These are the Part D questions Nebraskans ask most, with 2026 and 2027 numbers from CMS. Plan availability, premiums, pharmacy networks and benefits vary by county and change every year, and for 2027 the cap, the deductible and many premiums are all moving. For more depth, see our Part D page, the guide to the Part D out-of-pocket cap and our Part D 2027 explainer.
Frequently asked questions
Part D is Medicare's prescription drug coverage. Private insurance companies offer it in two ways: as a standalone drug plan you add to Original Medicare, or built into a Medicare Advantage plan. Each plan has its own list of covered drugs, called a formulary, its own pharmacy network and its own premium. Part D is optional, but waiting without other creditable coverage can mean a lifelong penalty.
No Part D plan can charge a deductible higher than $700 in 2027, up from $615 in 2026. Some plans charge a lower deductible or apply it only to higher-cost tiers. You pay the full plan price for covered drugs until you meet the deductible. Insulin and recommended adult vaccines covered by Part D are not subject to the deductible.
The yearly cap is $2,100 in 2026 and $2,400 in 2027. It counts what you pay for covered Part D drugs during the year, plus certain payments others make for you, such as Extra Help. Once you reach it, you pay nothing more for covered Part D drugs until the next calendar year. The cap resets every January 1.
A federal demonstration that lowered standalone drug plan premiums and limited how much they could rise ends after 2026, and plan costs are higher. The national average monthly bid rose from $239.27 to $296.05. KFF found no standalone drug plans with a zero premium for people without Extra Help in 2027. Your plan's exact 2027 premium is in its Annual Notice of Change.
CMS counts 9 standalone Part D plans in Nebraska for 2027, from 5 companies, down from 11 plans from 6 companies in 2026. The lowest standalone premium is $5.30 a month. Many Medicare Advantage plans in Nebraska also include drug coverage. Plans, premiums, drug lists and pharmacy networks change every year, so compare them with your own medications.
Pick a new drug plan during open enrollment, October 15 to December 7, 2026, so your coverage continues January 1. When a plan is not renewed, Medicare also gives a Special Enrollment Period from December 8 through the last day of February. For 2027, SilverScript Choice (PDP) and HealthSpring Extra Rx (PDP) are not offered in Nebraska. If you do nothing, you will have no drug coverage.
If you go 63 days or more in a row without Part D or other creditable drug coverage after your Initial Enrollment Period, you may owe a penalty. It equals 1% of the national base beneficiary premium for each full month without coverage, added to your premium for as long as you have Part D. The base premium is $38.99 in 2026 and $41.33 in 2027. People with Extra Help pay no penalty.
Extra Help is a federal program that lowers Part D costs for people with limited income and savings. For 2026, the limits are $23,940 in yearly income and $18,090 in resources for an individual, or $32,460 and $36,100 for a married couple. In 2027, Extra Help copays are no more than $5.80 for generics and $14.40 for other drugs. You qualify automatically if you have full Medicaid, a Medicare Savings Program or SSI.
Start with a list of every medication, including dose and how often you take it, plus the pharmacy you use. Enter that list in the Medicare.gov plan finder and compare the total yearly cost of each plan: premium, deductible and copays together. Check each drug's tier and any restrictions, like prior authorization. The lowest premium is often not the lowest total cost. For unbiased help, call 1-800-MEDICARE (1-800-633-4227), 24 hours a day, 7 days a week (TTY 1-877-486-2048), or Nebraska SHIP (formerly SHIIP) at 1-800-234-7119.
It is an optional way to spread your Part D out-of-pocket costs over the year. You pay nothing at the pharmacy and get a monthly bill from your plan instead. It does not lower your total drug costs, and there is no interest or fee. If you stay in the same plan, your participation renews automatically for 2027. If you change plans, you need to sign up again.
No more than $35 for a one-month supply of each covered insulin product, and the deductible does not apply. A 3-month supply cannot cost more than $35 for each month's supply. The limit applies to everyone with Part D, including people in Medicare Advantage plans with drug coverage and people who get Extra Help. Insulin covered under Part B, such as insulin used with a pump, has the same $35 limit.
Yes. Part D covers adult vaccines recommended by the Advisory Committee on Immunization Practices that Part B does not cover, such as shingles, Tdap and RSV shots, with no deductible and no copay. Flu, pneumonia and, for people who qualify, hepatitis B shots are covered under Part B instead. Ask your pharmacy whether it bills the vaccine to your Part D plan.
Part D plans generally do not cover drugs used only for weight loss, but the Medicare GLP-1 Bridge does. Since July 1, 2026, people who qualify can get Wegovy, Zepbound KwikPen or Foundayo for weight management for $50 a month. You need Part D coverage, a qualifying body mass index and a prior approval form from your prescriber. The program runs through December 31, 2027.
It depends on how you get your medical coverage. If you have Original Medicare, with or without a Medicare Supplement plan, you need a standalone Part D plan for drugs. If you choose Medicare Advantage, most plans include drug coverage, and you generally cannot add a separate drug plan to a plan that already has it. Compare both paths using your medications, doctors and budget.
Sources
- Medicare.gov: Part D costs, deductible and out-of-pocket limit (opens in a new tab)
- CMS: CY 2027 Medicare Advantage and Part D Rate Announcement (opens in a new tab)
- CMS: 2027 Medicare Advantage and Part D state-by-state fact sheets (opens in a new tab)
- KFF: Many Part D stand-alone drug plan enrollees will see modest premium increases for 2027 (October 2, 2026) (opens in a new tab)
- Medicare.gov: Help with drug costs (Extra Help) (opens in a new tab)
- Medicare.gov: Insulin coverage (opens in a new tab)
- Medicare.gov: Medicare GLP-1 Bridge (CMS Product No. 12234) (opens in a new tab)
- Medicare.gov: Avoid late enrollment penalties (opens in a new tab)
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. 1-800-MEDICARE (1-800-633-4227) is available 24 hours a day, 7 days a week. TTY users can call 1-877-486-2048.
