2026 Part D Drug Cost Calculator for Colorado
Enter the full monthly price of your covered prescriptions and your plan’s deductible. This walks the year month by month: the deductible, then 25% of the cost, until your out-of-pocket spending reaches the $2,100 cap.
Estimates only. Estimates only. Figures on this page use published plan-year values and the details you enter. They are not a quote, an offer of coverage, or a determination of eligibility. Your final premium and any tax credit are confirmed at enrollment with the carrier or Connect for Health Colorado. Everything is calculated in your browser; nothing you type is sent to us or anyone else.
How a year of prescription costs is walked month by month
The calculator follows the 2026 Part D standard benefit in the CMS final CY 2026 Part D redesign instructions. It treats your prescriptions as twelve monthly fills and tracks three phases.
The math assumes a steady monthly cost. If your fills are uneven, such as a 90-day supply or a seasonal medicine, enter the yearly total divided by twelve; the annual figure stays close, though the exact cap month can shift.
- Deductible phase: you pay the full price of covered drugs until you have paid the deductible, up to $615, or less if your plan sets a lower one.
- Coinsurance phase: you then pay 25% of each fill and the plan pays the remainder.
- Catastrophic phase: once your own spending reaches $2,100, covered drugs cost nothing until December 31.
- Running total: each month your share is added up, stopped at the cap, and the month you reach it is recorded.
- Reset: everything starts over on January 1.
Each month: you pay 100% until your total reaches the deductibleAfter that: you pay 25% of the monthly drug costStop: when your total reaches $2,100 (2026 cap)Plan pays = yearly drug cost minus your share Worked example: two Brighton neighbors, two very different drug bills
Hypothetical people, not clients. Both are on the 2026 standard benefit with the full $615 deductible.
June takes a brand-name drug with a full price of $1,000 a month. In January she pays the $615 deductible plus 25% of the remaining $385, which is $96.25: $711.25. From February she pays $250 a month. Her total reaches $2,100 in July, and fills cost her nothing for the rest of the year. Her drugs cost $12,000; the plan pays $9,900.
Walt takes generics with a combined full price of $300 a month. He pays $300 in January and February, finishes the deductible in March and moves to 25%. His year totals $1,361.25, of which $746.25 is coinsurance, well short of the cap.
Had June’s plan charged no deductible, she would still pay $2,100, reaching the cap in September instead of July. For heavy users the deductible changes when you pay, not how much.
June could also spread her $2,100 through the Medicare Prescription Payment Plan, receiving monthly bills instead of a large January charge at the pharmacy. Her total for the year stays the same.
| Scenario | Your yearly share | Cap reached |
|---|---|---|
| June, $1,000 a month | $2,100 | July |
| June, $0 deductible plan | $2,100 | September |
| Walt, $300 a month | $1,361.25 | not reached |
Mistakes that distort a Part D cost estimate
- Entering a copay instead of the full price. The tool needs each drug’s full negotiated price, shown on your plan’s explanation of benefits or in Medicare Plan Finder.
- Counting drugs the plan does not cover. Only formulary drugs count toward $2,100. An uncovered drug never moves you closer to the cap.
- Assuming the cap includes premiums. It does not. A $50 monthly premium adds $600 a year on top.
- Choosing on premium alone. Heavy users can come out ahead on a higher-premium plan whose tiers and pharmacies suit their drugs. Compare yearly totals.
- Paying a large January bill all at once. The Medicare Prescription Payment Plan spreads out-of-pocket costs into monthly bills. Medicare.gov is clear that it does not lower total costs; it only changes timing.
- Ignoring the pharmacy network. Filling at an out-of-network pharmacy can cost more or, outside limited situations, not be covered at all.
What changes for Colorado drug coverage in 2027
This calculator uses the 2026 benefit. For 2027 the CMS landscape file lists a $2,400 out-of-pocket threshold, and Medicare.gov uses the same $2,400 point for Extra Help enrollees.
Colorado’s 8 stand-alone drug plans for 2027 list deductibles of $300, $350, $687, $700 and premiums from $5.30 to $260.20 a month. Across Adams County’s 2027 Medicare Advantage plans, the average drug deductible is about $401 (CMS 2027 landscape file).
