What is the Medicare Part D premium for 2026?

The national base beneficiary premium for Medicare Part D in 2026 is $38.99/month, up from $36.78 in 2025. However, your actual plan premium varies — the average plan premium is about $34.50/month. Higher-income beneficiaries also pay Part D IRMAA surcharges ranging from $14.50 to $91.00/month on top of their plan premium.

What is the Medicare Part D out-of-pocket cap in 2026?

The Medicare Part D out-of-pocket cap in 2026 is $2,100. Once you spend $2,100 on covered prescription drugs (your cost-sharing — deductibles, copays, coinsurance), you enter catastrophic coverage and pay $0 for covered drugs for the rest of the year. This cap increased from $2,000 in 2025.

What is the Medicare Part D deductible in 2026?

The maximum Medicare Part D deductible in 2026 is $615. Plans can set their deductible at any amount up to this maximum. Some plans have no deductible. The deductible may not apply to all drugs — some plans waive it for preferred generics or Tier 1 drugs.

What is the Part D late enrollment penalty?

If you don't enroll in Part D when first eligible and go 63 or more days without creditable prescription drug coverage, you'll pay a late enrollment penalty. The penalty is 1% of the national base beneficiary premium ($38.99 in 2026) for each month you were without coverage. This penalty is added to your monthly premium permanently.

What is creditable drug coverage for Medicare Part D?

Creditable drug coverage is prescription insurance that is at least as good as the standard Medicare Part D benefit. It can include employer or union drug coverage, TRICARE, VA coverage, or other plans. If you have creditable coverage, you can delay Part D enrollment without penalty. Your employer or plan must notify you annually whether their coverage is creditable.

Do I have to pay Part D IRMAA?

Part D IRMAA surcharges apply if your 2024 income exceeded $109,000 (single) or $218,000 (married filing jointly). The surcharges range from $14.50 to $91.00/month added to your plan premium. Like Part B IRMAA, it's based on a 2-year lookback of your tax return. You can appeal if your income dropped due to a life-changing event.

Medicare Part D Costs 2026 — Premium, Deductible & $2,100 OOP Cap

Part D Standard Costs 2026

Medicare Part D provides prescription drug coverage through private plans. Your actual premium depends on the specific plan you choose — the figures below are national benchmarks set by CMS.

Cost Component	2025	2026	Change
Base Beneficiary Premium	$36.78/mo	$38.99/mo	+$2.21/mo
Average Plan Premium	~$32.00/mo	~$34.50/mo	+~$2.50/mo
Maximum Annual Deductible	$590	$615	+$25
Out-of-Pocket Cap	$2,000	$2,100	+$100

Actual premiums vary: Plan premiums range from $0 to $100+/month depending on your plan, county, and the drugs covered. Use Medicare's Plan Finder at medicare.gov/plan-compare to find plans in your area.

The New $2,100 Out-of-Pocket Cap — What It Means

The $2,100 out-of-pocket cap is the biggest beneficiary protection in recent Medicare history. Here's how it works in 2026:

1️⃣

Deductible Phase

You pay 100% of drug costs up to your plan's deductible (max $615). Some plans have $0 deductible for certain tiers.

2️⃣

Coverage Phase

After deductible, you pay copays or coinsurance. These counts toward your $2,100 OOP cap.

3️⃣

Catastrophic Phase

Once you reach $2,100 in OOP costs, you pay $0 for covered drugs for the rest of the calendar year.

Example: You take insulin and several expensive specialty drugs. By July, you've paid $2,100 in deductibles and copays. For the rest of the year (August–December), your covered Part D drugs cost you nothing. Without the cap, you would continue paying 5% of drug costs in the old catastrophic phase.

This cap was first introduced at $2,000 in 2025 under the Inflation Reduction Act, replacing the previous "catastrophic phase" where you still paid 5% of drug costs with no ceiling. Learn more about the $2,100 cap →

Part D IRMAA Surcharges 2026

Higher-income beneficiaries pay a monthly surcharge on top of their Part D plan premium. These are paid directly to Medicare (not the plan) and are based on your 2024 income.

