Medicare Part D deductible 2026

The Medicare Part D deductible 2026 can be no more than $615.00, and many plans charge less or none. After the deductible, you pay 25 percent of covered drug costs until out-of-pocket spending reaches $2,100.00, then nothing more for covered drugs. The average base Part D premium is $38.99 a month.

Key facts
Part D deductible maximum	$615.00No plan may charge more than this for the deductible.
Out-of-pocket cap	$2,100.00After this, covered drugs cost nothing for the rest of the year.
Cost sharing in the middle	25 percent coinsuranceYou pay 25 percent of covered drug costs after the deductible.
Base beneficiary premium	$38.99 a monthThe national average; actual plan premiums vary.
Part B premium	$202.90 a monthPaid separately from the Part D premium.
Part D IRMAA	Up to 91 dollars a monthAdded for higher-income beneficiaries, billed separately.
Catastrophic coverage	0 dollars for covered drugsBegins once the out-of-pocket cap is reached.

What the Part D deductible is

The Part D deductible is the amount you pay for covered prescription drugs before your plan begins to share the cost. For 2026, no Medicare drug plan may charge a deductible higher than $615.00. Some plans charge less, and some charge no deductible at all. The deductible applies to the plan's covered drug list, so a drug that is not on the list does not count toward it.

The deductible resets each calendar year. A person who meets it in January does not owe it again until January of the next year. A person who joins a plan mid-year owes the deductible for the remainder of that year, and it resets with the new plan year.

Medicare Part D premium 2026

The Part D premium is what you pay each month for the drug plan. It varies by plan and by region, and it is separate from the Part B premium. The national base beneficiary premium, which is the figure Medicare uses for penalty and subsidy calculations, is $38.99 a month for 2026. A person's actual plan premium can be higher or lower than that.

About two-thirds of beneficiaries pay the premium directly to the plan, and the rest have it deducted from their Social Security benefit. A person with a higher income can owe an income-related surcharge on top of the plan premium, and that surcharge is billed separately from the plan premium in many cases. The surcharge runs from 0 dollars up to 91 dollars a month for 2026.

Medicare Part D cost 2026

The total cost of Part D for a person depends on four things: the plan premium, the deductible, the cost sharing on each prescription, and whether the out-of-pocket cap is reached. Cost sharing in the middle phase is 25 percent of the cost of covered drugs, both generic and brand-name, until out-of-pocket spending reaches $2,100.00. At that point, catastrophic coverage begins and covered drugs cost nothing for the rest of the year.

The cap counts the deductible, the coinsurance and copayments, and certain payments made on the person's behalf, such as through the Extra Help program. It does not count the monthly premium. A person who pays a high premium but uses few drugs can still spend less in total than a person with a low premium and heavy drug use, which is why the plan comparison should be based on the actual prescription list.

What counts toward the cap

Payments that count toward the $2,100.00 cap include the deductible, coinsurance, copayments for covered drugs, and certain payments made on the person's behalf. Payments that do not count include the monthly premium, drugs not on the plan's formulary, and drugs bought outside the plan's network or without using the plan's card. A person who fills a prescription at a non-preferred pharmacy or buys a drug the plan does not cover can spend money that does not move them closer to the cap.

The cap is per person and per calendar year. A married couple each has their own cap, and unused cap does not carry over. A person who reaches the cap in November pays nothing for covered drugs in December, and the counter resets in January.

How Extra Help changes the numbers

Extra Help, also called the Low-Income Subsidy, pays the Part D premium up to a benchmark amount, the deductible, and most of the cost sharing. A person who qualifies for Extra Help pays a small copayment per prescription instead of the 25 percent coinsurance, and pays nothing once the catastrophic threshold is reached. Income and resource limits apply, and a person who qualifies for a Medicare Savings Program or Supplemental Security Income qualifies automatically.

The limits and copayment amounts change each year. For 2026, the income limit is $23,940.00 for an individual and $32,460.00 for a married couple, with resource limits of $18,090.00 and $36,100.00. The copayments are a few dollars per prescription for people who qualify, and 0 dollars for people with full Medicaid in the Qualified Medicare Beneficiary program.

