Updated August 19, 2026 — figures below have been re-verified directly against the CMS CY2026 Regional Rates and Benchmarks file and CMS’s 2026 Part D Bid Information fact sheet. Several regional numbers below have changed from an earlier version of this article — always cross-check the live CMS file before quoting a benchmark to a client.
Table of Contents
- What Is the Extra Help Benchmark?
- 2026 Extra Help (LIS) Benchmark Premiums — Full State-by-State Chart
- Key 2026 LIS Insights Brokers Must Pay Attention To
- Who Qualifies? 2026 Income & Resource Limits
- What Brokers Should Do Now
- FAQ
- Sources
2026 Brings the Biggest LIS Benchmark Drop in Years
The Medicare Extra Help program (also called the Low-Income Subsidy, or LIS) remains one of the most valuable benefits for seniors with limited income — it can eliminate a client’s Part D premium entirely. Every year CMS recalculates the regional benchmark premium — the maximum Part D premium Extra Help will fully cover — and for 2026, the change is dramatic: benchmarks fell in 33 of 34 regions, two regions (New Mexico and Alaska) landed at $0.00, and Florida and Texas dropped to just $4.82, the lowest benchmark on record. This article gives you the verified, CMS-sourced 2026 benchmark for every region and what it means for your book of business.
What Is the Extra Help Benchmark?
The LIS benchmark premium (formally the Regional Low-Income Premium Subsidy Amount, or LIPSA) is the maximum monthly Part D premium Medicare will fully subsidize for a beneficiary 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 plan’s premium is above the benchmark, the client owes the difference every month.
How is the benchmark calculated?
CMS sets a separate benchmark for each of the 34 Part D regions. Per CMS’s Medicare Prescription Drug Benefit Manual, Chapter 13, the benchmark is a weighted average of the basic-coverage premiums of every stand-alone PDP and MA-PD plan in the region, weighted by how many LIS enrollees are in each plan. A plan whose bid comes in at or below that weighted average becomes a “benchmark plan” — the plans CMS auto-assigns LIS beneficiaries into at $0 premium.
Why does the benchmark change every year?
Carrier bids shift every plan year based on projected drug costs, plan competition, and enrollment mix. When several low-cost carriers cut premiums or gain LIS market share in a region, the weighted average — and therefore the benchmark — drops. That is exactly what happened nationally in 2026: aggressive low-bid PDPs pulled regional averages down almost everywhere.
What happens if a client’s plan is above the benchmark?
They pay the difference between their plan’s premium and the regional benchmark, every month, on top of their $0 copay/deductible LIS benefits. A plan priced just $1/month above the benchmark costs a client an extra $12 a year — a completely avoidable cost if the broker checks the benchmark before enrolling.
2026 Extra Help (LIS) Benchmark Premiums — Full State-by-State Chart
Here is the verified 2026 CMS Low-Income Premium Subsidy Amount table, taken directly from CMS’s Regional Rates and Benchmarks 2026 file, with each region’s percent change from the 2025 benchmark for context.
| Region | States | 2025 Benchmark | 2026 Benchmark | YoY Change |
|---|---|---|---|---|
| 1 | NH, ME | $33.77 | $21.72 | -36% |
| 2 | CT, MA, RI, VT | $52.52 | $35.76 | -32% |
| 3 | NY | $72.34 | $58.82 | -19% |
| 4 | NJ | $56.86 | $54.17 | -5% |
| 5 | DE, DC, MD | $46.32 | $31.21 | -33% |
| 6 | PA, WV | $48.36 | $32.71 | -32% |
| 7 | VA | $30.70 | $24.56 | -20% |
| 8 | NC | $51.22 | $36.17 | -29% |
| 9 | SC | $46.57 | $35.66 | -23% |
| 10 | GA | $39.99 | $25.42 | -36% |
| 11 | FL | $20.30 | $4.82 | -76% |
| 12 | AL, TN | $40.01 | $27.74 | -31% |
| 13 | MI | $26.58 | $8.75 | -67% |
| 14 | OH | $39.30 | $31.38 | -20% |
| 15 | IN, KY | $49.58 | $38.44 | -22% |
| 16 | WI | $43.51 | $21.12 | -51% |
| 17 | IL | $22.77 | $15.20 | -33% |
| 18 | MO | $50.99 | $43.03 | -16% |
| 19 | AR | $20.91 | $8.93 | -57% |
| 20 | MS | $47.25 | $23.84 | -50% |
| 21 | LA | $55.63 | $32.89 | -41% |
| 22 | TX | $18.30 | $4.82 | -74% |
| 23 | OK | $49.75 | $28.24 | -43% |
| 24 | KS | $51.73 | $55.20 | +7% |
| 25 | IA, MN, MT, ND, NE, SD, WY | $50.63 | $41.47 | -18% |
| 26 | NM | $15.83 | $0.00 | -100% |
| 27 | CO | $37.02 | $35.24 | -5% |
| 28 | AZ | $30.10 | $16.95 | -44% |
| 29 | NV | $21.30 | $9.48 | -55% |
| 30 | OR, WA | $26.15 | $10.46 | -60% |
| 31 | ID, UT | $54.65 | $37.60 | -31% |
| 32 | CA | $29.66 | $12.00 | -60% |
| 33 | HI | $47.68 | $45.60 | -4% |
| 34 | AK | $38.85 | $0.00 | -100% |
Source: CMS Regional Rates and Benchmarks 2026 and 2025 files.
