Short answer
What is Medicare Extra Help, and who may qualify?
Extra Help is a Medicare program that helps people with limited income and resources pay Part D drug costs, and for 2026 the limits are $23,940 a year in income and $18,090 in resources for an individual ($32,460 and $36,100 for a married couple). (Medicare.gov, Help with drug costs) (Social Security, POMS HI 03001.020) People with full Medicaid, a Medicare Savings Program, or SSI get it automatically. (Medicare.gov, Help with drug costs) In 2027, people with Extra Help may pay a $0 plan premium and pay a $0 deductible and up to $5.80 for each generic or $14.40 for each brand-name drug, estimated until your plan confirms your costs. (Medicare.gov, Help with drug costs) (CMS, CY 2027 Rate Announcement, Table V-2)
| Fact | Individual | Married couple | Source |
|---|---|---|---|
| Yearly income limit, 2026 (official) | $23,940 | $32,460 | Medicare.gov; SSA POMS |
| Resource limit, 2026 (official) | $18,090 | $36,100 | Medicare.gov; SSA POMS |
| Who gets it automatically | Full-benefit Medicaid, a Medicare Savings Program, or SSI | Same | Medicare.gov |
| What you may pay in 2027 (estimated) | $0 deductible; may pay a $0 premium; up to $5.80 generic, $14.40 brand name; $0 after $2,400 in total drug costs | Same | Medicare.gov; CMS |
| How to apply | Online with Social Security, or call 1-800-772-1213 for an appointment | Same | SSA |
Source: Medicare.gov, Help with drug costs; Social Security, Apply for Medicare Part D Extra Help; CMS, CY 2027 Rate Announcement. Verified .
Social Security or your state decides eligibility. Benefit Bull is free and never applies for you.
Drug costs are the Medicare bill people most often stretch, split pills over, or skip. Extra Help is the federal program built for that problem. It helps pay Part D premiums, deductibles, coinsurance, and other costs, and while you have it you do not pay a Part D late enrollment penalty. (Medicare.gov, Help with drug costs)
The years matter on this page. The income and resource limits shown are for 2026, because the 2027 limits are not out yet. The costs shown are for 2027, because CMS has already set them. (Medicare.gov, Help with drug costs) (CMS, CY 2027 Rate Announcement, Table V-2)
What is Medicare Extra Help, and who may qualify?
"Extra Help" is a Medicare program to help people with limited income and resources pay Medicare drug coverage (Part D) costs. Some people get it automatically, and other people have to apply. (Medicare.gov, Help with drug costs)
Social Security's rules say you may be eligible if you have Medicare Part A or Part B, live in one of the 50 states or the District of Columbia, are not incarcerated, have income below 150 percent of the federal poverty level, have resources within the limits, apply (or are deemed eligible), and enroll in a Medicare drug plan. Starting January 1, 2024, everyone who gets Extra Help receives the full subsidy. (Social Security, POMS HI 03001.020)
Extra Help is not available in Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands, or American Samoa. Those areas have other programs, so call your State Medical Assistance (Medicaid) office there. (Medicare.gov, Help with drug costs)
Before you decide you earn too much, multiply your monthly income by 12 and compare it with the yearly limit. The limits are yearly, not monthly.
What is the income limit for Extra Help in 2026?
| Your situation | Yearly income limit | Resource limit |
|---|---|---|
| Individual | $23,940 | $18,090 |
| Married couple | $32,460 | $36,100 |
The income limits are 150 percent of the 2026 federal poverty level, which is $15,960 a year for one person and $21,640 for two. (Social Security, POMS HI 03001.020) Medicare.gov says these limits may go up each year. (Medicare.gov, Help with drug costs) Alaska and Hawaii use separate, slightly higher poverty levels. (Social Security, POMS HI 03001.020)
The resource limits include $1,500 per person for burial expenses, and the cash surrender value of life insurance does not count as a resource. (Social Security, POMS HI 03001.020) Indiana's SHIP office lists what counts in plain terms: checking and savings accounts, stocks, bonds, mutual funds, and IRAs count, while your home, car, household items, and burial plot do not. (Indiana SHIP, Help paying for your Medicare costs)
Count your bank and retirement balances as of today. Your home and car stay out of the total.
