Extra Help Income Limits 2026: Chart, Costs and How to Apply
Reviewed October 4, 2026. For 2026, you can qualify for Medicare Extra Help if your annual income is below $23,940 for an individual or $32,460 for a married couple living together, and your resources are below $18,090 for an individual or $36,100 for a couple (Social Security). Extra Help, also called the Part D Low-Income Subsidy (LIS), lowers your prescription drug premiums, deductibles and copays. Social Security estimates it’s worth about $5,700 a year.
Quick answer: Check the 2026 limits below, then apply free online at ssa.gov/medicare/part-d-extra-help or by calling Social Security at 1-800-772-1213 (TTY 1-800-325-0778). If you have full Medicaid, SSI, or a Medicare Savings Program, you already get Extra Help automatically.
Extra Help income limits 2026 chart
| Household | Annual income limit | About per month | Resource limit |
|---|---|---|---|
| Individual | $23,940 | $1,995 | $18,090 |
| Married couple living together | $32,460 | $2,705 | $36,100 |
Annual limits and resource limits are from Medicare.gov and Social Security. Monthly amounts are the annual limit divided by 12 and are rounded. The resource limits include up to $1,500 per person that you say you’ll use for funeral or burial expenses. Without that, the 2026 limits are $16,590 for an individual and $33,100 for a couple (CMS).
When your income can be higher
Social Security says you may still qualify with income above these limits if you support other family members who live with you, have earnings from work, or live in Alaska or Hawaii. Some income isn’t counted at all. If you’re close, apply anyway: there’s no cost, and Social Security makes the decision.
What counts as resources for Extra Help
| Counts as resources | Doesn’t count |
|---|---|
| Bank accounts (checking and savings) | Your home |
| Stocks, bonds and mutual funds | Your car(s) |
| IRAs and similar retirement accounts | Personal possessions |
| Cash at home | Life insurance policies |
| Real estate other than your home | Burial plots and money set aside for burial |
| Certain payments for nine months, such as retroactive Social Security benefits and tax refunds |
Based on Social Security’s Understanding the Extra Help with Your Medicare Prescription Drug Plan (August 2026).
What Extra Help pays in 2026 and 2027
| Cost | 2026 with Extra Help | 2027 with Extra Help |
|---|---|---|
| Drug plan premium | $0 in plans at or below your region’s benchmark premium | $0 in plans at or below your region’s benchmark premium |
| Deductible | $0 | $0 |
| Generic drugs | Up to $5.10 each | Up to $5.80 each |
| Brand-name drugs | Up to $12.65 each | Up to $14.40 each |
| After out-of-pocket cap | $0 after $2,100 | $0 after $2,400 |
Sources: CMS 2026 LIS memo and Medicare.gov. People with full Medicaid and income at or below 100% of the federal poverty level pay even less in 2026: $1.60 for generics and $4.90 for brand-name drugs. If you pick a plan that costs more than the benchmark, you pay the difference in premium. For how the coverage stages work, see how Medicare Part D works.
Who gets Extra Help automatically
According to Medicare.gov, you automatically qualify, and don’t need to apply, if you have:
- Full Medicaid coverage
- Supplemental Security Income (SSI)
- Help from your state paying your Part B premium through a Medicare Savings Program (QMB, SLMB or QI)
Medicare mails a purple notice to people who automatically qualify. If you qualify automatically but don’t choose a drug plan, Medicare generally enrolls you in one so you have coverage.
How to apply for Extra Help
- Gather information. Have your Social Security number, recent bank statements, investment and retirement account statements, and proof of income such as pension or benefit letters. Social Security may verify information with other agencies.
- Apply online, by phone or in person. Use the online application at ssa.gov/medicare/part-d-extra-help, call 1-800-772-1213 (TTY 1-800-325-0778), or visit your local Social Security office.
- Watch for the decision letter. Social Security will tell you whether you qualify and at what level.
- Join or keep a drug plan. Extra Help works with a Part D plan or a Medicare Advantage plan with drug coverage. Compare plans in Medicare Plan Finder.
- Respond to reviews. Social Security may review your eligibility. Report changes in income, resources or marriage.
Applying for Extra Help can also start an application for a Medicare Savings Program with your state, which may pay your Part B premium. Free help applying is available from your State Health Insurance Assistance Program (SHIP).
Other benefits of Extra Help
- No late enrollment penalty: you won’t pay the Part D late enrollment penalty while you get Extra Help.
- More chances to change plans: Medicare.gov says people with Extra Help may be able to change drug coverage once a month, not just during Open Enrollment.
- Lower copays all year: your copays are capped from the first prescription, with no deductible.
Examples using the 2026 limits
- Single, $1,800 a month in Social Security, $9,000 in savings. Yearly income of $21,600 and resources are both under the limits, so this person likely qualifies.
- Married couple, $2,500 a month combined, $30,000 in savings and an IRA combined. Income ($30,000 a year) and resources are under the couple limits, so they likely qualify.
- Single, $2,300 a month, $5,000 in savings. Income of $27,600 is above the individual limit. Unless special income rules apply, this person may not qualify, but should still check the state Medicare Savings Program and the Medicare Prescription Payment Plan.
These examples are simplified and use only the published limits. Social Security decides based on your full situation.
Extra Help vs. Medicare Savings Programs vs. Medicaid
| Program | Run by | What it helps with |
|---|---|---|
| Extra Help (Low-Income Subsidy) | Social Security and Medicare | Part D premiums, deductibles and copays |
| Medicare Savings Programs | Your state Medicaid office | Part B premium, and for QMB also Medicare deductibles and coinsurance |
| Full Medicaid | Your state | Broad health coverage, including some services Medicare doesn’t cover |
You can get more than one. Qualifying for a Medicare Savings Program or full Medicaid gives you Extra Help automatically. Learn how Medicare and Medicaid work together in our dual eligibility guide.
If your application is denied
Social Security’s letter explains the decision and how to appeal. Common reasons are income or resources over the limit, or missing information. If your situation changes, for example your savings drop or your spouse’s income stops, you can apply again at any time. You can also ask your state about a Medicare Savings Program, which has its own rules and may use more generous limits.
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. You may qualify with higher income in some situations, such as supporting family members or living in Alaska or Hawaii.
What is the resource limit for Extra Help in 2026?
$18,090 for an individual and $36,100 for a married couple, including up to $1,500 each for burial expenses. Your home, car and life insurance don’t count.
How much are Extra Help copays in 2027?
Medicare.gov lists up to $5.80 for each generic and $14.40 for each brand-name drug, with a $0 deductible and $0 after your costs reach $2,400.
Does Extra Help pay my Part D premium?
Yes, in full if you choose a plan at or below your region’s benchmark premium. If you choose a more expensive plan, you pay the difference.
Do I need to reapply for Extra Help every year?
Not usually. Social Security may review your eligibility, and you must report changes. If you qualify automatically through Medicaid, SSI or a Medicare Savings Program, Medicare checks your status each year and will send a notice if it changes.
Can I get Extra Help with a Medicare Advantage plan?
Yes. Extra Help applies to the drug coverage in a Medicare Advantage plan that includes Part D.
This article is general information, not individual insurance advice. Medicare365 is not affiliated with or endorsed by the U.S. government, Social Security or the federal Medicare program.