5 Ways $2,100 Part D Cap Works

Medicare’s new rule caps annual out-of-pocket drug costs at $2,100, after that you pay $0.

• The confusing four-phase system disappears, eliminating the infamous “donut hole” and surprise mid-year cost spikes.

• The $2,100 cap applies only to Part D prescriptions, not injections or drugs covered under Part B.

• Monthly premiums, surcharges, and penalties don’t count, only pharmacy payments for covered medications count toward $2,100.

• Drugs not on your plan’s formulary bypass the cap, leaving some patients paying hundreds or thousands monthly.