With Extra Help in 2027, Medicare.gov lists prescriptions at up to $5.80 for each generic and $14.40 for each brand-name drug, with a $0 plan premium and deductible.
Colorado’s State Health Insurance Assistance Program (SHIP), run by the Colorado Division of Insurance, gives free, unbiased Medicare counseling at 888-696-7213.
Key terms: Part D drug cost calculator
- Deductible
- What you pay in full before the plan shares costs; at most $615 in 2026.
- Coinsurance
- A percentage of a drug’s price, 25% in the standard design.
- Copay
- A flat dollar charge per fill that many plans use for each tier instead of coinsurance.
- Formulary
- The plan’s list of covered medications, grouped into tiers.
- Out-of-pocket threshold
- Yearly spending after which covered drugs cost you nothing: $2,100 in 2026, $2,400 in 2027.
Bring this to a drug plan review
- Each prescription with its strength and how often you refill it.
- Your preferred pharmacy, and whether mail order suits you.
- A recent explanation of benefits showing full negotiated prices.
- Your current plan’s 2027 Annual Notice of Change.
What this assumes
- Uses the 2026 standard benefit from CMS: a $615 deductible, 25% coinsurance, and a $2,100 out-of-pocket cap.
- Assumes the same drug cost every month. Real plans use copays and tiers, so your plan’s own figures will differ.
- Only drugs on the plan’s formulary count toward the cap. Drugs a plan does not cover are not included.
- The CMS landscape file for 2027 plans lists a $2,400 out-of-pocket cap.
- Extra Help lowers drug costs further for people with limited income and savings.
- An estimate from published figures and the numbers you enter, not a quote or an eligibility decision.
Where the figures come from
- CMS Final CY 2026 Part D Redesign Program Instructions Centers for Medicare & Medicaid Services, 2026
- CMS CY2027 Medicare Advantage and Part D landscape file (Colorado rows) Centers for Medicare & Medicaid Services, 2027
- Medicare.gov: help with drug costs (Extra Help) Centers for Medicare & Medicaid Services (Medicare.gov), 2026
- Medicare.gov: Medicare Prescription Payment Plan Centers for Medicare & Medicaid Services (Medicare.gov), 2026
What a standard-benefit estimate cannot show
- Your plan’s copays and tiers. Many plans use flat copays, so real bills differ in both directions.
- Preferred versus standard pharmacy pricing.
- Prior authorization, step therapy and quantity limits.
- Mid-year changes in dose or medication.
Bring me your prescription and pharmacy list during the Annual Enrollment Period, October 15 to December 7, 2026. I will price your drugs across the 2027 plans in your ZIP code so you see real totals, not a standard-benefit estimate.
Headwaters Health and Wealth is not connected with or endorsed by the United States government or the federal Medicare program. Medicare has neither endorsed nor reviewed this information.
We do not offer every plan available in your area. Currently we represent 10 organizations which offer 106 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
Common questions
What is the Part D out-of-pocket maximum in 2026?
$2,100 a year for covered drugs (CMS). Once your own spending reaches it, covered prescriptions cost you nothing for the rest of the year. The CMS landscape file for 2027 plans lists a $2,400 cap.
How much is the Part D deductible in 2026?
The standard deductible is $615, the most a plan can charge. Many plans charge less, or none, and some exclude cheaper drug tiers from the deductible.
How much will I pay for my prescriptions on Medicare?
On the 2026 standard benefit you pay the deductible, then 25% of each drug’s cost, until you reach the cap. For example, drugs with a full price of $1,000 a month would cost you about $2,100 for the year. Your plan’s copays and tiers change the real figure.
Can I spread my Part D costs over the year?
Yes. The Medicare Prescription Payment Plan lets you pay your out-of-pocket drug costs in monthly amounts instead of all at the pharmacy. You sign up through your drug plan.
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Content reviewed by Lisa Asmussen, Medicare Broker and Licensed Insurance Agent at Headwaters Health and Wealth in Brighton, Colorado, certified to sell Medicare plans since 2018 (8 years). Last updated .