Medicare 2026

Social Security's Extra Help Review: What to Do When the SSA-1026 Form Arrives

If an envelope from the Social Security Administration (SSA) lands in your mailbox with "Review of Your Eligibility for Extra Help" printed on the form inside, don't set it aside. That form — SSA-1026 — is part of a routine process required by federal law, and how you respond (or don't) can change whether you keep the subsidy that helps pay for your Medicare Part D drug costs.

Here's what the review is, who gets one, and what to do next.

Why the SSA-1026 exists

The Medicare Modernization Act of 2003 requires SSA to periodically check whether people still qualify for the Low-Income Subsidy — the program most people call Extra Help — and at what level. Each August, SSA's systems pull a sample of beneficiaries for these reviews. If you're picked, you get the SSA-1026 in the mail.

The form isn't a trick question. It mostly asks you to confirm the income and resource information SSA already has on file for you and to report only the things that have changed. If your situation looks the same as it did last year, you say so. If something changed — a different bank balance, a new source of income, a change in who lives with you — you note it.

Who does not get this review

If CMS has deemed you automatically eligible for Extra Help because you have Medicaid, a Medicare Savings Program, or Supplemental Security Income (SSI), you're excluded from SSA's periodic Extra Help review. SSA will direct you to report any changes through the program that qualifies you. So if you fall into one of those categories and an SSA-1026 somehow reaches you, it's worth calling SSA to double-check what they need.

The 30-day clock (and the extension)

You have 30 days to return the completed form. If you need more time — maybe you're waiting on a bank statement or you simply want help filling it out — you can contact SSA within the 30 days and ask for a one-time extension of up to 30 additional days.

If you don't return the form within 30 days (or by the end of your extension), SSA will send a due-process notice and then end your Extra Help. You'll also get a notice after the review is processed telling you whether your Extra Help will stay the same, increase, decrease, or end.

When changes take effect

Timing matters, especially at the end of the year:

• Returned by November 30: If the review results in a change, the change takes effect in January of the following year.
• Returned after November 30: The change takes effect the first day of the second month after you return the form. For example, a form returned in December takes effect February 1.

A different kind of review: subsidy-changing life events

Some life events can change what you qualify for on their own. These "subsidy-changing events" include marriage, the death of a spouse you live with, divorce, annulment, separation, or moving back in with a separated spouse. When one of these happens, SSA mails a version of the SSA-1026 with a longer, 90-day response window.

Disagree with the decision? You can appeal.

If SSA sends a notice and you think the decision is wrong, you can request an appeal. You have 60 days from the date you receive the notice, and SSA presumes the notice was received 5 days after its date. Importantly, if SSA has proposed to end your Extra Help and you file an appeal, your Extra Help automatically continues while the appeal is being decided.

How Extra Help fits into the bigger Part D picture

Extra Help pays for a large share of Part D premiums, deductibles, and copays for people who qualify. It works alongside the Part D program's standard rules, which in 2027 include an out-of-pocket cap of $2,400 (down from $2,100 in 2026) and a maximum allowable plan deductible of $700. The Part D base beneficiary premium — a national figure used to calculate any late-enrollment penalty — is $41.33 in 2027; actual plan premiums are set plan by plan.

If you're reviewing coverage during Annual Enrollment (October 15 – December 7, 2026, with choices effective January 1, 2027), knowing your Extra Help status going in makes it much easier to compare drug plans accurately.

A note for people with Medicaid or Extra Help

Since 2025, if you have Medicaid or Extra Help, you have a monthly Special Enrollment Period to move to Original Medicare paired with a stand-alone Part D plan, or to switch from one stand-alone Part D plan to another. If you're a full-benefit dual-eligible (both Medicare and full Medicaid), you can also enroll in an integrated Dual Eligible Special Needs Plan (D-SNP) in any month.

That flexibility means you don't have to wait for fall to make a change if your circumstances shift.

Weighing your coverage choices

Some people pair Original Medicare with a stand-alone Part D plan and a Medigap policy; others choose a Medicare Advantage plan that includes drug coverage. Each path has trade-offs — different cost structures, different provider access rules, different extra benefits. Neither is better for everyone; the right fit depends on your health, budget, providers, and prescriptions.

A few 2027 numbers aren't out yet. CMS typically announces the Part B standard premium and deductible, along with the IRMAA income brackets and surcharges, in the fall (usually November). For current, confirmed figures, go straight to the source.

Where to go next

For official, up-to-date information on Medicare, Part D rules, and Extra Help, visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227), available 24/7. For questions specifically about the SSA-1026 form or your Extra Help status, contact the Social Security Administration directly using the number on the notice you received.