Broker example: Region 11 (Florida)
A Florida broker enrolling an LIS client in AEP 2026 needs to know the benchmark dropped from $20.30 (2025) to just $4.82 (2026) — a 76% cut. Nearly every plan that was a $0-premium benchmark plan last year is now priced above the new benchmark. Per KFF’s analysis of CMS landscape data, Florida has only one PDP left that qualifies as a benchmark plan for 2026. If that broker defaults to last year’s plan recommendation without re-checking, the client could be hit with an unexpected monthly bill.
Key 2026 LIS Insights Brokers Must Pay Attention To
1. Two regions hit $0.00 — not one
New Mexico (Region 26) and Alaska (Region 34) both landed at a $0.00 benchmark for 2026, confirmed by CMS’s regional rates file and echoed in MedPAC’s March 2026 report to Congress, which notes benchmarks “ranging from $0 in New Mexico and Alaska to $59 in New York.” Two regions at zero simultaneously has not happened in prior plan years. In practice this means no standard Part D plan bid low enough to be a true $0-premium benchmark plan in either state for 2026 unless a carrier deliberately prices at $0.
2. Florida and Texas fell to the lowest benchmark ever recorded — $4.82
Both regions dropped over 70% year-over-year. KFF found Florida and Texas now have only one benchmark PDP each for 2026 auto-enrollment — the fewest of any state and the lowest count “since Part D started.”
3. The number of $0-premium benchmark plans nationwide is shrinking
According to KFF’s Part D snapshot, only 88 PDPs nationwide will be benchmark ($0-premium) plans in 2026 — two fewer than 2025, and the lowest number since the program began. That count ranges from just 1 plan in Florida and Texas up to 4 plans in 15 other states.
4. NY and NJ remain the highest, but even they dropped
New York’s Region 3 benchmark fell from $72.34 to $58.82 (-19%) and New Jersey’s Region 4 fell only slightly (-5%) to $54.17 — both still the two highest benchmarks in the country, keeping pressure on carriers serving the Northeast to keep bids competitive for LIS auto-enrollment.
5. This was a nationwide cut, not a modest adjustment
33 of the 34 regions saw benchmarks fall in 2026, most by 20–75%, driven by lower basic-coverage bids across the PDP market. Only Region 24 (Kansas) increased, rising about 7% to $55.20.
Who Qualifies? 2026 Income & Resource Limits
Since the Inflation Reduction Act eliminated the partial-subsidy tier effective 2024, every applicant who clears the income and resource test now gets the full (100%) Extra Help subsidy — there is no partial tier left to explain to clients. Per Medicare.gov’s official 2026 limits and the CMS CY2026 LIS Resource Limits memo:
| Household | 2026 Income Limit | 2026 Resource Limit |
|---|---|---|
| Individual | $23,940/year (150% FPL) | $18,090 (or $16,590 without the $1,500 burial-expense disregard) |
| Married couple | $32,460/year (150% FPL) | $36,100 (or $33,100 without the burial-expense disregard) |
The resource limits rose 3.01% from 2025 (from $16,100/$32,130) based on the September 2024–2025 CPI change, per the CMS memo above.
What is the 2026 Part D base beneficiary premium, and how does it relate to LIS?
