full month without creditable drug coverage, added to your premium for as long as you have Part D.