New York has one of the largest Medicare populations in the country, and thousands of eligible New Yorkers never apply for Extra Help simply because they assume their income is too high. Extra Help, also called the Low-Income Subsidy (LIS), is a federal benefit that can save a Medicare enrollee more than $5,000 a year in Part D premiums, deductibles, and copays. The income and resource rules are set federally, so the base numbers are identical in New York to every other state except Alaska and Hawaii.
New York adds a major advantage on top of the federal floor: its state-run Medicare Savings Programs (MSP) offer a faster, more generous path to full Extra Help than applying directly through the Social Security Administration. This guide covers the exact 2026 income limits for New York households, the Medicaid and MSP deeming shortcut, how to apply through either path, and what to do if your application is denied. For the broader national rules, see Extra Help eligibility nationwide. Check New York Medicare Savings Programs and New York EPIC for the two state-run programs that stack with Extra Help.
Direct Answer: Do You Qualify for Extra Help in New York?
Yes, New York Medicare beneficiaries qualify for Extra Help under the same 2026 federal limits used nationwide: income below $23,940 a year for one person or $32,460 for a married couple, and resources below $16,590 single or $33,100 married. Many New Yorkers qualify automatically because Medicaid, Supplemental Security Income (SSI), or a New York Medicare Savings Program (which has no asset test for its QMB and QI tiers) triggers deemed Extra Help eligibility, bypassing the federal resource test entirely.
New York Medicare Savings Programs and Medicaid: The Fastest Path to Extra Help
New York runs one of the most beneficiary-friendly gateways to Extra Help in the country. Any New York Medicare enrollee who receives full Medicaid benefits, Supplemental Security Income (SSI), or a New York Medicare Savings Program tier (QMB or QI) is automatically deemed eligible for full Extra Help. There is no separate Social Security Administration (SSA) application, no federal resource test, and no waiting on an SSA determination once the local Department of Social Services (DSS) or New York City's Human Resources Administration (HRA) approves the underlying program.
New York eliminated the resource test for its QMB and QI Medicare Savings Program tiers in 2023, so savings accounts, checking accounts, and investments no longer disqualify a New York applicant from those two tiers. The federal Extra Help resource limit, $16,590 single or $33,100 married in 2026, still applies to a direct SSA application, but it does not apply on the New York Medicaid or MSP route. A New York senior with $60,000 in savings who is turned down for Extra Help under the federal resource test can often still qualify for a New York Medicare Savings Program based on income alone and get deemed into full Extra Help automatically.
| Program | Individual monthly income limit | Couple monthly income limit | 2026 asset limit |
|---|---|---|---|
| QMB: pays Part A and Part B premiums, deductibles, and coinsurance | $1,856 | $2,509 | None |
| QI: pays the Part B premium only ($202.90/month in 2026) | $2,494 | $3,375 | None |
| QDWI: pays the Part A premium for working disabled individuals under 65 | $2,660 | $3,607 | $4,000 individual / $6,000 couple |
| Full Medicaid dual-eligibility | $1,856 | $2,509 | $33,038 individual / $44,796 couple |
SLMB is no longer a separate New York MSP tier; it was absorbed into the expanded QMB range when New York raised its thresholds in 2023. Qualifying for any of these tiers automatically deems a New York resident eligible for full Extra Help. Local Department of Social Services offices, not the Social Security Administration, decide these applications.
Source: NY State Department of Health: Medicare Savings Programs (2026); NY HIICAP Notebook 2026, Module 9
New York Extra Help Income Limits by Household Size (2026)
New York Medicare beneficiaries use the same federal Extra Help income ladder as every other state except Alaska and Hawaii. The table above this section lists the exact 2026 annual and monthly limits for New York households of 1 through 8 people, plus the amount added for each additional household member. Family size and household composition both matter here: a household generally includes you, your spouse, and any dependents living with you and relying on your income.
New York income slightly above these federal figures does not automatically disqualify a resident. Households with income just over the Extra Help limit should still check the Medicaid and New York Medicare Savings Program limits above, since New York evaluates aged and disabled applicants under Non-MAGI methodology (a different income-counting approach than the Modified Adjusted Gross Income, or MAGI, formula used for ACA marketplace and expansion-Medicaid applications).
What Extra Help Covers for New York Medicare Enrollees in 2026
New York Extra Help recipients get the exact same enhanced Part D benefit as recipients in every other state, because Extra Help is a federal subsidy paid through CMS, not a state-run benefit. Since the Inflation Reduction Act of 2022 eliminated the old partial-subsidy tier on January 1, 2024, every New York enrollee who qualifies gets the full package below regardless of whether their income sits at 60% or 149% of the Federal Poverty Level.
- Part D premium covered up to the New York regional benchmark plan premium
- Part D annual deductible: $0 (fully waived)
- 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
- Coverage gap (donut hole): eliminated for Extra Help recipients
- After the 2026 Part D out-of-pocket cap of $2,100 is reached: $0 copays for the rest of the year
Is New York a Medicaid Expansion State? What That Means for Extra Help
New York expanded Medicaid under the ACA in 2014 and covers adults with income up to 138% FPL through Medicaid, so New York has no ACA gap for working-age adults the way the 10 non-expansion states do (Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, and Wyoming). New York also runs the Essential Plan, a zero-premium marketplace plan for residents with income between 138% and 200% FPL who are under 65. Extra Help serves a different population: Medicare beneficiaries who are usually 65 or older or under 65 with a qualifying disability.
New York evaluates this older and disabled group under Non-MAGI rules rather than the Modified Adjusted Gross Income (MAGI) methodology used for ACA marketplace and expansion-Medicaid applications. Under Non-MAGI rules, family size, household composition, and countable resources are assessed with different formulas than an Essential Plan or marketplace application would use, which is why the Medicaid and Medicare Savings Program limits described above look different from the 138% FPL expansion threshold.