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Extra Help copay sketch

2026 Extra Help is generally full Extra Help. Compare copay levels — including $0 after the cap.

Since 2024, Extra Help at the usual income limits is generally full Extra Help — the old “partial Extra Help” 15% coinsurance was replaced. What still differs is the copay level. Confirm on Medicare.gov.

Which Extra Help level?Extra Help (most people) — $5.10 generic / $12.65 brandFull dual eligible, income at or under 100% FPL — $1.60 / $4.90Nursing home or certain home-and-community care — $0 / $0No Extra Help — standard 2026 Part D ($615 deductible, then 25% until the cap)

Generic fills this yearBrand fills this year

Extra Help copay sketch: $137.10 for those fills ($5.10 generic / $12.65 brand). Deductible $0.00. After you reach the $2,100.00 out-of-pocket threshold, Extra Help copays for covered Part D drugs are generally $0 for the rest of the year. Institutional / HCBS stays at $0. This is not a determination that you qualify.

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Extra Help copay sketch

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