Who gets Extra Help automatically?
You get Extra Help automatically if you get full-benefit Medicaid coverage, help from your state paying your Part B premiums through a Medicare Savings Program, or Supplemental Security Income (SSI) payments from Social Security. You get a notice in the mail that tells you what you will pay and which drug plan you are in. (Medicare.gov, Help with drug costs)
If you get Extra Help automatically and do not have a drug plan, Medicare enrolls you in one, and you can pick a different plan if you want. Once you have Extra Help, you keep it through December 31 even if your income changes during the year. If you do not get a notice from Medicare or Social Security, you keep Extra Help and the same plan for next year. (Medicare.gov, Help with drug costs)
A grey notice from Medicare, mailed in September, means you will no longer get Extra Help automatically next year. Medicare says to apply for Extra Help through Social Security or a Medicaid office. (Medicare.gov, Loss of Deemed Status Notice)
If you already have Medicaid, an MSP, or SSI, watch your mail instead of filing a new application. Keep any grey notice and act on it.
What will you pay with Extra Help in 2027?
For 2027, Medicare.gov lists a $0 plan deductible and copays of up to $5.80 for each generic drug and up to $14.40 for each brand-name drug at your plan's participating pharmacies. Once your total drug costs reach $2,400, you pay $0 for each covered drug. (Medicare.gov, Help with drug costs) (CMS, CY 2027 Rate Announcement, Table V-2)
Medicare.gov also lists a $0 plan premium for 2027, so you may pay a $0 premium. Social Security explains the limit: premium help covers up to the greater of the lowest plan premium or the CMS benchmark amount in your area, so you may still pay part of the premium if you pick a plan that costs more than the benchmark. (Medicare.gov, Help with drug costs) (Social Security, POMS HI 03001.020)
| Cost | 2026 | 2027 |
|---|---|---|
| Deductible | $0 | $0 |
| Generic drug, everyone else with Extra Help (including full Medicaid with income above 100 percent of poverty) | Up to $5.10 | Up to $5.80 |
| Brand-name drug, everyone else with Extra Help (including full Medicaid with income above 100 percent of poverty) | Up to $12.65 | Up to $14.40 |
| Generic drug, full Medicaid with income at or below 100 percent of poverty | Up to $1.60 | Up to $1.65 |
| Brand-name drug, full Medicaid with income at or below 100 percent of poverty | Up to $4.90 | Up to $5.00 |
| Full Medicaid in an institution or getting home and community-based services | $0 | $0 |
| After the out-of-pocket threshold | $0 after $2,100 | $0 after $2,400 |
Which row applies to you depends on your coverage. The lowest copays, up to $1.60 for a generic and $4.90 for a brand-name drug in 2026, are for people with full Medicaid whose income is at or below 100 percent of the poverty level. People with full Medicaid with income above that, and everyone else with Extra Help, have the higher 2026 maximums of $5.10 and $12.65. (CMS, CY 2026 LIS memo, Table 2) For 2027, CMS set the lowest tier at up to $1.65 for a generic and $5.00 for a brand-name drug. If you see a lower 2027 figure elsewhere, go by the CMS table, and ask your plan to confirm your costs. (CMS, CY 2027 Rate Announcement, Table V-2)
When you compare drug plans, check whether the premium is fully covered by Extra Help in your area. Ask the plan, or call 1-800-MEDICARE, before you switch.
How do you apply for Extra Help?
Apply online through Social Security, or call 1-800-772-1213 and tell the representative you want to set up an appointment to apply for Part D Extra Help. TTY users can call 1-800-325-0778. Phone lines are open Monday through Friday, 8 a.m. to 7 p.m. in most time zones. (Social Security, Part D Extra Help) You can apply any time before or after you enroll in Part D. (Social Security, Part D Extra Help)
Social Security asks you to gather these documents for you and your spouse: (Social Security, Part D Extra Help)
- Bank statements and tax returns
- Individual Retirement Account (IRA) or 401(k) account balances
- Statements for pensions, Veterans' benefits, annuities, and Railroad Retirement Board benefits
You can apply for Extra Help and Medicare Savings Programs at the same time: Social Security will send information to your state to start an MSP application unless you tell them not to on the Extra Help application. Your State Health Insurance Assistance Program (SHIP) can help you apply for free. (Medicare.gov, Help with drug costs) If you do not qualify now, you can reapply any time your income and resources change. (Medicare.gov, Help with drug costs)
You submit your application yourself on the official site. Benefit Bull is free and never files for you.
