Medicare Supplement

Extra Help in 2026: Cutting Drug Costs in Silver Spring

SILVER SPRING, Md. — For many Maryland retirees, prescription drugs are the part of Medicare that hits the wallet hardest. The good news heading into 2026: a federal program called the Low-Income Subsidy — better known as Extra Help — can dramatically ease those costs for people who qualify. And thanks to recent changes in Medicare Part D, the rules around drug spending are simpler than they've been in years.

Here's a plain-English look at how Extra Help works, who qualifies, and how Silver Spring residents can find personalized answers.

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 CMS — Medicare Part D program rules (medicare.gov), people who qualify get help with their Part D premium, their deductible, and their copays at the pharmacy counter.

Since 2024, Extra Help has been a single "full" benefit — the older partial version was phased out. That means people who qualify now receive the strongest level of assistance the program offers.

Extra Help is not a plan you buy. It's a status you qualify for. It attaches to whatever Part D coverage you have.

Why 2026 matters

Two big Part D changes are already reshaping drug costs for everyone on Medicare — not just people with Extra Help:

• The out-of-pocket cap for Part D is $2,100 in 2026. Once you hit that ceiling on covered drugs, you pay $0 for the rest of the calendar year.
• The maximum Part D deductible is $615 in 2026.
• The old "donut hole" coverage gap is gone as of 2025. Part D now has three simpler phases: deductible, initial coverage, and catastrophic.
• The Medicare Prescription Payment Plan lets anyone with Part D spread their drug costs over monthly installments instead of paying big bills at the pharmacy.

For someone who also qualifies for Extra Help, these caps become even more of a safety net.

Who qualifies for Extra Help

Eligibility is based on income and resources. For 2025 (the numbers used to determine 2026 eligibility), you generally qualify if:

• Your income is at or below 150% of the federal poverty level, and
• Your resources (savings, investments, real estate other than your home) fall under the program limits.

Some things do not count against you — your house, your car, burial funds up to certain limits, and household items. If you already have Medicaid, Supplemental Security Income (SSI), or a Medicare Savings Program, you're automatically enrolled in Extra Help.

Many people who qualify never apply because they assume they earn too much. It's worth checking even if you're not sure.

How Silver Spring residents can apply

Silver Spring is in Montgomery County, where residents have several Part D stand-alone plans and Medicare Advantage plans with drug coverage available — the exact count changes each year and is published at Medicare.gov's Plan Finder.

You can apply for Extra Help three ways:

1. Online at ssa.gov/extrahelp (the Social Security Administration runs the application). 2. By phone at 1-800-772-1213. 3. In person at a local Social Security office.

Applying is free, and there's no deadline — you can apply any time of year.

What to do if you don't qualify

If your income is above the Extra Help limits, you still have tools:

• Maryland's Senior Prescription Drug Assistance Program (SPDAP) helps some residents with Part D premiums. Eligibility rules apply.
• Medicare Savings Programs (run by the state) can help pay Part B premiums and, in some cases, open the door to Extra Help automatically.
• The Medicare Prescription Payment Plan doesn't reduce your total cost, but it smooths payments across the year so you're not hit with one big bill.

A State Health Insurance Assistance Program (SHIP) counselor can walk you through all of this at no cost. In Maryland, SHIP is called SHIP-MD and serves Montgomery County residents by phone and appointment.

Key dates to remember

• Annual Enrollment Period: October 15 – December 7 (change your Part D or Medicare Advantage plan for the next year).
• Medicare Advantage Open Enrollment: January 1 – March 31 (switch or drop Medicare Advantage).
• Extra Help applications: any time.

Higher-income beneficiaries should also note that IRMAA surcharges — extra amounts added to Part B and Part D premiums — begin above $109,000 in income for single filers in 2026.