Medicare Extra Help is a federal program that helps people with limited income and resources pay for Medicare Part D prescription drug costs. It is also known as the Low-Income Subsidy (LIS). In 2026, Extra Help covers most Part D premiums, eliminates the deductible, and caps copayments at a few dollars per prescription.
What Does Extra Help Cover?
| Cost | Without Extra Help | With Extra Help (Full) |
|---|---|---|
Part D monthly premium | Varies by plan (avg. ~$40) | Reduced or $0 for benchmark plans |
Annual deductible | Up to $615 | $0 |
Copayment per generic drug | Varies | Up to $4.50 |
Copayment per brand drug | Varies | Up to $11.20 |
Coverage gap (donut hole) | Higher cost-sharing | No gap applies |
2026 Income and Resource Limits
| Household Size | Income Limit (Monthly) | Resource Limit |
|---|---|---|
Individual | ~$1,903/month (150% FPL) | $17,220 |
Married couple | ~$2,575/month (150% FPL) | $34,360 |
QMB Enrollees Automatically Qualify
If you are enrolled in a Medicare Savings Program such as QMB, SLMB, or QI, you automatically qualify for Extra Help. You do not need to apply separately.
How to Apply
Apply online at ssa.gov/extrahelp, by calling Social Security at 1-800-772-1213, or by visiting your local Social Security or Medicaid office. There is no cost to apply and no penalty for applying even if you are not sure you qualify.
Does Extra Help affect my Part D plan choice?
No. You can enroll in any Part D plan. However, if your plan premium exceeds the Extra Help benchmark amount, you will pay the difference. Choosing a plan at or below the benchmark means $0 premium.
Can I get Extra Help if I have Medicare Advantage?
Yes, if your Medicare Advantage plan includes drug coverage (MA-PD). Extra Help applies to the drug portion of your plan.
Is Extra Help the same as Medicaid?
No. Extra Help is a federal subsidy specifically for Part D drug costs. Medicaid is a separate joint federal-state program that may cover additional healthcare costs.
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