Medicare Extra Help — officially the Part D Low-Income Subsidy (LIS) — pays your prescription drug plan premium, wipes out the deductible, and caps what you pay per prescription at $5.10 for generics and $12.65 for brand-name drugs in 2026. To qualify in 2026, your income must be at or below roughly $23,475 a year for a single person ($31,725 for a married couple living together), with resources under $18,090 single or $36,100 married. The Social Security Administration estimates the benefit is worth about $5,700 a year on average.
If you’re on Medicare and money is tight, this is one of the highest-value programs you can apply for — and one of the most under-enrolled.
What Exactly Does Extra Help Pay For in 2026?
| Cost | Without Extra Help | With full Extra Help |
|---|---|---|
| Part D monthly premium | Varies by plan | $0 (up to the benchmark amount) |
| Annual drug deductible | Up to plan maximum | $0 |
| Generic prescriptions | Plan copay/coinsurance | No more than $5.10 |
| Brand-name prescriptions | Plan copay/coinsurance | No more than $12.65 |
Two more features worth knowing. First, once your out-of-pocket drug spending hits the annual cap ($2,100 in 2026 for all Part D enrollees), covered drugs cost you nothing for the rest of the year — we explained that cap in Medicare Part D $2,100 Cap in 2026. Second, Extra Help enrollees get a Special Enrollment Period allowing plan changes outside the usual windows.
What Are the 2026 Income and Resource Limits?
Since 2024, there is a single level of Extra Help (the old "partial" tier was upgraded to full benefits). The 2026 limits work out to:
- Income: at or below 150% of the federal poverty level — approximately $23,475/year ($1,995/month) for an individual, $31,725/year ($2,705/month) for a married couple living together. Slightly higher limits apply if you support other family members or live in Alaska or Hawaii.
- Resources: at or below $18,090 (single) or $36,100 (married), counting bank accounts, stocks, and bonds — but not your home, one vehicle, personal belongings, or burial plots. A $1,500-per-person burial allowance is also excluded.
Not all income counts, either. SNAP benefits, housing assistance, and energy assistance don’t count against you.
Who Gets Extra Help Automatically?
You’re automatically enrolled — no application needed — if you have Medicare and any of the following:
- Full Medicaid coverage (dual eligibles — see Dual Eligible for Medicare and Medicaid in 2026)
- A Medicare Savings Program paying your Part B premium (covered in Medicare Savings Programs 2026)
- SSI benefits
Everyone else applies. If you’re in a Medicare Savings Program or close to those limits, apply for both — the income cutoffs are similar, and the combined savings routinely exceed $8,000 a year.
How Do You Apply?
- Online: ssa.gov/medicare/part-d-extra-help — takes most people under 30 minutes.
- Phone: 1-800-772-1213 (TTY 1-800-325-0778).
- In person: any Social Security office.
Applying is free. Decisions typically arrive by mail within a few weeks. If approved, pick a Part D plan at or below the benchmark premium for your state so the subsidy covers the full premium — SSA or SHIP counselors (free at shiphelp.org) can identify benchmark plans.
What If You’re Denied?
You can appeal a denial through SSA, and you can reapply any time your income or resources drop. Note that a denial for being slightly over the limits is worth revisiting each year — limits rise annually with the poverty level, and your circumstances change.
FAQ
Does Extra Help work with Medicare Advantage?
Yes. It applies to the drug portion of a Medicare Advantage plan (MA-PD) the same way it applies to standalone Part D plans.
Does owning a home disqualify me?
No. Your primary residence is excluded from the resource test, as is one vehicle.
Do I have to reapply every year?
No, but SSA periodically reviews eligibility and may mail you a review form. Respond by the deadline or benefits can end.
Is Extra Help the same as the Medicare Savings Program?
No. Extra Help lowers drug costs (Part D); Medicare Savings Programs pay Part B premiums and sometimes cost-sharing. Many people qualify for both.