Extra Help (Medicare Part D Low-Income Subsidy): 2026 Limits and How to Qualify

What Extra Help is and what it pays for

Extra Help is a federal program that helps people with limited income and resources pay for Medicare Part D, the part of Medicare that covers prescription drugs. You may also see it called the Low-Income Subsidy, or LIS — they are the same thing.

When you have Extra Help, the program lowers several Part D costs at once. It is not a separate drug plan; it works alongside whatever stand-alone Part D plan or Medicare Advantage drug plan you choose.

• Pays your monthly Part D premium, up to the 2026 national base premium of $38.99 (if you pick a plan that costs more, you pay the difference).
• Reduces your Part D deductible to $0 for all Extra Help categories in 2026.
• Caps what you pay at the pharmacy counter to a few dollars per prescription.
• Removes the Part D late-enrollment penalty for as long as you have Extra Help.

2026 income and resource (asset) limits

There are two tests: an income test and a resource (asset) test. You generally must meet both, and you must live in one of the 50 states or the District of Columbia.

Income limit: For the 48 contiguous states and Washington, D.C., the 2026 limit is 150% of the federal poverty level, which the Social Security Administration states as about $23,475 a year for one person and about $31,725 a year for a married couple. Alaska and Hawaii have higher limits because the poverty level is higher there: roughly $29,925 single / $40,575 married in Alaska, and about $27,540 single / $37,335 married in Hawaii.

Resource limit: For 2026 the full LIS resource limit is $16,590 (single) and $33,100 (married). If you tell Social Security that you expect to use some of your savings for burial expenses, a $1,500-per-person set-aside raises the limit to the more commonly cited $18,090 (single) and $36,100 (married). These resource limits rose 3.01% from 2025 (the single no-burial limit went from $16,100 to $16,590).

What counts as a resource — and what doesn't

"Resources" means money and property that could quickly be turned into cash. Many of the things people worry about most are actually excluded.

• Counts: checking and savings accounts, stocks, bonds, and other liquid assets you could convert to cash within 20 days, plus real estate that is not your primary home.
• Does NOT count: the home you live in, your car, personal possessions, life insurance policies, and burial plots.
• Because your home and car are excluded, owning them does not by itself disqualify you from Extra Help.

What you'll pay for drugs in 2026

Your exact copays depend on your income level and living situation. All Extra Help categories have a $0 deductible in 2026.

• Income between 100% and 150% of poverty: up to $5.10 for each generic drug and up to $12.65 for each brand-name drug.
• Full-benefit dual-eligible with income at or below 100% of poverty: up to $1.60 generic / $4.90 brand.
• Living in a nursing home (institutionalized) or getting home- and community-based services: $0 for all covered drugs.
• After you reach the 2026 Part D out-of-pocket cap of $2,100, you pay $0 for covered drugs for the rest of the year — the same cap that protects every Part D enrollee under the Inflation Reduction Act.

Who automatically qualifies and how to apply

Some people get Extra Help automatically and do not need to apply. You are auto-enrolled if you have both Medicare and full Medicaid (dual-eligible), are enrolled in a Medicare Savings Program (QMB, SLMB, or QI), or receive Supplemental Security Income (SSI).

Everyone else applies through the Social Security Administration. There is no application fee and no annual deadline — you can apply at any time.

It helps to know the difference between Extra Help and a Medicare Savings Program (MSP). Extra Help lowers your prescription drug (Part D) costs. An MSP helps pay your Part B premium and other Part A/B costs. They are separate programs, but qualifying for an MSP automatically qualifies you for Extra Help.

• Apply online at the Social Security website.
• Apply by phone at 1-800-772-1213.
• Apply in person at a local Social Security office.

One full subsidy level (no more partial) and the late-penalty break

Before 2024, Extra Help had partial subsidy tiers (such as 25%, 50%, and 75% help). Under the Inflation Reduction Act, partial subsidies were eliminated starting January 1, 2024. Now everyone who qualifies — with income up to 150% of poverty — receives the full subsidy. There is no longer a reduced or partial level.

Having Extra Help also protects you from the Part D late-enrollment penalty. That penalty is normally 1% of the $38.99 national base premium for each full month you went without creditable drug coverage, added to your premium for life. While you have Extra Help, you do not owe it.