Good news: the old coverage gap is gone. Here is how Part D drug costs actually work in 2026.
The Medicare Part D coverage gap ("donut hole") was eliminated in 2025. You no longer hit a stretch where your drug costs suddenly spike. The benefit was simplified into three clear phases.
For 2026, your out-of-pocket spending on covered prescription drugs is capped at $2,100 for the year. Once you reach it, you pay nothing for covered medications for the rest of the year. This is the single biggest change for people with high drug costs.
(1) Deductible — you pay full cost until you meet your plan's deductible. (2) Initial coverage — you pay copays/coinsurance while the plan pays its share. (3) Catastrophic — once your out-of-pocket reaches $2,100, covered drugs are $0 for the rest of the year.
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New here? Start for $7.49 →No. The Part D coverage gap was eliminated in 2025. In 2026 there is a simpler three-phase benefit with a $2,100 out-of-pocket cap.
$2,100. Once your spending on covered drugs reaches it, you pay nothing for covered medications for the rest of the year.
No. The cap applies automatically to Part D and Medicare Advantage drug plans in 2026.
Figures on this page are verified against U.S. government primary sources: