August 11, 2026Est. digital edition
Medicare

How the yearly cap on drug costs actually works

A closer look at what the out-of-pocket ceiling covers, what it does not, and who benefits most.

By Margaret Ellison·Senior Benefits EditorPublished ·6 min read
The cap resets at the start of each calendar year.
The cap resets at the start of each calendar year.

A closer look at what the out-of-pocket ceiling covers, what it does not, and who benefits most. The full text of this report is part of our expanding edition and will appear here in this template.

Sources & references

  • Official program guidance and enrollment materials as cited in the article text.
  • State Health Insurance Assistance Program (SHIP) counseling overview.

A note on accuracy: if you believe something here is wrong or out of date, request a correction. Substantive changes are logged with the update date above.

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