Quick Answer: In 2026, Medicare Part D Extra Help (also called the Low Income Subsidy, or LIS) is available to people with income up to 150% of the Federal Poverty Level -- roughly $23,940 for a single person or $32,460 for a married couple. Qualifying reduces your prescription drug costs to near zero.
Prescription drugs are one of the biggest out-of-pocket expenses for people on Medicare. A single brand-name drug can cost hundreds of dollars per month without help. Medicare Part D Extra Help -- officially known as the Low Income Subsidy (LIS) -- is a federal program that slashes those costs dramatically for people with limited income and assets. As of 2026, over 14 million Medicare beneficiaries receive Extra Help, but millions more qualify and have not yet applied.
This guide covers the 2026 income limits, resource limits, what the benefit actually covers, how to check if you qualify automatically, and how to apply if you do not.
What Is Medicare Part D Extra Help?
Medicare Part D is the prescription drug coverage component of Medicare. It is delivered through private insurance plans approved by Medicare. Without financial assistance, Part D enrollees pay monthly premiums, annual deductibles, and copayments for each drug.
Extra Help is a federal subsidy program run jointly by Medicare and the Social Security Administration (SSA). It pays most or all of those costs for people who meet income and asset limits. The formal name at SSA is the Low Income Subsidy (LIS). Medicare.gov calls it "Extra Help." Both terms refer to the same program.
There are two levels of Extra Help -- full and partial -- each with different benefit amounts. The 2026 rules describe below.
2026 Extra Help Income Limits
Extra Help eligibility is based on your income compared to the Federal Poverty Level (FPL). The 2026 threshold is 150% FPL.
| Household Size | Annual Income Limit | Monthly Income Limit |
|---|
| 1 person | $23,940 | $1,995 |
| 2 people | $32,460 | $2,705 |
| 3 people | $40,980 | $3,415 |
| 4 people | $49,500 | $4,125 |
| Each additional person | +$8,520 | +$710 |
Source: SSA 2026 Extra Help guidelines. Income limits are for the contiguous 48 states. Alaska and Hawaii have higher limits.
These figures include a $20 per month income disregard that SSA applies automatically. In practice, your counted income is slightly lower than your gross income, so some people right at the edge still qualify.
Income that counts includes wages, Social Security benefits, pensions, rental income, and most investment income. Income that does not count includes SNAP benefits, housing assistance, and some other public benefits.
2026 Extra Help Resource Limits
In addition to income, SSA looks at your financial resources -- savings, investments, and other assets. The 2026 resource limits are:
| Who | Resource Limit |
|---|
| Individual | $16,590 |
| Married couple | $33,100 |
Resources that count: checking and savings accounts, stocks, bonds, mutual funds, IRAs, and cash.
Resources that do NOT count: your primary home, one vehicle, personal belongings, life insurance with face value under $1,500, and burial funds up to $1,500.
If your resources are just over the limit, it is worth applying anyway. SSA calculations are nuanced and many applicants who expect to be denied are approved.
Who Gets Extra Help Automatically (No Application Needed)
Some Medicare beneficiaries receive Extra Help automatically, without filing any paperwork. You are automatically enrolled if you:
- Have both Medicare and full Medicaid (sometimes called "dual eligible")
- Receive Supplemental Security Income (SSI)
- Are enrolled in a Medicare Savings Program (MSP)
If you fall into any of these categories, you should receive a notice from Medicare each year confirming your Extra Help status. If you have not received that notice and you believe you should qualify automatically, call Medicare at 1-800-MEDICARE (1-800-633-4227).
What Extra Help Pays For in 2026
Once you qualify, here is what Extra Help covers in 2026:
Full Extra Help (most beneficiaries):
- No monthly Part D premium (up to the benchmark plan premium)
- No Part D deductible
- Copays capped at $5.10 for generics and $12.65 for brand-name drugs
- No copays at all once your total drug costs reach $2,100 for the year (the catastrophic coverage threshold)
Partial Extra Help:
- Reduced premium assistance
- Reduced or no deductible
- Lower copays than standard Part D, though higher than full Extra Help
The majority of people who qualify receive full Extra Help. The distinction between full and partial depends on whether you meet both the income and resource limits at the full subsidy level, or fall in a range where partial assistance applies.
How Much Can You Save?
The savings are substantial. Without Extra Help, a typical Part D plan in 2026 might cost:
- Monthly premium: $35 to $100+
- Annual deductible: up to $615
- Drug copays: 25% of drug cost in the coverage gap
With full Extra Help, those same costs drop to zero premiums (if you pick a benchmark plan), zero deductible, and $5.10 to $12.65 per drug. For someone on multiple brand-name medications, that can mean thousands of dollars per year in savings.
Extra Help and Medicare Savings Programs
Extra Help and Medicare Savings Programs (MSPs) are separate but related. MSPs help with Medicare Part A and Part B costs -- premiums, deductibles, and copays. Extra Help specifically covers Part D drug costs.
If you qualify for an MSP, you automatically qualify for Extra Help too. The reverse is not true: you can receive Extra Help without qualifying for an MSP. Applying for one does not automatically enroll you in the other, though SSA will sometimes screen for both.
You can check eligibility for both programs at coveredusa.org/screener. The screener covers all Medicare cost-assistance programs and takes about two minutes to complete.