Single Filers (and Married Filing Separately)

2024 MAGI (Single)	Part D IRMAA Surcharge	Total Monthly (plan + surcharge)
$109,000 or less	$0	Plan premium only
$109,001 – $137,000	+$14.50/mo	Plan premium + $14.50
$137,001 – $163,000	+$37.50/mo	Plan premium + $37.50
$163,001 – $183,000	+$60.40/mo	Plan premium + $60.40
$183,001 – $500,000	+$83.40/mo	Plan premium + $83.40
Over $500,000	+$91.00/mo	Plan premium + $91.00

Married Filing Jointly

2024 MAGI (Joint)	Part D IRMAA Surcharge
$218,000 or less	$0
$218,001 – $274,000	+$14.50/mo
$274,001 – $326,000	+$37.50/mo
$326,001 – $366,000	+$60.40/mo
$366,001 – $750,000	+$83.40/mo
Over $750,000	+$91.00/mo

Part D IRMAA uses the same income thresholds as Part B IRMAA. Both are based on your 2024 MAGI.

Part D Late Enrollment Penalty 2026

If you don't sign up for Part D when first eligible and go 63+ consecutive days without creditable drug coverage, you'll pay a permanent late enrollment penalty.

Penalty formula: 1% × $38.99 (2026 base premium) × number of full months without creditable coverage = monthly surcharge (rounded to nearest $0.10).

Months Without Coverage	Penalty (2026)	Extra Monthly Cost
12 months (1 year)	12%	+$4.68/mo
24 months (2 years)	24%	+$9.36/mo
36 months (3 years)	36%	+$14.04/mo
60 months (5 years)	60%	+$23.39/mo
120 months (10 years)	120%	+$46.79/mo

Important: The penalty recalculates each year based on the new base premium. So a 24% penalty on $38.99 in 2026 = $9.36/mo, but next year the base premium may change. The percentage stays constant, but the dollar amount adjusts annually. Calculate your penalty: Part D Penalty Calculator →

Extra Help (Low Income Subsidy)

Low-income beneficiaries may qualify for the Part D Extra Help program (also called LIS — Low Income Subsidy), which reduces or eliminates Part D costs.

Extra Help Level	Who Qualifies	Benefit
Full Extra Help	Income ≤135% FPL, limited assets	$0 premium, $0 deductible, minimal copays
Partial Extra Help	Income 136–150% FPL	Reduced premium and deductible, lower copays
No Extra Help	Income >150% FPL	Full Part D costs apply

Apply for Extra Help through Social Security at ssa.gov or by calling 1-800-772-1213.

Frequently Asked Questions

The national base beneficiary premium for Medicare Part D in 2026 is $38.99/month. This is used to calculate penalties and IRMAA surcharges. Your actual plan premium varies by plan — the average is about $34.50/month, but some plans have $0 premiums. Higher-income beneficiaries also pay Part D IRMAA surcharges from $14.50 to $91.00/month.

No. The Medicare Part D coverage gap (commonly called the "donut hole") was eliminated by the Inflation Reduction Act starting in 2025. In 2026, you pay your plan's copays or coinsurance throughout the year until you hit the $2,100 out-of-pocket cap, after which your plan pays 100%. There is no gap phase where you previously faced higher costs.

While you're not required to enroll in Part D, it's generally wise to do so even if you don't currently take medications. The risk: if you skip Part D and later need expensive medications, you'll face a late enrollment penalty. Many experts recommend enrolling in a low-cost Part D plan when first eligible to avoid the permanent penalty.

Yes. During the Annual Enrollment Period (October 15 – December 7), you can switch Part D plans. Coverage changes take effect January 1. You should review your plan every year because formularies, premiums, and covered drugs change annually. A plan that covered your drugs well in 2026 might not be the best choice in 2027.

Your own out-of-pocket spending counts — this includes your deductibles, copayments, and coinsurance paid to pharmacies for covered Part D drugs. Manufacturer discounts on brand-name drugs also count toward your cap. Your plan's premium does not count toward the $2,100 cap.

Your Part D late enrollment penalty is calculated as a percentage (1% per uncovered month) of the national base premium — and that base premium changes annually. So the dollar amount of your penalty fluctuates each year. In 2026, the base is $38.99, so a 24% penalty = $9.36/mo. If the 2027 base premium increases, your penalty dollar amount goes up too. Use our Part D Penalty Calculator to see your current penalty.

Part D Calculators

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Part D Cost Calculator

Estimate your annual drug costs

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Part D Penalty Calculator

Calculate your late enrollment penalty

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IRMAA Calculator

Check your Part D IRMAA surcharge

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Part D $2,100 Cap Guide

How the OOP cap works in detail

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: [email protected]

Medicare Part D Costs 2026