2026 Brings Big Changes — Are Your Clients Ready?
The Medicare Extra Help program (also called the Low-Income Subsidy, or LIS) continues to be one of the most valuable benefits for seniors with limited income. But every year, CMS updates the benchmark premium amounts — the maximum Part D premium that Extra Help will fully cover.
For 2026, some states saw double-digit decreases, others saw increases, and one region (New Mexico) hit $0.00, meaning no benchmark plan qualifies for a full premium subsidy unless carriers adjust pricing.
As a broker, understanding these numbers is absolutely essential. The benchmark determines whether a client pays $0 premium or owes the difference each month.
This article gives you the full 2026 Extra Help benchmark amounts by state and explains how much LIS will actually pay.
🔍 What Is the Extra Help Benchmark?
The LIS benchmark premium is the maximum monthly Part D premium Medicare will fully subsidize for people receiving full Extra Help.
If a client enrolls in a Part D plan at or below the benchmark, their monthly premium is $0.
If the premium is above the benchmark, the client pays the amount over the benchmark.
This is why brokers must know the regional benchmarks every year — especially during AEP and SEP enrollments.
🧭 2026 Extra Help (LIS) Benchmark Premiums — Full State-by-State Chart
CMS divides the country into 34 regions, each with its own benchmark.
Here is the official 2026 LIS benchmark premium chart, sourced from CMS.
| Region | States | 2026 LIS Benchmark Premium |
| 1 | NH, ME | $21.72 |
| 2 | CT, MA, RI, VT | $35.76 |
| 3 | NY | $58.82 |
| 4 | NJ | $54.17 |
| 5 | DE, DC, MD | $43.61 |
| 6 | PA, WV | $34.67 |
| 7 | VA | $29.93 |
| 8 | NC | $42.14 |
| 9 | SC | $31.58 |
| 10 | GA | $33.23 |
| 11 | FL | $18.41 |
| 12 | AL, TN | $31.78 |
| 13 | MI | $26.98 |
| 14 | OH | $31.27 |
| 15 | IN, KY | $36.91 |
| 16 | WI | $38.50 |
| 17 | IL | $26.78 |
| 18 | MO | $40.86 |
| 19 | AR | $14.03 |
| 20 | MS | $42.59 |
| 21 | LA | $44.69 |
| 22 | TX | $17.92 |
| 23 | OK | $42.14 |
| 24 | KS | $46.89 |
| 25 | IA, MN, MT, ND, NE, SD, WY | $45.04 |
| 26 | NM | $0.00 (major change) |
| 27 | CO | $30.75 |
| 28 | AZ | $26.15 |
| 29 | NV | $16.19 |
| 30 | OR, WA | $23.54 |
| 31 | ID, UT | $44.63 |
| 32 | CA | $25.24 |
| 33 | HI | $29.41 |
| 34 | AK | $30.71 |
🚨 Key 2026 LIS Insights Brokers Must Pay Attention To
1️⃣ New Mexico dropped to $0.00
This is the second time in history a region reached a zero-dollar benchmark.
What this means for brokers:
- No Part D plan qualifies as a $0 LIS plan unless carriers reprice.
- All Extra Help members may owe a premium unless plans adjust.
2️⃣ Florida, Nevada, Texas, Arkansas all remain under $20
This gives brokers more room to place clients into $0 premium options.
3️⃣ NY and NJ remain among the highest
Northeast states continue to have the highest benchmarks, raising carrier pressure to maintain low LIS-eligible plans.
4️⃣ Most states saw moderate decreases
On average, benchmarks dropped 6–12%, reflecting national downward pressure on Part D base premiums.
🎯 How Brokers Should Use This Information in 2026
✔ 1. Verify the benchmark for every LIS client you enroll
A Part D plan costing $1 above the benchmark will cost your client $12 per year — which brokers can easily prevent.
✔ 2. Re-check LIS plan qualification during AEP
Plans that qualified last year may not qualify this year.
✔ 3. Educate clients early
Use this data in:
• newsletter updates
• enrollment seminars
• compliance-friendly marketing printouts
✔ 4. Use AffordableCareAgents.com tools
(Insert internal link to LIS resources, Part D comparison guides, etc.)
🌟 Final Thoughts: Extra Help in 2026 Matters More Than Ever
As premiums shift and the Part D market evolves, understanding how much Extra Help really pays in each state is the difference between a satisfied client and one surprised by unexpected bills.
Brokers who stay informed — and who leverage tools and insights from Affordable Care Agents — will dominate in 2026.
CMS Disclaimer (Add to End of Article)
Disclaimer:
We are not connected with or endorsed by the United States government or the federal Medicare program. Extra Help (Low-Income Subsidy) benchmark premiums and Medicare Part D plan information are based on data published by the Centers for Medicare & Medicaid Services (CMS) for contract year 2026. Information is subject to change. For the most current details, beneficiaries should visit www.Medicare.gov, call 1-800-MEDICARE (1-800-633-4227), or consult the official CMS documents for the 2026 plan year.
