2026 PDP-Planner: Medicare Part D Out-of-Pocket Cost Calculator
Enter what your prescriptions cost and see, month by month, which phase of 2026 coverage you are in, what you pay, and what your plan, the drug manufacturer and Medicare pay — up to the $2,100 yearly cap on your out-of-pocket drug costs.
Try an example, or enter your own costs below
- Example 1: $800 a month, all brand-nameOut-of-pocket costs when you only have monthly prescription costs.
- Example 2: $2,400 every quarter, all brand-nameThe same yearly retail cost bought quarterly: the total does not change, but the month you reach catastrophic coverage can.
- Example 3: a combination of costs$100 monthly, $400 quarterly, $1,200 twice a year and $875 once — how to enter costs that are not the same every month.
- Reaching the $2,100 cap: $546.25 a monthCMS's $6,555 of yearly retail drug costs at the out-of-pocket threshold, bought evenly over the year.
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This is an estimate
- It follows the 2026 CMS defined standard Part D benefit: a $615 deductible, then 25% coinsurance until what you have paid reaches $2,100, then $0 for the rest of the year. On that benefit, about $6,555 of retail drug costs takes you to the cap.
- Real plans differ. Most charge flat copays by drug tier instead of 25%, many have a lower or $0 deductible or leave cheap generics out of it, and covered insulin and recommended vaccines are outside the deductible altogether. Copays can move the month you reach the cap.
- It assumes every drug is on your plan's formulary and bought at an in-network pharmacy. Drugs your plan does not cover do not count toward the cap.
- For your own plan's numbers, look a drug up in the drug finder or compare deductibles and tier costs in the 2026 Part D plan lists and 2026 Medicare Advantage plans.
- The 2026 parameters come from CMS's 2026 Part D standard benefit parameters.