Medicare Part D Drug Cost Calculator 2026
Calculate your out-of-pocket drug costs under the 2026 Part D benefit structure, including the Inflation Reduction Act $2,000 annual cap.
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2026 Part D Benefit Phases
| Phase | Drug Costs Range | What You Pay |
|---|---|---|
| Deductible | $0 – $590 | 100% of costs |
| Initial Coverage | $590 – $5,030 | 25% coinsurance |
| Coverage Gap | $5,030+ | 25% (IRA reform — manufacturer pays 75%) |
| Catastrophic | After $2,000 OOP | $0 (IRA $2,000 cap) |
Inflation Reduction Act Changes for 2026
The Inflation Reduction Act (IRA) made significant changes to Medicare Part D beginning in 2025:
- $2,000 Annual Out-of-Pocket Cap: Starting in 2025, Medicare Part D enrollees pay no more than $2,000 per year in out-of-pocket drug costs. This eliminates the old 5% catastrophic coinsurance that had no upper limit.
- Medicare Prescription Payment Plan: Enrollees can spread their out-of-pocket costs across monthly payments throughout the year, making high-cost medications more affordable.
- Insulin Cap: Insulin costs are capped at $35 per month for Medicare beneficiaries.
- Vaccine Coverage: All recommended vaccines are covered with $0 cost-sharing under Part D.
- Drug Price Negotiation: Medicare can now negotiate prices for select high-cost drugs. The first negotiated prices took effect in 2026.
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