Medicare Advantage

Extra Help Could Ease Drug Costs for Austin Seniors in 2026

People in Austin can choose from 56 Medicare Advantage plans for 2027, against 60 this year. 15 of this year’s plans are gone, 11 are new to Travis County, and 21 that continue have changed their premium, deductible, plan type or name, 8 of them under a new name.

AUSTIN, Texas — Prescription drug costs are one of the biggest worries Medicare beneficiaries share with us, and 2027 brings meaningful changes to how those costs work. For people with limited income, a program called Extra Help — also known as the Low-Income Subsidy (LIS) — can make Part D drug coverage far more affordable. If you live in Austin and you've never checked whether you qualify, this is a good year to take another look.

Austin retirees have a new reason to look at Extra Help

What Extra Help actually is

Extra Help is a federal program run through Medicare and the Social Security Administration. It lowers what people with limited income and resources pay for their Part D prescription drug coverage. That can include help with monthly drug plan premiums, the yearly deductible, and the copays you owe at the pharmacy counter.

As of 2024, Extra Help was expanded so that everyone who qualifies now gets the full subsidy — the old "partial" tier is gone. That's a real change, because it means more people qualify for the strongest level of help than in past years.

Who may qualify in 2027

Eligibility is based on income and resources (things like money in checking, savings, stocks, and bonds — your home and car don't count). The income and resource limits are updated each year by the Social Security Administration, and they're higher than many people assume. A lot of Austin residents who think they earn too much actually qualify.

A few things worth knowing:

• If you already have Medicaid, Supplemental Security Income (SSI), or a Medicare Savings Program, you automatically get Extra Help — you don't need to apply.
• If you don't fall into those categories, you can still apply directly. There's no fee, and you can reapply if your situation changes.
• You can apply any time of year — it isn't tied to Medicare's fall enrollment window.

For current income and resource limits, check medicare.gov or ssa.gov/extrahelp.

How Extra Help fits with 2027's other Part D changes

Even for people who don't qualify for Extra Help, Part D looks different in 2027 under CMS rules:

• The annual out-of-pocket cap for Part D is $2,100 in 2026. Once you hit it, you pay $0 for covered drugs the rest of the year.
• The maximum Part D deductible is $615.
• The old "donut hole" coverage gap was eliminated in 2025. Part D now has three phases instead of four.
• The Medicare Prescription Payment Plan lets you spread your out-of-pocket drug costs across the calendar year in monthly installments instead of paying big amounts at the counter. It's optional and free to opt into through your drug plan.
• IRMAA surcharges (higher premiums for higher earners) start above $109,000 in income for a single filer in 2026.

Extra Help sits on top of these rules. For someone who qualifies, it reduces costs further — often dramatically — within the same Part D framework.

What this looks like in Austin

Austin is in Travis County, where Part D and Medicare Advantage plan availability is set at the county level by CMS. That means the specific menu of drug plans a Travis County resident can choose from may look different from what a friend in Williamson or Hays County sees. When you compare plans on medicare.gov, the tool automatically uses your ZIP code and county to show you what's available.

If you qualify for Extra Help, you can also switch Part D plans outside the usual Annual Enrollment Period (Oct. 15 – Dec. 7) — people with LIS get additional chances during the year to change plans. That's a flexibility most beneficiaries don't have.

How to apply

There are three easy paths:

1. Online: ssa.gov/extrahelp 2. Phone: Call Social Security at 1-800-772-1213 (TTY 1-800-325-0778) 3. In person: Visit a local Social Security office, or get free one-on-one help from Texas's State Health Insurance Assistance Program (SHIP), called the Health Information, Counseling and Advocacy Program (HICAP) in Texas. HICAP counselors are trained volunteers who don't sell anything.

You'll be asked about your household income, savings, and current Medicare coverage. Most applications take about 10–15 minutes.