For 2027, the Part D out of pocket limit (TrOOP) threshold is $2,400. Increased from $2,100 in 2026. TrOOP is the amount CMS uses to determine when you enter catastrophic coverage.
Once you reach the catastrophic level there are no out of pocket costs for the rest of the calendar year.
For 2027 the maximum deductible your Part D can apply is $700 (it may be lower in your plan)
What counts toward the $2,400 toward TrOOP?
Your deductible
✅ Yes
Your copays
✅ Yes
Your coinsurance
✅ Yes
Payments you make for covered Part D drugs
✅ Yes
Certain payments made on your behalf by charities
✅ Yes
Qualified State Pharmacy Assistance Program payments
✅ Yes
Certain supplemental benefits that pay for covered Part D drugs
✅ Yes
Part D plan’s payments
❌ No
Medicare payments
❌ No
Manufacturer discounts under the Medicare Manufacturer Discount Program
❌ No
Part D premiums
❌ No
Drugs not covered by your Part D plan
❌ No
Most manufacturer patient-assistance programs
❌ No
CMS specifically says that since 2025, certain supplemental-benefit payments can count toward TrOOP, while Manufacturer Discount Program payments do not. They did apply before 2025
