Under the Inflation Reduction Act (IRA), the limits for the Medicare Extra Help program have been significantly expanded, eliminating partial coverage and allowing people with limited income to qualify for full savings on Part D drug premiums and deductibles. This change represents direct financial relief of up to $5,000 per year for eligible beneficiaries who previously only received partial aid.
"2026 Key Change: The 'Partial Extra Help' category no longer exists. Everyone who qualifies receives the FULL benefit: $0 Part D premiums, $0 deductibles, and minimal copays of $0-$4.50 for generic drugs."
What Full Extra Help Covers
| Part D Cost |
WITHOUT Extra Help |
WITH Full Extra Help |
| Monthly plan premium |
$30 – $80+/month |
$0 |
| Annual deductible |
$590 (2026) |
$0 |
| Generic drug copay |
25% of cost |
$0 – $4.50 |
| Brand-name drug copay |
25% of cost |
$0 – $11.20 |
| Annual out-of-pocket cap (OOP cap) |
$2,000 (New IRA cap) |
$0 |
2026 Eligibility Limits
| Criterion |
Individual |
Couple |
| Max annual income (150% FPL) |
~$22,590 |
~$30,660 |
| Resource limit (excluding home/car) |
$17,220 |
$34,360 |
How to Apply for Extra Help: Step-by-Step
| Step | Action | Detail |
|---|
| 1 | Apply online (Fastest) | ssa.gov/medicare/part-d-extra-help |
| 2 | Apply by phone | 1-800-772-1213 (TTY: 1-800-325-0778) |
| 3 | Paper application | Form SSA-1020 (available at local SSA offices) |
| 4 | Through Medicaid | If you receive Medicaid or SSI, you qualify automatically — no need to apply |
Medicare Savings Programs (MSP): Essential Supplement
Medicare Savings Programs go beyond Extra Help and cover Part B premiums, deductibles, and coinsurance. If you qualify for Extra Help, you most likely qualify for an MSP as well. Apply through your state Medicaid office:
| MSP Program | What It Covers | Max Income (approx.) |
|---|
| QMB (Qualified Medicare Beneficiary) | Part A and B premiums + deductibles + copays | 100% FPL (~$15,060) |
| SLMB (Specified Low-Income) | Part B premiums | 120% FPL (~$18,072) |
| QI (Qualifying Individual) | Part B premiums | 135% FPL (~$20,331) |
Application Resources
"Immediate Action: If your income is below $22,590 (individual) or $30,660 (couple) and you have Medicare, apply for Extra Help TODAY at ssa.gov/medicare/part-d-extra-help. Savings can exceed $5,000 annually on medications."