Gather the bank, retirement, and benefit statements for you and your spouse before you open the online form. It goes faster with the numbers in front of you.
What if you can't afford your prescriptions now?
Medicare's Limited Income Newly Eligible Transition (LI NET) program gives temporary Medicare Part D drug coverage to people who qualify for Extra Help or Medicaid but are not enrolled in a Medicare drug plan yet. You may be able to get some money back if you paid for covered Part D drugs after you qualified for LI NET. Keep your receipts and call LI NET at 1-800-783-1307 (TTY 711), 8 a.m. to 7 p.m. Eastern time. (Medicare.gov, Help with drug costs)
Most people with Medicare can only switch plans at certain times of the year, but if you have Medicaid or get Extra Help, you may be able to change your drug coverage once per month. (Medicare.gov, Help with drug costs)
If you have Extra Help and think you are paying the wrong amount, contact your drug plan, which may ask for proof that you get Extra Help, and tell it how many days of medication you have left. You can also call 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048. (Medicare.gov, Help with drug costs)
If you have Extra Help or Medicaid and no drug plan yet, call LI NET before you pay cash for a covered drug, and keep every receipt.
What Extra Help numbers should you know?
- $23,940
- Official 2026 yearly income limit, individual
- $18,090
- Official 2026 resource limit, individual
- $0
- Estimated 2027 deductible with Extra Help
- Up to $14.40
- Estimated 2027 maximum per brand-name drug, most enrollees
See which Medicare help programs may fit your household, with estimated values and official links.
Sources: (Medicare.gov, Help with drug costs) (Social Security, POMS HI 03001.020) (CMS, CY 2027 Rate Announcement, Table V-2)
What this adds up to
Extra Help may cut your Medicare drug costs to a $0 deductible and capped copays: in 2027, up to $5.80 for a generic and $14.40 for a brand-name drug for most enrollees, with a $0 premium possible depending on your plan. (Medicare.gov, Help with drug costs) (CMS, CY 2027 Rate Announcement, Table V-2) (Social Security, POMS HI 03001.020) For 2026, the limits are $23,940 a year in income and $18,090 in resources for one person. If you have full Medicaid, a Medicare Savings Program, or SSI, you get it automatically; otherwise you apply yourself through Social Security, online or at 1-800-772-1213. (Medicare.gov, Help with drug costs) (Social Security, Part D Extra Help) For more on senior benefits, see The Senior Money Checklist.
Sources
Every claim above links to the source it came from. Figures checked October 2026. Last updated October 18, 2026.
- Medicare.gov, Help with drug costs (Extra Help) (accessed October 18, 2026)
- Social Security Administration, Apply for Medicare Part D Extra Help program (accessed October 18, 2026)
- Social Security Administration, POMS HI 03001.020, Eligibility for Extra Help (Prescription Drug Low-Income Subsidy), 02/11/2026 (accessed October 18, 2026)
- Centers for Medicare and Medicaid Services, Announcement of Calendar Year 2027 Medicare Advantage Capitation Rates and Part C and Part D Payment Policies, April 6, 2026, Table V-2 (PDF) (accessed October 17, 2026)
- Centers for Medicare and Medicaid Services, Calendar Year 2026 Resource and Cost-Sharing Limits for Low-Income Subsidy (LIS), October 31, 2025, Table 2 (PDF) (accessed October 17, 2026)
- Medicare.gov, Loss of Deemed Status Notice (grey notice) (accessed October 18, 2026)
- Medicare.gov, Medicare Savings Programs (accessed October 17, 2026)
- Indiana Department of Insurance, SHIP, Help paying for your Medicare costs (accessed October 18, 2026)
