Medicare Part D Out-of-Pocket Maximum Calculator (2026 and 2027)

Scenario: You expect to spend $250 per month out of pocket on covered Part D drugs in 2026, and your plan has the statutory maximum deductible of $615.

Cap reached: You would hit the $2,100 out-of-pocket cap in September 2026. After that, you pay $0 for covered drugs for the rest of the year — October through December at $0.

What the cap saves: Without the $2,100 ceiling, the same spending pattern would total $3,000 over the year. The cap itself saves you $900.

Payment plan timing: The Medicare Prescription Payment Plan spreads your costs across the year instead of front-loading them. Your total remains $2,100 either way — the plan changes when you pay, not what you pay. Peak monthly payment drops from $250 to $175.

Critical clarification: This is a standard-benefit simulation using statutory 2026 parameters. The tool does not know your plan's negotiated drug prices or cost sharing, so no figure here is a pharmacy quote. The Medicare Prescription Payment Plan changes the timing of payments, not total drug costs.