Medicare Part D Cost Calculator

Under the Inflation Reduction Act, starting in 2025 Medicare Part D beneficiaries pay a maximum $2,000 in out-of-pocket prescription costs per year - a dramatic improvement over the prior donut-hole structure. The cap continues in 2026 with inflation adjustment. Eligible beneficiaries can also opt into the Medicare Prescription Payment Plan (M3P) to spread the $2,000 across monthly payments.

Base premium varies by plan - typically $15-$90/month, with a national average benchmark around $36 in 2026. Plus the standard deductible (max $590 in 2026), then copays/coinsurance during the initial coverage phase until you hit the $2,000 OOP cap. Total annual cost: premium × 12 + up to $2,000 OOP = $2,180-$3,080 for most beneficiaries.

If you don't enroll when first eligible (during your 7-month Initial Enrollment Period around your 65th birthday) and lack creditable drug coverage elsewhere, you pay 1% of the national base premium × months uncovered, added to your premium permanently. Going 24 months without Part D adds ~$8.65/month for life. Creditable coverage (e.g., employer drug plan as good as Part D) prevents the penalty.

During the Medicare Annual Enrollment Period (October 15 - December 7) - changes take effect January 1. Also during the Medicare Advantage Open Enrollment Period (Jan 1 - Mar 31), and during Special Enrollment Periods for qualifying events. Switching plans is free; use Medicare's Plan Finder tool to compare costs based on YOUR drug list - premiums alone hide the real cost differences.