CMS set the 2026 Part D base beneficiary premium at $38.99, about 6% higher than 2025, per CMS’s 2026 Part D Bid Information fact sheet. The base beneficiary premium is a national, non-weighted figure used for other calculations (like late enrollment penalties); it is not the same number as a region’s LIS benchmark, which is enrollment-weighted and region-specific — don’t confuse the two when talking to clients.
What Brokers Should Do Now
- Re-verify every LIS client’s plan against the new 2026 benchmark before AEP ends and again at every SEP — a plan that was $0 last year in Florida, Texas, Michigan, Arkansas, Nevada, or Oregon/Washington almost certainly is not $0 this year given the size of these cuts.
- Flag NM and AK clients specifically — with both regions at $0.00, virtually no standard plan will be a true benchmark plan; check current carrier bids directly rather than assuming last year’s answer still holds.
- Don’t rely on last AEP’s cheat sheet. Pull the current regional number straight from the CMS 2026 Regional Rates and Benchmarks file every time you enroll or re-shop an LIS client.
- Watch for the 2027 release. CMS’s July 28, 2026 2027 Part D bid information fact sheet already shows the base beneficiary premium climbing to $41.33 for 2027 — CMS typically publishes the 2027 regional LIS benchmarks in the same late-summer window, so build a reminder to re-check before next AEP.
- Use this chart in compliant marketing — newsletters, seminars, and printed materials — but always cite CMS directly and avoid implying any guarantee about a named plan’s premium.
FAQ
How much does Extra Help pay in 2026?
It depends entirely on your region. Extra Help fully covers a Part D premium up to the regional benchmark, which for 2026 ranges from $0.00 (New Mexico and Alaska) to $58.82 (New York). See the full 34-region chart above.
Why did my client’s Extra Help plan suddenly have a premium in 2026?
Because the regional benchmark dropped — in most regions substantially, 20–76% — while their plan’s premium stayed roughly the same or increased. If the plan’s premium is now above the new benchmark, the client owes the difference.
Is Extra Help still 100% of the premium, or are there partial tiers?
Since January 1, 2024, the Inflation Reduction Act eliminated the partial-subsidy tier. Everyone who qualifies for Extra Help now gets the full 100% subsidy up to the regional benchmark — there is no more 25%/50%/75% tier.
Where can I find the official CMS numbers myself?
CMS publishes the current year’s regional benchmarks in the “Regional Rates and Benchmarks” file at cms.gov’s Ratebooks and Supporting Data page, alongside the annual Part C&D bid announcement.
What income and resources qualify a client for Extra Help in 2026?
Income below 150% of the Federal Poverty Level — $23,940/year for an individual or $32,460/year for a married couple — and resources at or below $18,090 (individual) or $36,100 (couple), per Medicare.gov.
Ready to Grow Your Book with Better Client Retention?
Knowing the exact LIS benchmark for every state you write business in is exactly the kind of detail-level expertise that keeps clients loyal and referring — and it’s the kind of training and back-office support brokers get when they’re contracted with the right FMO. Partner with Affordable Care Agents today for access to 200+ carriers, full back-office support, and hands-on compliance training, or contract now. Call (646) 233-1499 or (561) 652-5770, or email [email protected].
Sources
- CMS — Regional Rates and Benchmarks 2026 (official LIS benchmark table)
- CMS — Regional Rates and Benchmarks 2025 (for year-over-year comparison)
- CMS — 2026 Ratebooks and Supporting Data page
- CMS — 2026 Medicare Part D Bid Information Fact Sheet
- CMS — Medicare Part D 2027 National Average Monthly Bid Amount Information
- CMS — CY2026 LIS Resource and Cost-Sharing Limits Memo
- CMS — Medicare Prescription Drug Benefit Manual, Chapter 13
- Medicare.gov — Extra Help Income and Resource Limits (2026)
- KFF — A Current Snapshot of the Medicare Part D Prescription Drug Benefit
- MedPAC — March 2026 Report to Congress, Part D Status Chapter
CMS Disclaimer: The Centers for Medicare & Medicaid Services (CMS) does not endorse any particular agent, broker, or organization. Assistance with Marketplace enrollment is available at no cost from certified Navigators and licensed agents/brokers who complete annual FFM training. This article is for educational purposes only and does not replace official CMS guidance. 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 CMS for contract year 2026 and are subject to change. For the most current details, beneficiaries should visit www.Medicare.gov, call 1-800-MEDICARE (1-800-633-4227), or consult official CMS documents for the 2026 plan year.
