How the $2,100 Cap Protects You in 2026
The Inflation Reduction Act caps your annual out-of-pocket Part D drug spending at $2,100 in 2026. Enter your expected drug costs to see your protection.
The most you'll pay in 2026
The cap applies to covered Part D drugs on your plan's formulary. Premiums don't count toward the cap. You can also spread costs into monthly payments via the Medicare Prescription Payment Plan. Insulin remains capped separately at $35/month per prescription.
What Counts Toward the Cap
- Counts: Deductible payments, copays, and coinsurance for covered formulary drugs
- Doesn't count: Your monthly plan premium, non-formulary drugs, and drugs covered under Part B (like infusions)
Important Disclaimer
CaliforniaMedicare.com is not connected with or endorsed by the United States government, the Centers for Medicare & Medicaid Services (CMS), or the federal Medicare program. This calculator provides estimates for educational purposes only, using figures published in the CMS 2026 Medicare Parts A & B Premiums and Deductibles fact sheet (November 14, 2025). Results are not an official determination of your premiums, penalties, or eligibility — only the Social Security Administration and CMS can make official determinations, which depend on your individual records. Verify your specific amounts at Medicare.gov or by calling 1-800-MEDICARE (1-800-633-4227; TTY 1-877-486-2048).
Frequently Asked Questions
What is the Part D out-of-pocket cap for 2026?
$2,100. Once your out-of-pocket spending on covered drugs reaches $2,100 in a calendar year, your plan pays 100% of covered drug costs for the rest of the year.
Do premiums count toward the $2,100 cap?
No. Only deductibles, copays, and coinsurance for covered formulary drugs count. Your monthly plan premium is separate.
Can I spread my drug costs into monthly payments?
Yes. The Medicare Prescription Payment Plan lets you spread out-of-pocket costs across the year in predictable monthly amounts instead of paying at the pharmacy counter.