{
  "title": "Medicare Part D 2026: Deductible, Out-of-Pocket Cap, Premium and Payment Plan",
  "canonical": "https://quantcalc.app/medicare-part-d-2026/",
  "status": "OFFICIAL",
  "license": "CC-BY-4.0",
  "date_modified": "2026-10-11",
  "sources": [
    {
      "label": "CMS, CY 2026 Rate Announcement (7 April 2025), Table V-2 Part D benefit parameters",
      "url": "https://www.cms.gov/files/document/2026-announcement.pdf"
    },
    {
      "label": "CMS, Final CY 2026 Part D Redesign Program Instructions",
      "url": "https://www.cms.gov/files/document/final-cy-2026-part-d-redesign-program-instruction.pdf"
    },
    {
      "label": "CMS, CY 2027 Rate Announcement (6 April 2026), Part D benefit parameters table",
      "url": "https://www.cms.gov/files/document/2027-announcement.pdf",
      "verified": "pdftotext of 2027-announcement.pdf, benefit-parameter table: 'Deductible $615 $700' and 'Out-of-Pocket Threshold $2,100 $2,400' (CY 2026 and CY 2027 columns)."
    },
    {
      "label": "CMS, Annual Release of Part D National Average Bid Amount (28 July 2025)",
      "url": "https://www.cms.gov/files/document/july-28-2025-parts-c-d-announcement.pdf"
    },
    {
      "label": "CMS, Medicare Part D 2027 National Average Monthly Bid Amount Information (28 July 2026)",
      "url": "https://www.cms.gov/newsroom/fact-sheets/medicare-part-d-2027-national-average-monthly-bid-amount-information",
      "verified": "Text read 2026-09-24: 'In 2027, the NAMBA will be $296.05' and 'For 2027, the base beneficiary premium will be $41.33'."
    },
    {
      "label": "42 CFR §423.137 (Medicare Prescription Payment Plan)",
      "url": "https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-B/part-423/subpart-C/section-423.137"
    },
    {
      "label": "Medicare.gov, What's the Medicare Prescription Payment Plan?",
      "url": "https://www.medicare.gov/prescription-payment-plan"
    },
    {
      "label": "Medicare.gov, Insulin coverage",
      "url": "https://www.medicare.gov/coverage/insulin"
    },
    {
      "label": "Medicare.gov, Medicare costs (what you pay in 2026)",
      "url": "https://www.medicare.gov/basics/costs/medicare-costs"
    },
    {
      "label": "CMS, 2026 Medicare Parts A & B Premiums and Deductibles (14 November 2025)",
      "url": "https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles"
    }
  ],
  "figures": {
    "deductible": {
      "2025": 590,
      "2026": 615,
      "2027": 700
    },
    "out_of_pocket_cap": {
      "2025": 2000,
      "2026": 2100,
      "2027": 2400
    },
    "coinsurance_after_deductible_pct": 25,
    "base_beneficiary_premium": {
      "2026": 38.99,
      "2027": 41.33
    },
    "insulin_max_per_month": 35,
    "gross_drug_cost_to_reach_cap_standard_design_2026": 6555,
    "payment_plan_first_month_max_from_january_2026": 175,
    "part_d_irmaa_2026": [
      {
        "single_over": 109000,
        "joint_over": 218000,
        "monthly": 14.5
      },
      {
        "single_over": 137000,
        "joint_over": 274000,
        "monthly": 37.5
      },
      {
        "single_over": 171000,
        "joint_over": 342000,
        "monthly": 60.4
      },
      {
        "single_over": 205000,
        "joint_over": 410000,
        "monthly": 83.3
      },
      {
        "single_over": 500000,
        "joint_over": 750000,
        "monthly": 91
      }
    ]
  }
}