Medicare Part D Explained: 2027 Drug Coverage in Colorado

Medicare Part D is prescription drug coverage sold by private companies, either as a standalone plan alongside Original Medicare or built into a Medicare Advantage plan. For 2027, CMS has set the maximum standard deductible at $700 and the yearly out-of-pocket cap at $2,400, up from $615 and $2,100 in 2026 (CMS CY2027 Rate Announcement). Once you reach the cap, you pay nothing more for covered drugs that year. Colorado has 8 standalone Part D plans for 2027 in the CMS Landscape file, with premiums from $5.30 to $260.20 a month, and each covers drugs differently, so the plan that fits depends on exactly what you take and where you fill it.

How a year of Part D works

• Deductible: if your plan has one, you pay the plan price for covered drugs until you meet it. For 2027 it can be no more than $700. Many plans charge less, and many keep low-cost generics outside the deductible.
• Initial coverage: you pay copays or coinsurance set by the drug's tier, and the plan pays the rest. Under the standard benefit CMS defines, that share is 25 percent of the drug's cost.
• Catastrophic coverage: once your out-of-pocket spending reaches $2,400 in 2027 ($2,100 in 2026), you pay $0 for covered Part D drugs for the rest of the calendar year.
• The count starts over every January 1, so the deductible and the cap reset each year.

What counts toward the $2,400 cap

Your deductible, copays and coinsurance for covered Part D drugs all count. So do payments made for you by Extra Help, most State Pharmaceutical Assistance Programs and many drug manufacturer programs.

Your monthly premium does not count, and neither does anything you pay for a drug your plan does not cover, a drug bought outside the plan, or the $50 copay in the Medicare GLP-1 Bridge. A drug that is not on your plan's formulary can cost you the full price all year without moving you closer to the cap, which is why the drug list matters more than the premium.

A worked example: one brand drug and two generics in 2027

Here is an illustration using the 2027 standard benefit, not a quote. Say you take one brand-name drug that costs your plan $800 a month and two generics that cost $10 each, so $820 a month or $9,840 a year at plan prices. Real plans use their own copays and tiers, so your path will differ, but the cap works the same way in every plan.

A second example: three low-cost generics

Now take someone with three generics that cost a plan $12 a month together, $144 a year. This person will never get near the cap. In a plan whose $700 deductible applies to every drug, they pay the full $144; in a plan that keeps generics outside the deductible, they may pay only small copays. Add the premium and the gap between plans is mostly premium: about $231.60 for the year in Wellcare Classic if generics are covered at plan price, against more than $3,200 in the highest-premium plan.

The lesson from both examples: for light users the premium and the deductible matter most, and for heavy users the formulary and the cap matter most. That is why we price your actual drugs at your actual pharmacy for all twelve months.

Formularies, tiers and coverage rules

Each plan has its own formulary, the list of drugs it covers, sorted into tiers. Lower tiers (usually generics) cost less; higher tiers (brand-name and specialty drugs) cost more. Two plans can put the same drug on very different tiers.

Watch for coverage rules: prior authorization (the plan must approve the drug first), step therapy (you try a lower-cost drug first) and quantity limits. If your doctor believes you need a drug the plan restricts, you can ask the plan for an exception, and your doctor can send a supporting statement.

Pharmacies matter too. Many plans have preferred pharmacies with lower copays, and the same plan can cost different amounts at two pharmacies in Brighton. Mail order can lower the price of drugs you take every day.

The Medicare Prescription Payment Plan

Every Part D plan, standalone or inside Medicare Advantage, must offer the Medicare Prescription Payment Plan. Instead of paying your drug costs at the pharmacy counter, you pay $0 there and get a monthly bill from your plan that spreads the cost across the rest of the year. It does not lower what you owe in total, and it has no interest or fees.

If you opt in for January and your costs reach the 2027 cap, the most you would owe in any month is about $200, which is $2,400 spread over twelve months. If you join later in the year, the remaining costs are spread over fewer months. It helps most when one expensive fill early in the year would otherwise land in a single month.

Under the CMS final rule for 2026, if you are in the payment plan and stay in the same Part D plan the next year, your participation renews automatically unless you opt out. If you switch plans for 2027, your participation ends on December 31 and you opt in again with the new plan. Call the plan to join or leave.

