What Extra Help Is Worth
Extra Help pays your Medicare Part D prescription drug costs. The Social Security Administration puts the average value at around $5,700 a year per person.
If you qualify, it covers your Part D premium, removes the deductible entirely, and caps what you pay at the pharmacy at a few dollars a prescription. Once your out-of-pocket spending hits the annual threshold, covered drugs cost nothing for the rest of the year.
Roughly 12.5 million people receive it. CMS estimates another two to three million qualify and have never applied.
It is also called the Part D Low-Income Subsidy, or LIS. Same programme, three names, which is part of why people miss it.
2026 Income and Resource Limits
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Eligibility runs on 150% of the federal poverty level.
| Individual | Married couple living together | |
|---|---|---|
| Annual income | $23,940 | $32,460 |
| Resources (base) | $16,590 | $33,100 |
| Resources (with burial exclusion) | $18,090 | $36,100 |
The burial exclusion is worth understanding. You can set aside up to $1,500 per person for burial expenses and it does not count toward the resource limit, which effectively raises the ceiling to $18,090 and $36,100.
A note on conflicting figures. You will find plenty of pages citing $23,475 for an individual and $31,725 for a couple. Those are the 2025 numbers, based on the previous year’s poverty guidelines. The figures above use the 2026 guidelines. If a site is publishing last year’s limits, treat the rest of its figures with caution too.
What counts as a resource
Bank accounts, stocks, bonds and other savings. Not your home, not one vehicle, not personal possessions, and not the burial funds described above.
This trips people up in the same way it does with Medicare Savings Programs. People look at a house and a car, assume they are over the limit, and never apply.
You May Already Qualify Without Applying
Three groups are automatically enrolled. No application, no paperwork:
- People with both Medicare and Medicaid, known as dual eligibles
- People receiving Supplemental Security Income
- People enrolled in a Medicare Savings Program through QMB, SLMB or QI
That last one is the important connection. If you qualify for a Medicare Savings Program, Extra Help comes with it automatically. One application, two benefits.
One exception: QDWI, the fourth Medicare Savings Program, pays the Part A premium for certain working people with disabilities and does not carry Extra Help with it.
What You Actually Pay
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See What I Qualify For →🔒 Free · Private · Takes 2 minutesThe Inflation Reduction Act simplified this considerably. The old partial subsidy was eliminated in 2024, so there is now a single level of full Extra Help for everyone who qualifies.
With Extra Help in 2026:
- Part D premium: paid in full, up to your state’s benchmark amount. If you choose a plan priced above the benchmark, you pay the difference
- Deductible: zero
- Generic prescriptions: capped at $5.10
- Brand-name prescriptions: capped at $12.65
- After the annual cap: $0 for covered drugs for the rest of the year
The Part D out-of-pocket cap is $2,100 in 2026, rising to $2,400 in 2027. Every dollar Extra Help pays toward your covered drugs counts toward that cap, so you reach the zero-cost stage far faster than you would without it.
For someone on several regular medications, that combination is the difference between hundreds a month and a few dollars a prescription.
How to Apply
Free and trusted resources to help you take the next step.
Federally qualified health centers offer care on a sliding fee scale. You pay based on your ability, even without insurance.
Find a ClinicPatient assistance programs from drug manufacturers can provide medications at no cost if you meet income guidelines.
Find Rx AssistanceHealth program enrollees often qualify for SNAP, housing assistance, and utility bill help. Screen for everything.
Free Eligibility CheckThese are recommended resources based on the topic of this article. We only suggest free, official, or widely trusted services.
The Social Security Administration handles applications. It is free, and you never need to pay anyone to help you.
- Apply online at ssa.gov, by phone on 1-800-772-1213, or on paper.
- Have ready: your Social Security card, bank statements, and information about any investments, pensions or other income.
- Apply even if you are unsure. The resource rules exclude more than people expect, and there is no penalty for being turned down.
- Enrol in a Part D plan. This is the step people miss. Extra Help is a subsidy, not a drug plan. Being approved does nothing until you are actually in a Part D plan.
If you do not choose a plan, you may be assigned one automatically so the benefit can take effect. That works, but a plan you pick yourself is more likely to cover the specific drugs you take. Worth doing during Medicare Open Enrollment, which runs 15 October to 7 December.
