Extra Help for Medicare Part D: 2026 Income Limits & How to Apply
In 2026, you can get Extra Help paying for Medicare drug coverage if your yearly income is at or below $23,940 for a single person or $32,460 for a married couple living together, and what you own (not counting your home or car) is at or below $18,090 single or $36,100 married. If you qualify, you pay a $0 premium, $0 deductible, and no more than $5.10 per generic or $12.65 per brand-name prescription. You apply free through Social Security — never through an insurance company or a website like ours.
- $0monthly premium (benchmark plans)
- $0yearly deductible
- $5.10 / $12.65max copay generic / brand
- $0after $2,100 out of pocket
What Extra Help is — and why so many people miss it
Extra Help is a federal program, run by Social Security, that pays most Medicare Part D drug costs for people with limited income and savings. It’s also called the Low-Income Subsidy, or LIS. Same program, two names.
Here’s the problem: many people who qualify never apply. Some assume they earn too much. Some have never heard of it. Some think it’s a sales pitch. Meanwhile they keep paying full premiums, a full deductible, and full copays every single month. If your income is anywhere near the limits below, the ten-minute application is worth it — and it costs nothing to find out.
One rule to remember: Extra Help is never sold. There’s no product, no enrollment fee, and no salesperson. You apply directly with Social Security, online or by phone. Anyone who asks you to pay to apply is not legitimate.
The 2026 income and resource limits
Two things decide eligibility: your income, and your “resources” (what you own that could be turned into cash). You must be at or below both limits. The income limit is 150% of the federal poverty level — for one person that’s $15,960 × 1.5 = $23,940.
2026 Extra Help limits (48 states and D.C.)
Your situation | Yearly income limit | Resource limit |
|---|---|---|
Single | $23,940 | $18,090 |
Married, living together | $32,460 | $36,100 |
Alaska and Hawaii: income limits are higher — Alaska $29,925 single / $40,575 married; Hawaii $27,540 single / $37,335 married. Resource limits are the same everywhere.
About the resource figures: they include a $1,500-per-person allowance for burial expenses. If you tell Social Security you don’t expect to use any savings for burial costs, the limits are $16,590 single / $33,100 married.
Close to a limit? Apply anyway. Social Security doesn’t count everything (see below), so people slightly over these numbers can still qualify. Only Social Security can make the actual decision.
Where Extra Help exists: all 50 states and D.C. It’s not offered in Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands, or American Samoa — those areas have separate programs through the local Medicaid office.
What counts as a “resource” — and what doesn’t
Counts toward the limit
- Checking and savings accounts
- Stocks, bonds, and mutual funds
- IRAs and similar retirement accounts
- Cash at home or anywhere else
- Real estate other than the home you live in
Never counts
- The home you live in
- Your vehicles
- Household items and personal belongings
- A burial plot, plus up to $1,500 per person set aside for burial expenses
- Life insurance policies
Some people get Extra Help automatically
You don’t need to apply — you already get Extra Help — if any of these is true:
You have Medicaid
Full-benefit Medicaid coverage alongside your Medicare.
You’re in a Medicare Savings Program
Your state helps pay your Part B premium (QMB, SLMB, or QI).
You get SSI
Supplemental Security Income payments from Social Security.
If that’s you, a notice comes in the mail confirming your Extra Help and your drug plan. If you don’t have a Part D plan yet, Medicare enrolls you in one automatically so you don’t miss the savings — and you can switch to a different plan if you’d rather.
Quick check: could you qualify?
Answer four questions and we’ll compare your numbers to the official 2026 limits. This is a screening guide, not a decision — only Social Security can determine eligibility, and they don’t count everything you type here.
2026 Extra Help eligibility checker
Free · No sign-up · Nothing you enter is saved or sent
We use this to pick the right federal limits for where you live. We also check whether your state runs its own drug program.
Include Social Security benefits, pensions, and wages for you (and your spouse, if married).
Bank accounts, stocks, bonds, IRAs, and cash. Don’t include your home, vehicles, or life insurance.
This checker runs entirely in your browser. We don’t save, send, or see anything you type — including which state you pick. No sign-up, no follow-up calls.
How to apply — free, through Social Security
Extra Help is a federal benefit. The application is Social Security’s form SSA-1020, and applying is always free. Here’s the whole process:
- 1Gather your financial basics
Recent income amounts (Social Security benefits, pensions, wages) and rough balances for bank accounts, stocks, bonds, and IRAs. Exact-to-the-penny numbers aren’t required to start. - 2Apply with Social Security
Online at Social Security’s Extra Help page (about 10–15 minutes), by phone at 1-800-772-1213 (TTY 1-800-325-0778), Monday–Friday 8 a.m.–7 p.m., or on paper with form SSA-1020. Your local State Health Insurance Assistance Program (SHIP) will help you apply, free. - 3Watch the mail for your decision
Social Security mails a decision letter, usually within a few weeks — online applications tend to move fastest. You can also check your application status on ssa.gov. - 4If you qualify, the savings start
Medicare enrolls you in a drug plan if you don’t have one (you can pick a different one), and you keep Extra Help through at least December 31 — even if your income changes mid-year. One more perk: while you have Extra Help, you can switch drug plans once a month, and you pay no Part D late enrollment penalty.
Apply free at ssa.gov →Find free local SHIP help
Why we send you to ssa.gov: Extra Help has no middleman. No insurance company, agent, or comparison site — including this one — can apply for you, speed it up, or improve your odds. The official application is the only application. That’s where you should go, so that’s where we point.
