Medicare Extra Help 2026: Income Limits and Costs
Extra Help is federal money toward your Medicare Part D drug costs. Here are the 2026 limits, what you pay once you have it, and the one application that gets it.
By mendmeds · Published · 4 min read
The short version
- Extra Help, also called the Part D Low-Income Subsidy, is a federal program that pays much of the cost of Medicare drug coverage for people with limited income and savings.
- In 2026, the income limit is $23,940 a year for one person and $32,460 for a married couple living together.
- Once you have it, a covered brand-name drug costs you at most $12.65 and a generic at most $5.10 in 2026, with no Part D deductible.
- You get Extra Help automatically with full Medicaid, SSI or a Medicare Savings Program; everyone else applies once through Social Security.
What Extra Help does
Extra Help is formally the Low-Income Subsidy, or LIS. If you qualify, you pay no Part D deductible and your cost for each covered prescription is capped at a few dollars, far below the usual copay or coinsurance. It works inside the drug plan you already have: the federal government pays your plan, and the plan charges you less at the pharmacy.
It applies only to drugs your plan covers. If yours is not on the plan’s list, you or your prescriber can ask the plan for an exception.
2026 income and savings limits
| Limit | One person | Married couple living together |
|---|---|---|
| Yearly income | $23,940 | $32,460 |
| Savings and other resources | $16,590 | $33,100 |
| Resources, if you set money aside for burial costs | $18,090 | $36,100 |
Income limits are higher in Alaska and Hawaii. Social Security’s own publications quote the higher resource figures, which include burial funds.
Resources are things like money in the bank, stocks and bonds. The home you live in does not count.
These are not hard cutoffs. Not everything you earn or own is counted, and Medicare’s own advice is to apply if you are close. It costs nothing to try.
What you pay once you have it
| Drug | Standard Extra Help | Lowest income levels |
|---|---|---|
| Generic | $5.10 | $1.60 |
| Brand-name | $12.65 | $4.90 |
People with full Medicaid who live in a nursing home pay nothing for covered drugs.
That sits well under the $2,100 yearly out-of-pocket cap on Part D spending, which applies to everyone with a Part D plan.
Who gets it automatically
You do not need to apply if you have any of these:
- Full Medicaid coverage.
- Supplemental Security Income (SSI) payments from Social Security.
- Help paying your Part B premium through a Medicare Savings Program (QMB, SLMB or QI).
How to apply
- Apply online with Social Security at ssa.gov/medicare/part-d-extra-help. You will need your income and savings figures.
- The same application is also sent to your state for a Medicare Savings Program, unless you ask them not to.
- For free one-on-one help, contact your State Health Insurance Assistance Program (SHIP) at shiphelp.org. For questions about your Extra Help level, call 1-800-MEDICARE (1-800-633-4227).
If you qualify, you keep Extra Help through December 31 even if your income rises during the year. It is not offered in Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands or American Samoa, where the local Medicaid office runs similar help.
Extra Help and manufacturer programs
Some drug-maker programs that accept Medicare patients want proof that you applied for Extra Help first. As of November 2026, 4 of the 53 manufacturer patient assistance programs we track that accept Medicare patients list an Extra Help denial among the documents they require, including NovoLog, Skyrizi, Taltz and Tresiba.
So applying can matter even if you expect to be turned down: the denial letter may be the document a program asks for. Each drug’s page lists what its programs require, and how patient assistance programs work covers the rest of the application.
These figures change every January
Medicare resets the limits and amounts each plan year. Everything above is for 2026; the next set takes effect on January 1.
Common questions
What is the Extra Help income limit in 2026?
$23,940 a year for one person and $32,460 for a married couple living together. Savings and other resources must also be under $16,590 for one person or $33,100 for a couple ($18,090 and $36,100 if you set money aside for burial costs).
Can I get Extra Help if my income is over the limit?
Possibly. Not all income and resources are counted, and the income limits are higher in Alaska and Hawaii. Medicare advises applying if you are close, because applying costs nothing.
Does Extra Help cover brand-name drugs?
Yes, if your plan covers the drug. You pay no more than $12.65 for a covered brand-name prescription in 2026, or $4.90 at the lowest income levels.
Do I have to reapply for Extra Help every year?
Not usually. Medicare says that if you still meet the limits for the next year you keep Extra Help, and it sends a notice only if you no longer qualify or are moved to a different plan.
Want the numbers for your own prescription? Pick your drug and see which programs it offers, what each one requires, and the source we checked.
Sources
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This article is general information, not medical, legal or financial advice. Program rules change, so check the program’s own page before you apply.