How this tool works
This calculator estimates what you might pay in a year for Medicare Part D prescription drug coverage in 2027. It uses the standard benefit figures from the CMS 2027 Rate Announcement (April 6, 2026). Your own plan may be set up differently, so treat the result as a ballpark.
You enter two numbers:
- The estimated total yearly cost of your covered drugs (the full price, before any plan payment)
- Your plan's monthly premium
The tool then applies the 2027 standard benefit:
- Deductible: you pay the first $700 (or the full cost, if it is less).
- Coinsurance: after that, you pay 25% of the remaining cost.
- Cap: your out-of-pocket drug costs stop at $2,400 for the year. After that you pay $0 for covered Part D drugs.
As a formula: out-of-pocket = the smaller of $2,400 and [the smaller of cost and $700] + 25% × [cost − $700, if above zero].
It then adds 12 months of premiums. Premiums do not count toward the $2,400 cap. Finally, it shows your out-of-pocket amount divided by 12, as a rough monthly figure if you use the Medicare Prescription Payment Plan, which lets you spread drug costs over monthly payments.
A worked example
Your covered drugs cost $4,000 a year, and your premium is $45 a month.
- Deductible: $700
- Coinsurance: 25% × ($4,000 − $700) = 25% × $3,300 = $825
- Out-of-pocket: $700 + $825 = $1,525 (below the $2,400 cap)
- Premiums: 12 × $45 = $540
- Estimated yearly total: $1,525 + $540 = $2,065
- With the Payment Plan: $1,525 ÷ 12 = about $127.08 a month
| Yearly drug cost | Estimated out-of-pocket (before premiums) |
|---|---|
| $500 | $500 |
| $2,000 | $700 + $325 = $1,025 |
| $7,500 | $700 + $1,700 = $2,400 (cap reached) |
| $10,000 | $2,400 (capped) |
For more on 2027 changes, see our guide to Medicare Part D costs in 2027.
Limits of this tool
Many plans use a lower deductible or flat copays instead of 25% coinsurance, so your real costs may be lower or spread differently. Drugs not on your plan's list (formulary) do not count. Covered insulin is capped at $35 for a month's supply, so insulin costs may be lower than this estimate shows. The Payment Plan figure assumes you join at the start of the year; actual monthly bills can vary. The national base premium for 2027 is $41.33 a month, but actual plan premiums vary.
When to talk to your doctor
If drug costs are hard to manage, ask your doctor or pharmacist whether lower-cost options exist. Never skip doses or stop a medicine because of cost without talking to them first. You can compare plans during Open Enrollment, October 15 to December 7, or call Medicare at 1-800-633-4227. Our medication schedule planner can help you keep an up-to-date list to bring along.
Frequently asked questions
At what drug cost do I reach the $2,400 cap?
Under the standard benefit, at $7,500 in yearly drug costs: $700 deductible plus 25% of the next $6,800 ($1,700) equals $2,400.
Do my premiums count toward the cap?
No. Monthly premiums are paid separately and never count toward the $2,400 out-of-pocket limit.
What is the Medicare Prescription Payment Plan?
It is an option that lets you pay your out-of-pocket drug costs in monthly amounts during the year instead of all at the pharmacy. You opt in through your plan. It does not lower your total costs.
How do 2027 numbers compare with 2026?
The standard deductible maximum rises from $615 to $700, and the out-of-pocket cap rises from $2,100 to $2,400.
Sources
Want the full picture? Read our guide: Medicare Part D in 2027: the $700 Deductible, the $2,400 Cap and How Your Costs Work.
Read the guideThis tool gives general information for education only. It does not diagnose any condition or replace advice from your doctor, nurse or pharmacist. In an emergency call 911. See our medical disclaimer and sources.