If you get Part D Extra Help (Low-Income Subsidy) and you’ve seen headlines this week about Medicare Part D premium subsidy ending, you might be worried. Take a breath — this news is about a different program, and it doesn’t change your Extra Help benefits. This doesn’t mean you can ignore it altogether though.
What is actually happening with the Part D Premium Subsidies
On July 28, 2026, the Centers for Medicare & Medicaid Services (CMS) announced it’s ending the Part D Premium Stabilization Demonstration. This was a temporary program that gave insurance companies extra federal money to keep Part D premiums stable while they adjusted to the Inflation Reduction Act’s changes. That premium subsidy program will be cancelled after the 2026 plan year. This means insurers will set 2027 Part D premiums without the federal subsidies.
These changes may influence premiums overall, with CMS Administrator Dr. Mehmet Oz has said most beneficiaries can see premium increases of less than $10 a month and others saying it will vary by plan and region.
Many concerned beneficiaries are wondering how this will affect their Part D Low Income Subsidy, Extra Help. We are here to clear things up for you!
Why these changes won’t affect Extra Help benefits
The subsidy that’s ending is a premium stabilization subsidy paid to insurance companies, not the individual benefit for low-income individuals. Extra Help is something completely different — it’s a benefit tied directly to low-income individuals, based on income and resources, and helps reduce their monthly premium, eliminates their deductible, and reduces copays regardless of their Part D plan.
If a client qualifies for Extra Help, none of their current benefits will be affected:
- Their premium assistance will remain in place. Extra Help pays some or all of the Part D premium (up to a benchmark amount) for beneficiaries who qualify. This Extra Help premium assistance is not part of the premium subsidy program that is ending.
- Their copay and deductible assistance will remain in place. Extra Help recipients will continue to receive assistance for their copays and deductible.
- They will still qualify to eliminate their Part D penalty if they have one.
What may change is how much insurers may charge for premiums next year without subsidies. See below for this could affect you in 2027, as well as how to avoid it.
What could affect your Part D in 2027
Because insurers are losing their premium subsidies, it is expected that many Part D plans may raise prices in 2027. This may or may not affect your Part D premium if you have Extra Help. Remember, Extra Help reduces your Part D premium by the benchmark premium. This amount varies by state, but if your Part D premium is at or below this benchmark, then you pay $0 per month.
If your plan increases rates next year, but it is still below the benchmark rate then you still pay $0 a month. If you get your Part D through a Medicare Advantage Plan, then the premium savings still apply.
See graph at the end of article for your state’s benchmark premium.
How to Mitigate Premium Increases For 2027
The end of the Part D Premium Subsidies will not affect your Extra Help, but you still should do your due diligence during the Annual Enrollment Period. If premiums rise across the board, you will need to compare plans to keep your premiums low or zero. Our licensed agents can help you search for plans in your area that have premiums at or below your state’s benchmark premium. We can help make sure the plan covers your prescriptions at the lowest cost.
2026 Low Income Premium Benchmark by State
| NH, ME | 21.72 |
| CT, MA, RI, VT | 35.76 |
| NY | 58.82 |
| NJ | 54.17 |
| DE, DC, MD | 31.21 |
| PA, WV | 32.71 |
| VA | 24.56 |
| NC | 36.17 |
| SC | 35.66 |
| GA | 25.42 |
| FL | 4.82 |
| AL, TN | 27.74 |
| MI | 8.75 |
| OH | 31.38 |
| IN, KY | 38.44 |
| WI | 21.12 |
| IL | 15.20 |
| MO | 43.03 |
| AR | 8.93 |
| MS | 23.84 |
| LA | 32.89 |
| TX | 4.82 |
| OK | 28.24 |
| KS | 55.20 |
| IA, MN, MT, ND, NE, SD, WY | 41.47 |
| NM | 0.00 |
| CO | 35.24 |
| AZ | 16.95 |
| NV | 9.48 |
| OR, WA | 10.46 |
| ID, UT | 37.60 |
| CA | 12.00 |
| HI | 45.60 |
| AK | 0.00 |
Need help reviewing your Part D prescription plan coverage? Our friendly licensed agents are here to help! Contact us here.
Hi, My name is Butterfly. I have been a licensed agent for over 10 years. I am contracted and certified to assist Medicare beneficiaries through the Medicare process. I specialized in educating the public about Medicare enrollment rules, timelines, and coverage options. My goals is to help you understand your options and help you avoid common enrollment mistakes that can lead to penalties or gaps in coverage.
