Low-Income Subsidy (“Extra Help”) — What to Know for 2026

If you’re on Medicare and living on a fixed income, the Low-Income Subsidy (LIS) — also called “Extra Help” — can be a real lifesaver.

It helps pay for your Part D prescription drug plan, lowering or even eliminating your monthly premium, deductible, and copays.

But here’s what has many people talking lately: important changes are coming for 2026.

Some people who automatically qualified this year might not automatically qualify next year.

“We’ve already had several clients call after getting letters from Social Security,” says Mary Manos Mitchem, M3 Insurance agent. “They were confused and worried they might lose coverage — and they weren’t sure what to do next.”

Let’s take a moment to go over what’s happening and how to stay protected.

💊 What the LIS / “Extra Help” program does

This program helps Medicare beneficiaries with limited income and savings pay for their Part D costs — the plan that covers your prescriptions.

If you qualify, you could:

• Pay no monthly premium on certain plans

• Have a lower (or zero) deductible

• Pay small or no copays for covered prescriptions

• Change drug plans any month if you need to

In 2025, many people were automatically placed in an LIS-approved plan.

However, starting in 2026, some of those automatic qualifications will expire unless your financial situation still meets the program’s guidelines.

That means you may need to re-apply to keep your Extra Help.

“The key is to read every letter you get from Medicare or Social Security,” says Alexis Mitchem. “Even if it looks routine, open it — because it might be telling you your subsidy level or eligibility has changed for 2026.”

⚠️ What’s changing for 2026

Here’s what we know so far:

• Some people who were automatically eligible in 2025 may lose that automatic status in 2026.

• You might need to submit a new application if your income or assets have changed.

• If you still qualify, you’ll receive a notice confirming your continued coverage (often on orange paper).

• If you don’t automatically qualify, you’ll get a different notice (often grey paper) explaining what to do next.

The big takeaway: Don’t assume “no news is good news.”

If you get a letter — act on it right away or call your agent for help.

📝 What to do next

Here’s what Mary and Alexis recommend for anyone currently receiving (or hoping to receive) Extra Help:

1. Check your eligibility now.

   Review your current income and savings levels — you can check the most recent LIS limits at Medicare.gov.

2. Open all mail from Social Security or Medicare.

   These letters tell you whether your LIS is continuing or ending for 2026.

3. If you lose automatic coverage, apply again.

   You can re-apply at any time through Social Security, your local Medicaid office, or with an agent’s help.

4. Review your Part D plan each fall.

   Even with Extra Help, your medications and plan coverage can change each year.

5. Call us before you make changes.

   Our team at M3 can review your options and help you stay enrolled in a plan that fits your needs and budget.

“We don’t want anyone paying more than they have to,” says Mary.“That’s why we encourage people to reach out early — so we can make sure they keep every bit of help they’re entitled to.”

The Extra Help program isn’t going away — in fact, it continues to be one of the best ways for seniors to lower their prescription drug costs.

But with fewer automatic approvals expected in 2026, it’s more important than ever to stay alert, stay informed, and stay connected with a trusted advisor.

As Alexis puts it: “A quick phone call today can save you hundreds of dollars next year.”

💬 Final Thought

If you’re unsure whether your Extra Help will continue in 2026, don’t wait for the letters to pile up.

Give our M3 Insurance team a call, and we’ll walk through it together — step by step.

📞 Call M3 Insuranc and schedule a free review

Because peace of mind shouldn’t depend on fine print.