Full answer: In 2026, Medicare Extra Help (also called the Low-Income Subsidy or LIS) is available to people enrolled in Medicare Part A or Part B who have annual income below 150% of the Federal Poverty Level, which is $23,940 for a single person or $32,460 for a married couple in most states. You must also have limited resources of no more than $16,590 as a single person or $33,100 as a married couple (excluding your home, vehicle, and certain burial funds). Since the Inflation Reduction Act of 2022 took effect on January 1, 2024, there is only one level of Extra Help, which covers your full Part D premium up to the regional benchmark, eliminates your deductible, and caps your drug copays at $5.10 for generics and $12.65 for brand-name drugs in 2026.
Medicare Extra Help, also known as the Low-Income Subsidy (LIS), is a federal program that reduces out-of-pocket prescription drug costs for Medicare Part D enrollees with limited income and assets. In 2026, about 14 million Medicare beneficiaries receive this benefit, which can be worth over $5,000 per year in savings on drug premiums, deductibles, and copays.
Eligibility depends on two tests: an income test (below 150% of the Federal Poverty Level) and a resource test (below specific asset limits). Many people who qualify never apply because they assume they earn too much. This page shows the exact 2026 income and asset limits by household size so you can check eligibility in minutes.
2026 Resource (Asset) Limits for Extra Help
In addition to the income test, you must pass a resource test. Resources are things like bank accounts, stocks, bonds, CDs, and retirement accounts. The 2026 resource limits are set by CMS and adjusted annually using the Consumer Price Index.
If you notify SSA that you plan to use some of your savings for burial expenses, you can exclude up to an additional $1,500 per person from your countable resources, raising the limit to $18,090 single or $36,100 married.
2026 Extra Help Resource Limits| Household | Standard limit | With burial set-aside | Excluded from count |
|---|
| Single person | $16,590 | $18,090 | Home, 1 vehicle, personal property |
| Married couple | $33,100 | $36,100 | Home, 1 vehicle, personal property |
Countable resources include checking/savings accounts, CDs, stocks, bonds, mutual funds, and IRAs. Life insurance policies and the cash value of life insurance are generally counted.
Source: CMS CY2026 LIS Resource Limits Memo (October 31, 2025)
What Extra Help Covers in 2026: Benefits You Get
Since January 1, 2024, the Inflation Reduction Act of 2022 eliminated the old partial subsidy level. All Extra Help recipients now receive the same full Medicare Part D benefit package. This was a major expansion: previously, beneficiaries between 135% and 150% FPL only received a partial subsidy.
In 2026, Extra Help covers all of the following for eligible Part D enrollees:
- Part D premium: covered up to the regional benchmark premium (you pay the difference if your plan costs more)
- Part D deductible: $0 (waived completely)
- Generic drug copay: no more than $5.10 per fill in 2026
- Brand-name drug copay: no more than $12.65 per fill in 2026
- After $2,100 in out-of-pocket drug costs: $0 copays for the rest of the year (catastrophic phase)
- Coverage gap (donut hole): eliminated for Extra Help recipients
Who Gets Extra Help Automatically (Without Applying)
You do NOT need to apply for Extra Help if you already receive any of the following. SSA and CMS automatically enroll you and notify you by mail each fall about your drug plan assignment for the next year.
- Full Medicaid coverage (Medicaid that covers prescription drugs)
- Supplemental Security Income (SSI) from SSA
- Qualified Medicare Beneficiary (QMB) program
- Specified Low-Income Medicare Beneficiary (SLMB) program
- Qualifying Individual (QI) program
Medicare Savings Programs: Related but Different
Extra Help covers Part D drug costs. Medicare Savings Programs (MSPs) are separate state-run Medicaid programs that help with Part A and Part B costs like premiums, deductibles, and coinsurance. Many people qualify for both. Being enrolled in any MSP automatically qualifies you for Extra Help.
The four Medicare Savings Programs and their 2026 income thresholds (approximate, vary by state) are: QMB covers Part A and B premiums plus cost-sharing at about 100% FPL; SLMB covers Part B premium only at about 100 to 120% FPL; QI covers Part B premium at about 120 to 135% FPL; QDWI covers Part A premium for working disabled individuals at about 200% FPL. Apply for MSPs through your state Medicaid agency.
