Medicare Part D and Extra Help - 2026

Medicare Part D, which covers prescription drugs, is available either as a standalone Part D plan which works with Original Medicare, or included in the Medicare Advantage plan benefits package.  In addition to any plan premium, the Part D annual deductible in 2026 is $615. The maximum out-of-pocket cost is $2,100, which includes the deductible, copays and coinsurance; premiums are not included in this amount.  Should someone reach $2,100 in out-of-pocket costs, the Part D plan will cover the costs of their medications in full for the remainder of the calendar year. 

Medicare beneficiaries with Extra Help (which one gets automatically with Medicaid and/or a Medicare Savings Program) can get a “benchmark” Part D plan for $0 premium. The “benchmark” amount in 2026 is $58.82.  Those with Extra Help have no deductible and lower copays. Beneficiaries with incomes up to 100% FPL will have copays up to 1.60 generic/$4.90 brand; those with Incomes over 100% FPL will have copays of $5.10 generic/$12.65 brand. Extra Help applies whether one has a standalone Part D plan which works with Original Medicare, or a Medicare Advantage managed care plan.

The best way to select a Part D plan is by using the Medicare.gov planfinder and entering in one’s medications and preferred pharmacies.  The planfinder allows the user to select whether they have Medicaid or a Medicare Savings Program to allow for more accurate cost-sharing estimates.