What your drugs cost with Extra Help in 2026
2026 costs with full Extra Help
Cost | Without Extra Help (typical) | With Extra Help |
|---|---|---|
Monthly plan premium | Varies by plan | $0 for many plans in your area¹ |
Yearly deductible | Up to $615 | $0 |
Generic prescription | Plan copay or coinsurance | $5.10 or less² |
Brand-name prescription | Plan copay or coinsurance | $12.65 or less² |
After $2,100 out of pocket | $0 (applies to everyone) | $0 |
¹ Extra Help covers the premium up to a benchmark amount set for your region each year. Plans at or below the benchmark cost you $0; choose a more expensive plan and you pay only the difference.
² These are the 2026 maximums for people between 100% and 150% of the poverty level. If you also have full Medicaid, your copays are lower still — between $0 and $4.90 — and $0 if you live in a nursing home or get long-term care services at home.
Don’t qualify? Some states run their own drug-cost programs
Extra Help isn’t the only help. Some states run their own programs that help with drug costs — called State Pharmaceutical Assistance Programs, or SPAPs. They can pay your Part D plan premium, lower your copays, or both, and each state sets its own rules.
Here’s why they matter if Social Security turned you down: these programs generally have no savings test, and most have higher income limits than Extra Help. So if you were denied because of savings or investments — the most common reason people just over the line miss out — your state’s program may still say yes.
States with comprehensive senior drug-assistance programs
State | Program | Who it’s for |
|---|---|---|
Delaware | Age 65+ or on Social Security disability. Income limits apply. You can also qualify if your drug costs are high compared to your income. | |
Indiana | Age 65+. Uses the same income limit as Extra Help but has no savings test — built for people who miss Extra Help only because of savings. Helps pay Part D premiums — works with certain drug plans only. | |
Maine | Age 62+ (or 19+ with a disability). Income limits apply, with an allowance if drug costs are high. Apply through Maine DHHS. | |
Maryland | People with Medicare; income limits apply. Helps pay your Part D plan premium. Only for people who don’t qualify for full Extra Help or Medicaid. | |
Massachusetts | Age 65+ (some younger people with disabilities). Income limits apply and reach well above the Extra Help limit. You must apply for Extra Help first. | |
Montana | People on Medicare with income under $31,920 single / $43,280 married (2026). Helps pay Part D premiums. Not for people whose premium Extra Help already fully covers. | |
New Jersey | Age 65+ or 18–64 on Social Security disability, with income under $54,943 single / $62,390 married (2026). Pays your drug plan’s premium up to a benchmark amount; prescriptions cost at most $5 generic / $7 brand. One NJSave application also checks you for Extra Help. | |
New Jersey | For incomes just above the PAAD limits — between $54,943 and $64,943 single / $62,390 and $72,390 married (2026). Same NJSave application as PAAD. | |
New York | Age 65+ with income under $75,000 single / $100,000 married (2026) — far above the Extra Help limit. The EPIC application doubles as your Extra Help application. | |
Pennsylvania | Age 65+. Two levels with different income limits (limits changed mid-2026 — check the current figures on the official page). | |
Rhode Island | Rhode Island Pharmaceutical Assistance to the Elderly (RIPAE) | Age 65+ (some people 55+ on Social Security disability). Income limits apply — check the current figures on the official page. Only for people who don’t have Extra Help or Medicaid. |
Vermont | People with Medicare who have a Part D plan. Three levels of help; income limits apply. The lowest level must apply for Extra Help first. | |
Wisconsin | Age 65+. No income cap — your income sets your level of help. $30-per-year enrollment fee. | |
U.S. Virgin Islands | Age 60+; income limits apply. Federal Extra Help isn’t offered in the territories — this program helps fill that gap. |
How these work with Extra Help: some states ask you to apply for Extra Help first as part of their application — New York’s EPIC even files it for you — and having Extra Help doesn’t disqualify you there. A few programs (Maryland, Montana, Rhode Island) are only for people who don’t have Extra Help — if Social Security said no, that’s exactly who they’re for. The rest don’t check either way. Each program’s page spells out its rule.
Two useful side effects: what a state program pays counts toward your $2,100 Part D out-of-pocket total for the year, so you reach the $0 stage sooner. And joining one gives you a once-a-year chance to switch Part D plans outside the usual enrollment windows (a Special Enrollment Period).
Your state isn’t listed, or you’re not sure? Some states offer smaller or condition-specific help that isn’t in this table. Your local State Health Insurance Assistance Program (SHIP) counselor knows what’s available where you live and helps for free: shiphelp.org or 1-877-839-2675. We link only to official state pages — these programs, like Extra Help, are never sold and have no middleman.
Sources
Every dollar figure on this page was verified against these primary sources on July 14, 2026. Limits change every year; this page is reviewed and re-verified annually when CMS and HHS publish new figures.
- Medicare.gov — Help with drug costs (2026 income/resource limits, copays, automatic qualification, and state pharmaceutical assistance programs)
- CMS — CY 2026 Resource and Cost-Sharing Limits for Low-Income Subsidy (Oct 31, 2025 memo: resource limits, copay table, $2,100 threshold)
- Social Security — Apply for Medicare Part D Extra Help (application channels and phone numbers)
- HHS ASPE — 2026 Poverty Guidelines (150% FPL calculations, including Alaska and Hawaii)
- Social Security — Form SSA-1020 (paper application)
- SHIP — State Health Insurance Assistance Program (free local help with Extra Help and state program applications)
- Each state program in the state programs section links to its official state page, where its eligibility rules were verified.
Content on this page is educational and is not an eligibility determination. Only the Social Security Administration can determine Extra Help eligibility. Extra Help is a federal program — we earn nothing when you apply, and we link you straight to the official Social Security application.