Yearly cap: $2,400. Once you’ve paid $2,400 out of pocket for covered drugs, you pay $0 for covered drugs the rest of the year. It was $2,100 in 2026.
Deductible: up to $700. Some plans have a lower deductible or none at all for certain drugs.
Your monthly premium doesn’t count toward the cap. Only what you pay at the pharmacy counts.
Insulin is capped at $35 a month for covered insulin.
You can spread out your costs. The Medicare Prescription Payment Plan lets you pay your drug costs in monthly amounts instead of all at once.
Every plan has its own drug list. Drugs are placed in price tiers. The same drug can cost very different amounts from one plan to the next.
Pharmacy choice matters. Many plans have preferred pharmacies with lower copays.
Lower prices on more drugs. Medicare negotiated prices on 15 more drugs starting in 2027, including Ozempic and Wegovy.
