Short answer: For 2026, a $0 plan premium and $0 deductible, then up to $5.10 for each generic and $12.65 for each brand-name drug at a network pharmacy, and $0 once total drug costs reach $2,100. People with full Medicaid who are also in QMB pay no more than $4.90 per drug.
Medicare.gov’s 2026 Extra Help figures:
- Plan premium: $0
- Plan deductible: $0
- Up to $5.10 for each generic and up to $12.65 for each brand-name drug at a participating pharmacy
- $0 per covered drug once total drug costs (including what Extra Help pays) reach $2,100
- With full Medicaid and QMB: no more than $4.90 per covered drug
The $0 premium has a limit. Under 42 CFR 423.780 the premium subsidy covers the basic drug coverage premium only up to the region’s low-income benchmark (or the lowest basic plan premium in the region, if higher). Someone who picks a plan priced above that, or an enhanced plan, can owe the difference. Check the plan’s premium with Extra Help applied before enrolling.
Sources
Medicare.gov, Help with drug costs (archived 03-02-2026, 2026 figures)web.archive.org/web/20260302023355/https://www.medicare.gov/basics/costs/help/drug-costs42 CFR 423.780, premium subsidy (eCFR)ecfr.gov/current/title-42/section-423.780CMS HPMS memo, CY 2026 LIS limitscms.gov/files/document/cy2026-lis-resource-limits-memo.pdfeCFR, 42 CFR 423.780ecfr.gov/api/versioner/v1/full/2026-10-20/title-42.xml?section=423.780