If you need coverage immediately
The Limited Income Newly Eligible Transition programme, known as LINET, provides temporary Part D coverage for up to two months for people who qualify for Extra Help or Medicaid and have no drug coverage yet. It bridges the gap while you enrol in a plan. It is administered by Humana.
Extra Help and Medicare Savings Programs Are Not the Same
These get confused constantly, and the distinction is simple:
Extra Help covers Part D. Prescription drugs.
Medicare Savings Programs cover Part A and Part B costs, mainly the Part B premium, which is $202.90 a month in 2026.
They are separate programmes with separate limits, but they overlap heavily, and qualifying for a Medicare Savings Program hands you Extra Help automatically.
So if you are going to apply for one, apply for the Savings Program first. It is the one that brings the other with it. Our Medicare Savings Programs guide covers the income bands and how to apply.
Mistakes That Cost People the Most
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Thousands of people miss benefits they qualify for. Check now and see your estimated monthly amount.
Check My Benefits in 2 Minutes →Assuming savings disqualify you. Your home, one car and $1,500 per person in burial funds do not count. The effective resource limit is $18,090 for an individual.
Reading last year’s income limits. A lot of pages still show $23,475. The 2026 figure is $23,940.
Getting approved and stopping there. Extra Help does nothing until you are enrolled in a Part D plan.
Assuming you need to apply when you do not. If you have Medicaid, SSI or a Medicare Savings Program, you already have it.
Paying someone to apply. The application is free through Social Security. Anyone charging a fee is not helping you.
Not reapplying after a change. If your income or resources drop, apply again even if you were turned down before.
Why This Matters More Right Now
Two things land in the next few weeks.
Medicare Open Enrollment runs 15 October to 7 December, and it is the window to choose or change the Part D plan Extra Help attaches to.
The 2027 Part D figures are already confirmed: the out-of-pocket cap rises to $2,400 and the standard deductible rises to $700. With Extra Help, that deductible is zero regardless.
And the 2027 Social Security cost-of-living adjustment, announced on 14 October, will push some people’s income upward. A raise that moves you over a threshold can cost you a benefit worth far more than the raise itself, which is worth checking rather than discovering at the pharmacy counter. Our 2027 COLA guide has a calculator for working out the increase.
Frequently Asked Questions
What is the income limit for Extra Help in 2026?
$23,940 a year for an individual and $32,460 for a married couple living together, which is 150% of the 2026 federal poverty level. Pages citing $23,475 are using the 2025 figure.
What is the resource limit?
$16,590 for an individual and $33,100 for a couple, rising to $18,090 and $36,100 once you apply the $1,500 per person burial exclusion. Your home, one vehicle and personal possessions do not count.
How much does Extra Help save?
SSA estimates around $5,700 a year on average. It pays the Part D premium up to your state benchmark, removes the deductible, and caps copays at $5.10 for generics and $12.65 for brand-name drugs in 2026.
Do I have to apply?
Not if you have Medicare and Medicaid together, receive SSI, or are enrolled in a Medicare Savings Program through QMB, SLMB or QI. Those all qualify you automatically. Everyone else applies through Social Security.
Is Extra Help the same as a Medicare Savings Program?
No. Extra Help covers Part D prescription costs. Medicare Savings Programs cover Part A and Part B costs, mainly the Part B premium. Many people have both, and qualifying for a Savings Program grants Extra Help automatically.
Does Extra Help pay for my drugs by itself?
No. It is a subsidy that attaches to a Part D plan. You must be enrolled in a plan for it to do anything. If you do not choose one, you may be assigned a plan automatically.
Is there still a partial Extra Help?
No. The Inflation Reduction Act eliminated the partial subsidy in 2024. There is now a single level of full Extra Help for everyone who qualifies.
What if I need drug coverage before my plan starts?
The LINET programme provides temporary Part D coverage for up to two months for people approved for Extra Help or Medicaid who have no drug coverage yet.
Where to Start
If you are on Medicare and your income is limited, apply for a Medicare Savings Program first through your state Medicaid office. It pays your Part B premium and hands you Extra Help automatically.
If you do not qualify for that, apply for Extra Help directly through Social Security. It is free, and the resource rules exclude more than most people assume.
Not sure what else you may qualify for? Our free eligibility checker takes about two minutes.