Other protections built into Part D

• Covered insulin costs no more than $35 for a month's supply, and the deductible does not apply.
• Vaccines recommended by the CDC's advisory committee, such as shingles, cost $0 under Part D.
• Many plans offer a Medication Therapy Management review at no extra cost if you take several drugs for chronic conditions.
• If you are new to a plan and take a drug it does not cover, the plan generally must give you a temporary transition supply while you and your doctor switch drugs or request an exception.

All 8 standalone Part D plans in Colorado for 2027

Standalone Part D plans are priced by region, and all of Colorado is one region (PDP region 27), so the same 8 plans are offered in Brighton, Greeley and Denver. These are the figures in the September 2026 release of the CMS CY2027 Landscape file. Plans are listed for information, not as a recommendation, and the cheapest premium is not always the cheapest year.

Drug coverage inside Medicare Advantage near Brighton

Most Medicare Advantage plans include drug coverage: 31 of the 36 standard plans in Adams County and 20 of the 25 in Weld County for 2027 (CMS CY2027 Landscape). Their drug deductibles range from $0 to $700. The same $700 deductible limit, $2,400 cap, $35 insulin limit and $0 recommended vaccines apply inside them.

If you have Original Medicare, with or without a supplement, you need a standalone Part D plan. If you choose a Medicare Advantage plan, you usually get drug coverage inside it and cannot add a separate Part D plan to most HMO and PPO plans. What differs is the formulary, the tiers and the pharmacy network, which are set plan by plan.

The late enrollment penalty

If you go 63 days or more in a row without Part D or other creditable drug coverage after your Initial Enrollment Period ends, a penalty is added to your premium for as long as you have Part D. It is 1 percent of the national base beneficiary premium for each full month you went without, rounded to the nearest 10 cents.

Two years without coverage means 24 percent. With the 2026 base premium of $38.99 that is about $9.40 a month. CMS set the 2027 base premium at $41.33 in its July 28, 2026 Part D announcement, so the same 24 months adds about $9.90 a month in 2027. The penalty is recalculated each year as the base premium changes.

Creditable coverage includes many employer and union plans, TRICARE and VA coverage. Keep the yearly creditable coverage notices from your employer, because Medicare may ask for proof later.

Higher income and Part D

Part D has an income-related surcharge, like Part B. In 2026 it starts above $109,000 of modified adjusted gross income for a single filer or $218,000 joint, and ranges from $14.50 to $91.00 a month on top of your plan premium, based on your 2024 tax return (CMS, 2026). It is paid to Medicare, not to your plan, and applies even inside a Medicare Advantage plan with drug coverage.

CMS announces the 2027 Part D IRMAA amounts in the fall, along with the 2027 Part B premium. If retirement lowered your income, form SSA-44 lets you ask Social Security for a new decision.

GLP-1 weight-loss drugs and the Medicare GLP-1 Bridge

Part D plans generally do not cover drugs used only for weight loss. Starting July 1, 2026, Medicare began a separate program, Medicare GLP-1 Bridge, that lets eligible people with Part D get certain GLP-1 medicines for $50 a month, with eligibility based on BMI and certain health conditions. That $50 does not count toward your Part D deductible or out-of-pocket cap. If you are considering one of these drugs, ask your doctor whether you qualify, and see our blog post on the program for details.

What to ask before you pick a plan

• Is every one of my drugs on the 2027 formulary, and on which tier?
• Do any of my drugs need prior authorization, step therapy or have a quantity limit?
• Is my pharmacy in network, and is it a preferred pharmacy?
• What is the deductible, and does it apply to my generics?
• What will twelve months of premiums plus my drug costs add up to?
• If I am in the Medicare Prescription Payment Plan, will it renew, or do I need to opt in with a new plan?

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The bottom line

Part D is capped: in 2027 you will pay no more than $2,400 out of pocket for covered drugs, and the deductible can be no more than $700. Within those limits, Colorado's 8 standalone plans differ a lot, from $5.30 to $260.20 a month, and their formularies and pharmacies differ even more. Price your actual drugs at your actual pharmacy for the whole year, avoid gaps that trigger the penalty, and review every fall. Send us your drug list and we will run the comparison with you.