Prescription drug costs are one of the biggest financial burdens for seniors on Medicare. The Medicare Extra Help program — also known as the Low-Income Subsidy (LIS) — is a federal benefit that can dramatically reduce or eliminate your Part D drug costs. In 2026, Extra Help is worth an average of nearly $6,000 per year in drug savings. Yet millions of eligible beneficiaries haven’t applied.
This guide explains exactly what Extra Help is, who qualifies, what it covers, and how to apply.
What Is Medicare Extra Help?
Medicare Extra Help is a Social Security Administration program that subsidizes Medicare Part D (prescription drug) costs for people with limited income and resources. It pays for all or part of your:
- Part D monthly premium
- Part D annual deductible
- Prescription drug copays and coinsurance
- Costs during the coverage gap (“donut hole”)
Full Extra Help vs. Partial Extra Help
Extra Help comes in two levels based on your income and resources:
| Level | Income Limit (Individual) | What It Covers |
|---|---|---|
| Full Extra Help | ∼$20,783/year (135% FPL) | $0 premium, $0 deductible, minimal copays |
| Partial Extra Help | ∼$22,590/year (150% FPL) | Reduced premium, reduced deductible, sliding-scale copays |
Married couple limits are higher — approximately $28,208 for full Extra Help and $30,660 for partial Extra Help (2026 estimates; thresholds adjust annually).
Who Qualifies for Extra Help in 2026?
You automatically qualify for full Extra Help if you have any of the following:
- Full Medicaid coverage
- Supplemental Security Income (SSI)
- Enrollment in a Medicare Savings Program (QMB, SLMB, or QI)
If you don’t have any of the above, you may still qualify if you meet the income and resource limits. In 2026, the general resource limits are:
- Individual: ∼$17,220 in assets (excluding home, car, and certain other assets)
- Married couple: ∼$34,360 in assets
What Counts as a Resource?
Many assets are excluded from the Extra Help resource test, including:
- Your primary home
- One car
- Life insurance with cash value under $1,500
- Burial funds up to $1,500
- Personal belongings and household goods
Assets that do count include bank accounts, savings, stocks, bonds, and real estate other than your home.
How Much Can Extra Help Save You?
The savings from Extra Help are substantial. In 2026, full Extra Help beneficiaries can expect:
| Cost | Without Extra Help | With Full Extra Help |
|---|---|---|
| Part D Monthly Premium | $30–$100+/month | $0 |
| Annual Deductible | Up to $590 | $0 |
| Generic Drug Copay | $1–$20+/fill | $4.90/fill |
| Brand Drug Copay | $20–$100+/fill | $12.15/fill |
| Coverage Gap Costs | 25% of drug costs | $0 (no gap) |
| Annual Savings (average) | — | ∼$5,900/year |
How to Apply for Extra Help
If you don’t automatically qualify (because you have Medicaid, SSI, or an MSP), you need to apply. Here’s how:
Option 1: Apply Online
Visit SSA.gov/extrahelp and complete the online application. It takes about 15 minutes and you’ll get a decision within a few weeks.
Option 2: Call Social Security
Call 1-800-772-1213 (TTY: 1-800-325-0778) to apply by phone or schedule an appointment at your local Social Security office.
Option 3: Apply in Person
Visit your local Social Security office to complete a paper application with assistance from a representative.
Option 4: Apply Through Your State
Some states allow you to apply for Medicaid and Extra Help simultaneously through your state’s Medicaid office.
Extra Help and D-SNPs
If you have full Extra Help AND Medicaid, you likely qualify for a D-SNP, which may offer even richer benefits than standard Part D plans. D-SNP members with Extra Help typically enjoy:
- $0 Part D premium
- $0 drug deductible
- $0 copays on most drugs (or very low copays)
- All the additional D-SNP benefits: dental, vision, OTC card, food benefit, etc.
Find Out If You Qualify for Extra Help
Our licensed agents can check your eligibility for Extra Help, Medicaid, and D-SNPs — all in one free call.
📞 Call 1-866-340-3441