Medicare Part D
Recent law expands Medicare Extra Help for Delray Beach residents
DELRAY BEACH, Fla. — For many older adults along Florida's Gold Coast, the monthly pharmacy bill is one of the biggest — and most stressful — line items in the household budget. A federal program called Extra Help, also known as the Low-Income Subsidy (LIS), can bring those costs down for people with Medicare who qualify. And thanks to recent changes in the law, more people are eligible than ever before.
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Click to call 855-729-3240Key takeaways
- Extra Help, also called the Low-Income Subsidy, lowers what you pay for a Medicare Part D drug plan, and full Extra Help caps copays at a small amount set by Medicare each year.
- Starting in 2024, the law expanded full Extra Help to everyone up to 150% of the federal poverty level, and resource limits are higher than many people think, since things like your home, one car, and burial funds generally don't count.
- For 2026, Medicare Part D has a $2,100 annual out-of-pocket cap and a $615 maximum deductible, and the old "donut hole" coverage gap is gone, leaving just three coverage phases.
- You can apply for Extra Help through Social Security online, by phone, or in person at no cost, and Palm Beach County residents can also get free one-on-one help from the Florida SHINE program.
A quieter way to lower prescription costs
Here's what Delray Beach readers should know for 2026, in plain English.
What Extra Help actually does
Extra Help is a federal benefit that lowers what you pay for a Medicare Part D prescription drug plan. According to Medicare, people who qualify get help with:
- Part D premiums (up to a set benchmark amount),
- Part D deductibles, and
- Copays at the pharmacy for covered drugs.
If you qualify for full Extra Help, your copays for covered prescriptions are capped at a small amount set by Medicare each year. You also don't have to worry about a late enrollment penalty for Part D if you sign up while you have Extra Help.
And here's the bigger picture for 2026: Medicare Part D now has a $2,100 annual out-of-pocket cap on covered drugs for everyone with a Part D plan. The Part D maximum deductible is $615, and the old "donut hole" coverage gap was eliminated in 2025 — the program now has just three phases. Extra Help stacks on top of those protections for people with limited income.
Who qualifies for 2027
Extra Help is based on income and resources, not age or health. You automatically qualify if you have Medicare and also get:
- Full Medicaid,
- Supplemental Security Income (SSI), or
- Help from a Medicare Savings Program paying your Part B premium.
If none of those apply, you can still qualify by applying through Social Security. As of 2024, the law expanded full Extra Help to everyone up to 150% of the federal poverty level — so many people who were only partially eligible before now get the full benefit. Resource limits also apply, but they're higher than many people realize, and things like your home, one car, and burial funds generally don't count.
If you're not sure whether you qualify, it's worth applying. There's no cost to apply, and Social Security says a decision usually comes within a few weeks.
A Delray Beach snapshot
Delray Beach is in Palm Beach County, where Medicare beneficiaries have a wide range of stand-alone Part D drug plans and Medicare Advantage plans that include drug coverage to choose from. Because Palm Beach County is one of Florida's larger Medicare markets, the plan landscape can feel overwhelming — which is exactly why free, unbiased local help matters.
The Florida SHINE program (Florida's State Health Insurance Assistance Program, or SHIP) offers no-cost, one-on-one Medicare counseling for Palm Beach County residents. Counselors can walk you through an Extra Help application and help you compare Part D options if your income situation changes.
How to apply
There are three easy front doors:
1. Online at ssa.gov/extrahelp 2. By phone at Social Security, 1-800-772-1213 3. In person at a local Social Security office
You'll be asked about income, savings, and household size. If you're approved, Medicare will let you pick a Part D plan — or auto-enroll you in one — and your reduced costs kick in.
Another tool worth knowing about: the Medicare Prescription Payment Plan. This is optional and separate from Extra Help. It lets anyone with Part D spread their out-of-pocket drug costs across the year in monthly installments instead of paying big amounts at the pharmacy counter. You can use it whether or not you qualify for Extra Help.
Key dates to keep on the calendar
- Annual Enrollment Period: October 15 – December 7, 2026 (change Part D or Medicare Advantage plans for 2027)
- Medicare Advantage Open Enrollment: January 1 – March 31
- Extra Help: You can apply any time of year — there's no deadline.
If you're approved for Extra Help mid-year, you also get a Special Enrollment Period to switch Part D plans, so you're not locked in.
By the numbers
Medicare Part B premium, 2006–2026
The standard monthly Part B premium has climbed from $88.50 in 2006 to $202.90 in 2026. Hover any point for that year’s premium.
Source: CMS. Standard premium shown; in some hold-harmless years many existing enrollees paid less. Confirm at Medicare.gov.
By the numbers
How people get Medicare in Palm Beach County
(MA penetration in Palm Beach County)
MA penetration from CMS enrollment data; Medigap share is an estimate. U.S. average is about 54% Medicare Advantage. These are area-level figures, not plan-specific.
Try it
Find your 2026 Medicare premium
Most people pay the standard Part B premium. If your 2024 income was higher, an income-related surcharge (IRMAA) applies. Enter your details to see your bracket.
Surcharges are added to your premiums and based on your 2024 tax return. Married-filing-separately uses a different schedule. Confirm at Medicare.gov.
Try it
How the 2026 Part D drug cap works
Slide to your estimated yearly prescription costs and see how the new $2,100 out-of-pocket cap protects you. This illustrates the standard Part D benefit; your plan may structure costs differently.
Once your out-of-pocket spending on covered drugs reaches $2,100, you pay nothing more for the rest of 2026. Confirm details at Medicare.gov.
Good to know
Frequently asked questions
Q: I own my home in Delray Beach. Does that disqualify me from Extra Help?
Q: I'm on Medicaid in Florida. Do I need to apply for Extra Help separately?
Q: Will Extra Help affect my Social Security check or my Part B premium?
- CMS — Medicare Part D program rules (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.