Original Medicare (Part A and Part B) on its own has no yearly limit on what you pay out of pocket. Medicare Advantage plans have a yearly limit; once you reach it, you pay nothing for covered services for the rest of the year. And in 2027, your out-of-pocket spending on covered Part D drugs is capped at $2,400.
The amounts
2026
2027
Yearly cap on what you pay for covered Part D drugs
$2,100Official
$2,400Official
What matters most
Original Medicare has no cap
With Original Medicare (Part A and Part B) alone, there's no yearly limit on what you pay out of pocket.
Medicare Advantage has a cap
Medicare Advantage plans have a yearly limit on what you pay for covered services. Once you reach it, you pay nothing more for covered services that year.
Drug costs are capped in 2027
In 2027, once your out-of-pocket spending on covered Part D drugs reaches $2,400, you won't have to pay for covered drugs the rest of the year.
Want the detail? How it works, a worked example and common mix-ups are in .
Words on this page
Out-of-pocket costs
the money you pay yourself, like deductibles, copayments, and coinsurance
Original Medicare
Part A and Part B, run directly by the federal government
Medicare Advantage
a Medicare-approved plan from a private company that bundles Part A and Part B (also called Part C)
Catastrophic coverage
the stage where you pay nothing for covered Part D drugs after you hit the yearly cap
Who can answer for your situation
1-800-MEDICARE (1-800-633-4227) can explain how a specific plan's yearly limit works.
If drug costs are hard to afford, this program can lower them further.
Two different kinds of limits
For doctor and hospital care, it depends on how you get your Medicare. With Original Medicare (Part A and Part B) alone, there's no yearly limit on what you pay out of pocket, unless you also have coverage like Medigap.
Medicare Advantage plans work differently. They have a yearly limit on what you pay for covered services, and after you reach it you pay nothing more for those services that year.
Prescription drugs (Part D) have their own separate yearly cap on what you pay out of pocket.
How the $2,400 drug cap works
Your out-of-pocket spending on covered Part D drugs adds up over the year. In 2027, once it reaches $2,400, you've hit the yearly cap.
After that, you won't have to pay out of pocket for your covered Part D drugs for the rest of the calendar year — a stage called catastrophic coverage.
An example
Say you take costly medicines in 2027. What you pay out of pocket for covered Part D drugs adds up. Once it reaches $2,400, you won't have to pay for those covered drugs again until the new year begins.
Common mix-ups
These are the pairs people most often mix up.
The drug cap vs. a cap on all costs
The $2,400 cap in 2027 is only for covered Part D drugs. It puts no limit on what you pay for doctor or hospital services under Original Medicare (Part A and Part B).
Original Medicare vs. Medicare Advantage
Original Medicare (Part A and Part B) has no yearly out-of-pocket limit; a Medicare Advantage plan does, and once you reach it you pay nothing for covered services for the rest of the year. A Medigap policy can also help cover costs under Original Medicare.
A deductible is what you pay before Medicare starts to pay. A copayment is a set dollar amount, like a flat fee. Coinsurance is a percentage of the cost, like 20%.
In 2026, most people pay $202.90 a month for Part B (medical insurance: doctor visits and outpatient care). You also pay a $283 yearly deductible, then usually 20% of the cost for each covered service.
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Can I trust this?
Checked by TapTap. Every fact on this page was checked against the official sources it quotes, on September 28, 2026.
Checking compares each fact with the official source it quotes. It isn’t medical or legal advice.
1 What the source says · Out-of-pocket costs (Original Medicare)
There's no yearly limit on what you pay out-of-pocket, unless you have supplemental coverage (like Medicare Supplement Insurance (Medigap)
Checked September 27, 2026
2 What the source says · Out-of-pocket costs (Medicare Advantage)
Plans have a yearly limit on what you pay for covered Medicare services (which may include different limits for in-network and out-of-network services). Once you reach your plan's limit, you'll pay nothing for covered services for the rest of the year.
General education, not individualized advice. For your own situation, you can call 1-800-MEDICARE or your State Health Insurance Assistance Program (SHIP).
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