Medicare Part D Is Not Going Away

What the Changes Actually Mean for You

By Better Family Legacy Insurance | Serving seniors and families across Georgia, Texas, Maryland, Washington D.C., Louisiana, and beyond

A close friend and I were out walking recently, just enjoying each other's company, when she stopped and asked me something that caught me off guard.

"I heard Medicare Part D is ending at the end of the year," she said. "Is that true?"

I honestly wish I knew exactly what she had seen or heard to bring her to that conclusion. My best guess is that it had something to do with all the news and political conversation around Medicare changes. But I am not going to go down that road here. What I can do is give you the facts.

I want to be very clear: Part D is not going away.

What my friend had likely heard was news about changes to Part D — and there have been some big ones. But big changes and elimination are two very different things. Part D is actually getting better for most beneficiaries, not worse.

If you or someone you love has heard something similar and is worried, this article is for you. Let me explain what is actually happening in plain language.

First, What Is Medicare Part D?

Medicare Part D is prescription drug coverage. It is the part of Medicare that helps pay for your medications at the pharmacy.

You get Part D either through a stand-alone drug plan added to Original Medicare, or through a Medicare Advantage plan that already includes drug coverage. Either way, Part D is what stands between you and paying full price for your prescriptions.

Part D has been part of Medicare since 2006. It is not going anywhere.

So What Has Changed?

The Inflation Reduction Act, a law passed by Congress in 2022, made the biggest changes to Part D since it started. These changes have been rolling out one step at a time. Here is what has already happened and what it means for you.

The donut hole is gone.

For years, Medicare Part D had a coverage gap in the middle called the donut hole. Once you and your plan spent a certain amount on drugs, you fell into that gap and had to pay more out of pocket until you hit a higher spending level. It confused everyone and cost people real money.

As of January 1, 2025, the donut hole is permanently gone. You no longer fall into a coverage gap. Your coverage works more simply now.

There is now a cap on what you pay.

Before 2025, there was no limit on how much you could pay out of pocket for prescription drugs under Part D. Some people with expensive medications were spending thousands of dollars a year with no end in sight.

That changed. Here is how the cap has grown:

• 2025 — $2,000 cap (the first ever out-of-pocket cap for Part D)

• 2026 — $2,100 cap (adjusted upward to keep pace with drug cost increases)

• 2027 — $2,400 cap (projected by CMS — official confirmation expected in fall 2026)

This is good news. For anyone taking expensive medications, this cap means there is finally a ceiling on what you will spend. Once you hit that number, your covered drugs cost you nothing for the rest of the year.

Some drug prices went down.

The Inflation Reduction Act also allowed Medicare to negotiate prices directly with drug companies for certain high-cost medications for the first time ever. The first round of negotiated prices took effect in 2026. If you take one of those drugs, your copay may be lower than it was before.

Insulin costs are capped.

Since 2023, Medicare beneficiaries pay no more than $35 a month for covered insulin. That cap is still in place.

You can spread out your drug costs.

A new option called the Medicare Prescription Payment Plan lets you spread your out-of-pocket drug costs across the whole year instead of paying a large amount all at once. You pay the same total but in smaller monthly amounts. This option is available by contacting your Part D plan.

What Does Part D Coverage Look Like Now?

It is simpler than it used to be. Here is how it works now:

• Deductible phase: You pay the first part of your drug costs up to your plan's deductible. The maximum deductible a plan can charge in 2026 is $615 (increasing for 2027). Some plans charge less or none at all.

• Coverage phase: Your plan will share with you the cost of covered drugs after you meet the deductible, until you hit the out-of-pocket cap.

• Cap reached: Once you have paid $2,100 out of pocket in 2026 (increasing for 2027), your covered drugs cost you nothing for the rest of the year.

No more donut hole in the middle. No more unlimited out-of-pocket spending. Just a cleaner, simpler structure with a real ceiling on your costs.

What Does Not Count Toward the Cap?

This is an important detail. Not everything you spend on medications counts toward the cap.

• Your monthly plan premium does not count

• Drugs not covered by your plan do not count

• Drugs covered under Part B instead of Part D do not count

• Costs paid by someone else on your behalf generally do not count

Only your actual out-of-pocket spending on covered Part D drugs counts toward the cap. That includes your deductible, your copays, and your coinsurance.

Why Do People Think Part D Is Going Away?

My friend is not the only one who has said something like this. When big changes happen to a program, people hear pieces of the story and fill in the rest themselves.

They may have heard that the donut hole is gone and assumed that meant the coverage was gone. They may have heard about plan changes and assumed that meant Part D itself was changing. They may have seen a headline and worried that their drug coverage was at risk.

None of that means Part D is going away. It means Part D is changing — and in most ways, changing for the better.

The best thing you can do when you hear something that worries you about Medicare is to check the source. Medicare.gov and CMS.gov are the official places to find out what is actually happening. Or ask someone who knows — like a licensed Medicare advisor who can walk you through what your specific plan actually covers.

What Should You Do Right Now?

Here are a few simple steps worth taking:

• Check your current Part D plan. Make sure the medications you take are still covered and that your plan still works for your situation. Plans change every year.

• Watch for your Annual Notice of Change. Your plan will mail this to you in September. It tells you exactly what is changing in your coverage for the coming year. Do not throw it away.

• Know your AEP dates. The Annual Enrollment Period runs October 15 through December 7. That is your window to make changes to your Medicare drug coverage for 2027 if needed.

• Ask questions. If and when you hear headlines or stories about Medicare, of course our first instinct is to believe that it's true. My motto is "Peace comes from knowing, not guessing, so ask someone who knows before you panic. A licensed Medicare advisor can help you separate fact from rumor.

• Check if your drugs are negotiated. If you take a high-cost medication, ask your pharmacist or advisor whether it is one of the newly negotiated drugs with lower prices in 2026.

A Note From Me

When my friend asked me on our walk whether Part D was ending, I was glad she asked. Not because I had every answer right there on the spot, but because I could help her find them.

That is what this blog is for. Medicare changes can feel scary when you only hear part of the story. But once you understand what is actually happening, it is usually a lot less frightening than the headline made it sound.

Part D is not going away. The donut hole is gone. There is now a cap on what you spend — and it is going up to a projected $2,400 in 2027. AEP opens October 15 — a good time to make sure your plan still works for you.

If you have questions about your Part D coverage or want help reviewing your plan before AEP, reach out. Send me a message at info@betterfamilylegacy.com or drop a comment below. I will help point you in the right direction.

Peace comes from knowing, not guessing.

This article is for general educational purposes only. Medicare rules, plan designs, and costs change annually. The 2027 out-of-pocket cap figure is a CMS projection and subject to official confirmation in fall 2026. Information was verified against official CMS and Medicare.gov sources on August 4, 2026. Contact Medicare at 1-800-633-4227 or visit Medicare.gov for the most current information about your specific coverage.

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