New in 2026: $2,100 Out-of-Pocket Cap. Once you've spent $2,100 on covered Part D drugs (what you pay, not the plan), your cost drops to $0 for the rest of the year. This is a major benefit under the Inflation Reduction Act. Learn more →
Part D Cost Calculator — 2026
Estimated Drug Total
$600.00
per year
Part D IRMAA Surcharge
$0.00
per month
Plan Premium
$39.00/mo
Part D IRMAA Surcharge
$0.00/mo
Total Premium Cost
$468.00/yr
Estimated Drug OOP Costs
$600.00/yr
Estimated Total Part D Cost
$1,068.00/yr
Progress toward $2,100 OOP Cap
29%
$0
$600 of $2,100 cap
$2,100 cap
2026 Part D IRMAA Surcharges
| 2024 Income (Single) | 2024 Income (MFJ) | Monthly Surcharge | Annual Added Cost |
|---|---|---|---|
| ≤ $109,000 | ≤ $218,000 | $0.00 | $0.00 |
| $109,001–$137,000 | $218,001–$274,000 | +$14.50 | +$174.00 |
| $137,001–$163,000 | $274,001–$326,000 | +$37.50 | +$450.00 |
| $163,001–$183,000 | $326,001–$366,000 | +$60.40 | +$724.80 |
| $183,001–$500,000 | $366,001–$750,000 | +$83.40 | +$1,000.80 |
| > $500,000 | > $750,000 | +$91.00 | +$1,092.00 |
Medicare Part D FAQs — 2026
Starting in 2026, the Medicare Part D catastrophic coverage redesign caps your annual out-of-pocket drug costs at $2,100. This amount counts what you personally pay in deductibles, copayments, and coinsurance for covered drugs throughout the year. Once you hit the $2,100 threshold, you pay $0 for covered Part D drugs for the remainder of the calendar year. Plan premiums do not count toward the cap, and the cap resets each January 1. This is a major improvement from the pre-2024 structure when beneficiaries faced significant costs in the "donut hole" coverage gap.
Most Medicare Advantage plans already include drug coverage (called MA-PD plans). If you enroll in one of these, you cannot also enroll in a standalone Part D plan. If your MA plan does not include drug coverage (MA-only), you can add a Part D plan. If you enroll in a standalone Part D plan while in an MA-PD plan, you may be disenrolled from your MA plan. Always check what drug coverage your MA plan includes before purchasing a separate Part D policy.
Creditable drug coverage is prescription drug coverage that is expected to pay, on average, at least as much as standard Medicare Part D coverage. Examples include employer-sponsored drug coverage, TRICARE, VA benefits, and some union plans. Your employer must notify you annually whether your coverage is creditable. Having creditable coverage allows you to delay Part D enrollment without incurring the late enrollment penalty.
You can change or enroll in a Part D plan during: (1) the Annual Enrollment Period (October 15 – December 7), with coverage starting January 1; (2) a Special Enrollment Period due to qualifying life events; or (3) the Medicare Advantage Open Enrollment Period (January 1 – March 31) if you're switching from MA to Original Medicare. Plan formularies (covered drug lists) and premiums change annually — always review your plan during open enrollment.
Yes. The Extra Help program (also called Low Income Subsidy or LIS) significantly reduces Part D costs for eligible beneficiaries, including reducing or eliminating premiums, deductibles, and copayments. In 2026, beneficiaries with incomes up to about 150% FPL may qualify. If you qualify, you also automatically get Extra Help if you receive Medicaid, Medicare Savings Program benefits, or SSI. Apply through the Social Security Administration or your state Medicaid office. Use our Savings Program Calculator to check eligibility.
Disclaimer: MedicareBudget provides Medicare cost calculators and educational information for informational purposes only. This is not medical advice, legal advice, or a substitute for licensed professional guidance. Medicare premiums, deductibles, and program details change annually — always verify current figures at Medicare.gov or call 1-800-MEDICARE (1-800-633-4227). Contact: contact@medicarebudget.net