How to Apply for Extra Help in 2026
Applying is free. There are four ways to do it:
Option 1: Apply online at SSA.gov
- Go to ssa.gov/medicare/part-d-extra-help
- Click "Apply for Extra Help"
- Create or log into your my Social Security account
- Complete the online application (takes 15 to 30 minutes)
- Submit and wait for a determination letter by mail
Option 2: Call SSA
- Call 1-800-772-1213 (TTY: 1-800-325-0778)
- Tell the representative you want to apply for Part D Extra Help
- They can take the application over the phone or mail you Form SSA-1020
Option 3: Visit your local SSA office
- Find your nearest office at ssa.gov/locator
- Bring proof of income, bank statements, and your Medicare card
- Staff will help you complete Form SSA-1020 in person
Option 4: Apply through your State Medicaid office
Your state may have a combined application that screens for Medicaid, MSPs, and Extra Help at the same time. Contact your state Medicaid office or call your State Health Insurance Assistance Program (SHIP) for guidance.
What Documents to Gather Before You Apply
Having these ready speeds up the process:
- Medicare card (or Medicare number)
- Social Security number
- Recent bank statements (checking, savings, money market)
- Recent investment statements (IRAs, stocks, bonds)
- Proof of income (Social Security award letter, pension statements, recent pay stubs if working)
- Information on any other insurance you have
You do not need to submit all documents upfront. SSA will request any additional verification if needed.
After You Apply
SSA typically processes Extra Help applications within a few weeks. You will receive a letter stating whether you are approved or denied.
If approved, the letter will tell you your benefit level (full or partial) and when it starts. If you do not already have a Part D plan, Medicare will automatically enroll you in a benchmark plan in your area. You can switch to a different plan during any enrollment period.
If denied, you have the right to appeal. Contact SSA within 60 days of the denial letter to request reconsideration.
Extra Help Enrollment Periods
Extra Help itself has no enrollment deadline -- you can apply any time of year. However, using Extra Help to change your Part D plan follows Medicare enrollment rules:
- Once approved for Extra Help, you can switch Part D plans once per quarter (January through September) and once during the Annual Enrollment Period (October 15 to December 7).
- If you lose Extra Help eligibility, you get a Special Enrollment Period to switch plans.
Does Extra Help Renew Automatically?
For most beneficiaries, yes. If you are automatically enrolled (dual eligible, SSI, MSP), your status renews each year without reapplication.
If you applied directly through SSA, the agency redetermines eligibility annually. SSA will mail you a questionnaire. Respond promptly to avoid a gap in coverage. If your income or resources have changed, you may need to report that.
State Pharmaceutical Assistance Programs (SPAPs)
Many states offer their own drug assistance programs that layer on top of Extra Help. These State Pharmaceutical Assistance Programs (SPAPs) can help with costs that Extra Help does not cover -- particularly for higher-cost drugs or if you are on a partial subsidy.
Whether an SPAP exists in your state and what it covers varies significantly. Contact your state SHIP office to ask about local programs.
Check Your Eligibility Now
Not sure if you qualify? The CoveredUSA screener checks your eligibility for Extra Help, Medicare Savings Programs, Medicaid, and other coverage options based on your income and household. It takes two minutes, costs nothing, and is available in English and Spanish. Check your eligibility now at CoveredUSA -- it takes 2 minutes.
You can also reach Medicare at 1-800-MEDICARE (1-800-633-4227), or your local SHIP office for free, unbiased counseling.
Frequently Asked Questions
What is the income limit for Medicare Extra Help in 2026?
In 2026, the income limit for Extra Help is 150% of the Federal Poverty Level -- $23,940 per year for a single person and $32,460 for a couple. Monthly that is approximately $1,995 for one person and $2,705 for two. SSA applies a $20 monthly income disregard, so your counted income is slightly lower than your gross income.
What counts as income for Extra Help?
SSA counts wages, Social Security benefits, pensions, annuities, rental income, and most investment income. It does not count SNAP benefits, housing subsidies, the first $20 per month of most income sources, or income of household members who are not applying.
What is the difference between Extra Help and a Medicare Savings Program?
Extra Help pays for Part D prescription drug costs -- premiums, deductibles, and drug copays. Medicare Savings Programs (MSPs) pay for Part A and Part B costs -- hospital premiums, outpatient premiums, and cost-sharing. They are different programs with separate applications, though qualifying for an MSP automatically qualifies you for Extra Help.
Do I have to reapply for Extra Help every year?
If you receive Extra Help automatically (because of dual Medicare/Medicaid status, SSI, or MSP enrollment), it renews automatically. If you applied directly through SSA, you will receive an annual redetermination form to complete. Respond to that form to keep your coverage.
Can I get Extra Help if I have a 401(k) or IRA?
Retirement accounts like 401(k)s and IRAs count toward the resource limit. In 2026, that limit is $16,590 for an individual and $33,100 for a couple. If your total countable resources (savings, investments, retirement accounts) are below those thresholds, you can still qualify.
What happens to my Part D plan if I get Extra Help?
If you do not already have a Part D plan when you are approved for Extra Help, Medicare will automatically enroll you in a benchmark plan in your area. You can switch to any Part D plan that meets your needs during your quarterly enrollment windows or the Annual Enrollment Period.
Can I still qualify if I am over the income limit?
Possibly. SSA applies certain income exclusions that lower your counted income below your gross income. If you are close to the limit, applying is worth it. Additionally, your state may have its own pharmaceutical assistance program for people who do not qualify for Extra Help.
How long does the Extra Help application take to process?
SSA typically processes applications within a few weeks. Complex cases may take longer. You will receive a written determination by mail. If approved, coverage is generally retroactive to the month you applied.
Is Extra Help the same as the Low Income Subsidy (LIS)?
Yes. Extra Help and Low Income Subsidy (LIS) are two names for the same program. Medicare.gov uses "Extra Help." SSA and insurance plans often use "LIS." You may see either term in official communications -- they refer to identical benefits.
