Partial Extra Help went away
People used to hear “full Extra Help” versus “partial Extra Help. ” Partial Extra Help paid a slice of the premium and left you with a deductible and 15% coinsurance. Starting in 2024, people who meet Extra Help income and resource limits generally get full Extra Help. If someone is still describing the old partial program, check the year they are using.
Copay levels that still exist in 2026
Most people with Extra Help pay $5.10 for a generic and $12.65 for a brand-name covered Part D drug, with a $0 deductible. Full dual eligibles with income at or under 100% of the federal poverty level pay $1.60 generic and $4.90 brand. People in a nursing home or certain home-and-community-based services often pay $0. After you reach the $2,100 out-of-pocket threshold for 2026, Extra Help copays for covered Part D drugs are generally $0 for the rest of the calendar year.
No Extra Help
Without Extra Help, the 2026 defined standard Part D benefit includes a $615 deductible, then 25% coinsurance until the $2,100 cap. After the cap, covered Part D drugs are generally $0 for the rest of the year. Premiums usually do not count toward the cap.
How to apply
How to apply, and who is enrolled automatically, is on Extra Help. This page is only the 2026 copay amounts. The 2027 Extra Help copays from the CMS rate announcement are on Medicare Part D in 2027.