How to choose a Part D plan

A person choosing a Part D plan should compare three things: the premium, the deductible, and the cost sharing on the specific drugs the person takes. A plan with a low premium and a high deductible can cost more overall than a plan with a higher premium and no deductible, if the person takes expensive drugs early in the year. The plan finder on Medicare.gov compares the total annual cost for a given prescription list, which is more useful than comparing premiums alone.

The pharmacy network matters too. A plan can have a lower cost at a preferred pharmacy and a higher cost at a standard one. A person who has a regular pharmacy should check whether it is preferred before enrolling, and whether mail order is available for maintenance medications.

Worked example

Consider a person with a plan that has the full $615.00 deductible and a 25 percent coinsurance. In January, the person fills a prescription with a 400 dollars cost. The person pays the first $615.00 of that, which is the deductible, and 25 percent of the remaining 215 dollars, which is 53.75 dollars. The person's out-of-pocket spending for January is $615.00 plus 53.75 dollars.

By October, the person's out-of-pocket spending has reached $2,100.00. From that point, the person pays nothing more for covered drugs for the rest of the year. The plan and Medicare pay the rest. The monthly premium continued to be owed throughout the year, because the premium does not count toward the cap.

A second person has Extra Help and the same prescription. The deductible is paid by the program, and the person pays a small copayment per prescription instead of the 25 percent coinsurance. The person reaches the catastrophic threshold faster, because payments made on the person's behalf count toward the cap, and pays nothing for covered drugs for the rest of the year.

What the Part D deductible does not decide

The deductible is a plan feature within a federal maximum. A plan with no deductible usually charges a higher premium, so the total cost depends on how the plan is structured.
The cap applies to covered drugs only. Drugs not on the formulary, or bought outside the plan, do not count toward it.
The premium is separate from the cap. A person can reach the cap and still owe the monthly premium.
This page explains the standard figures. It does not recommend a specific plan, because the right plan depends on the person's prescriptions, pharmacy, and budget.

Frequently asked questions

What is the Medicare Part D deductible for {year}?

The maximum Part D deductible for 2026 is $615.00. Many plans charge less, and some charge no deductible at all.

What is the Part D out of pocket cap for {year}?

The Part D out-of-pocket cap for 2026 is $2,100.00. After you reach it, you pay nothing more for covered drugs for the rest of the year.

Does the Part D cap include premiums?

No. The monthly premium is not counted toward the out-of-pocket cap. The cap counts the deductible, coinsurance, copayments, and certain payments made on your behalf.

How much is the average Part D premium?

The national base beneficiary premium for 2026 is $38.99 a month. Actual plan premiums vary by plan and region, and higher-income beneficiaries can owe an additional surcharge.

What happens after I reach the Part D cap?

Catastrophic coverage begins. You pay nothing more for covered Part D drugs for the rest of the calendar year. The monthly premium is still owed.

How does Extra Help change Part D costs?

Extra Help pays the premium up to a benchmark amount, the deductible, and most of the cost sharing. A person who qualifies pays a small copayment per prescription instead of the 25 percent coinsurance.

Source table

Figure	Value used	Official source
Part D deductible maximum	$615.00	Medicare.gov Part D costs 2026Checked October 28, 2026
Part D out-of-pocket cap	$2,100.00	Medicare.gov Part D costs 2026Checked October 28, 2026
Base beneficiary premium	$38.99 a month	CMS 2026 Part D bid informationChecked October 28, 2026
Extra Help income and resource limits	$23,940.00 / $32,460.00 income	Medicare.gov Extra Help 2026Checked October 28, 2026

See the hand-worked examples in the verification log

Where to compare plans before you enroll

The figures are the standard Medicare amounts for 2026, checked against Medicare.gov and CMS on 2026-10-28. Plan premiums, deductibles, and formularies vary by region, so the comparison should be based on your own prescription list and pharmacy. Use Medicare's plan finder to compare the total annual cost of each plan, including the premium, deductible, and cost sharing on your specific drugs.

For the surrounding costs, use the Part D out-of-pocket cap guide for what counts toward the cap, the Part B late enrollment penalty calculator if drug coverage timing is in question, and the Medicare Savings Program and Extra Help calculator if income is limited.