02/16/2026
If you’re a senior on Medicare and noticed that some of your prescription drug copays are a little higher this year (2026) than they were before — even if you qualify for help with costs — you’re not alone.
Here’s what happened:
A special Medicare program called Value-Based Insurance Design (VBID) let many Medicare Advantage plans offer $0 copays on drugs for people who get the Low-Income Subsidy (also called Extra Help).
Extra Help is a government program that lowers or eliminates drug costs for seniors with limited income and resources — it helps pay premiums, deductibles, and copays so prescriptions are more affordable.
The VBID program gave plans extra flexibility to waive even those small remaining copays for Extra Help members. But unfortunately, that VBID program ended on January 1, 2026 because, according to CMS, it became too expensive to continue.
So now, some plans can’t offer those $0 copays the same way anymore. You still get the strong protection from Extra Help (very low or no copays in most cases), plus the new $2,100 cap on your total yearly drug costs — but the extra “free” layer from VBID is gone for many people.
If this change affects you, check your plan details or give us a call — we can help review options, like other Medicare Advantage plans or ways to keep costs low. You’re not stuck — help is here!
Questions? Drop a comment or message us. We’re here for you. ❤️
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