Common Reasons Extra Help Applications Are Denied
SSA denies roughly 1 in 5 Extra Help applications for one of these reasons. Most denials can be fixed by submitting missing documentation or correcting information within 60 days.
- Income above 150% FPL after counting all household members' income
- Resources above the limit (often because retirement accounts were not correctly excluded)
- Not enrolled in Medicare Part A or Part B at the time of application
- Missing or incomplete documentation (bank statements, proof of income)
- Failure to respond to SSA requests for additional information within the required window
Dual-Eligible Strategy: Stacking Extra Help With Medicaid
If your income falls below your state's Medicaid income limit (which varies but is typically around 100 to 138% FPL for adults), you may qualify for both Medicare and Medicaid, a status called dual eligibility. About 12 million Americans are dual-eligible. Dual eligibles receive Extra Help automatically and also get Medicaid covering services Medicare doesn't, such as long-term care, dental, and vision in many states.
Dual-eligible individuals enrolled in a Dual Special Needs Plan (D-SNP) can coordinate Medicare and Medicaid benefits in a single plan. D-SNPs often include zero-dollar drug copays, dental, vision, hearing, and transportation benefits beyond standard Extra Help.
Frequently Asked Questions
What is the income limit for Extra Help in 2026?
In 2026, the income limit for Extra Help is $23,940 per year for a single person and $32,460 per year for a married couple living together (in 48 states and D.C.). This equals 150% of the Federal Poverty Level. Each additional household member adds $8,520 to the limit. Alaska and Hawaii have higher limits. All types of income count, including Social Security, wages, and pension payments.
What is the asset limit for Extra Help in 2026?
The 2026 resource (asset) limit is $16,590 for a single person and $33,100 for a married couple. If you notify SSA that you are setting aside money for burial expenses, these limits increase to $18,090 and $36,100, respectively. Your primary home, one vehicle, and personal belongings do not count. Bank accounts, investment accounts, CDs, stocks, bonds, and IRA balances do count.
Does Extra Help automatically enroll me in a Part D plan?
If you qualify for Extra Help automatically through Medicaid, SSI, QMB, SLMB, or QI, and you are not already in a Part D plan, CMS will assign you to a low-cost benchmark Part D plan in your area. You can switch to a different plan at any time. If you apply for Extra Help manually through SSA, you must choose and enroll in your own Part D plan.
How did the Inflation Reduction Act change Extra Help?
Before 2024, Extra Help had two levels: a full subsidy (for income up to 135% FPL) and a partial subsidy (for income 135 to 150% FPL). The partial subsidy required beneficiaries to pay partial premiums, deductibles, and higher copays. The Inflation Reduction Act of 2022 eliminated the partial subsidy starting January 1, 2024. All Extra Help recipients now receive the full benefit regardless of whether their income is 100% or 149% of FPL.
Can I get Extra Help if I have a 401k or IRA?
It depends on the balance. IRAs, 401k accounts, and other retirement accounts count as resources unless they are entirely in distribution (payout) mode. If your combined countable resources, including the account balance, stay below $16,590 (single) or $33,100 (married) after excluding your home and vehicle, you can still qualify. If the balance pushes you over the limit, consult a benefits counselor about legitimate strategies to reduce countable resources.
How does Extra Help interact with the $2,100 Part D out-of-pocket cap in 2026?
In 2026, all Part D enrollees have a $2,100 annual out-of-pocket cap. For Extra Help recipients, your copays count toward this cap at the same rate as other enrollees. Because your copays are already reduced ($5.10 generic, $12.65 brand-name), it may take more prescriptions to reach $2,100. Once you hit the cap, all covered drugs are $0 for the rest of the year regardless of Extra Help status.
Do I need to reapply for Extra Help each year?
If you receive Extra Help automatically through Medicaid, SSI, or a Medicare Savings Program, you are automatically re-enrolled each year with no action required. You will receive a notice each fall from CMS confirming your status and Part D plan assignment. If you applied manually through SSA, you may be asked to renew if SSA determines your circumstances have changed, but many manual recipients are also automatically continued.
Can I get Extra Help if I am not a U.S. citizen?
You must reside in one of the 50 states or D.C. (not incarcerated) and be enrolled in Medicare Part A or Part B. Citizenship is not a requirement, but you must be a legal U.S. resident. Undocumented individuals are not eligible because they cannot enroll in Medicare. Legal permanent residents and other legal immigrants who have Medicare can apply for Extra Help.
