Medicare Extra Help 2026: Pay Less for Your Prescription Drugs

What is the Medicare Extra Help program?

Medicare Extra Help is a federal program that helps pay for costs. You may also hear it called the Low-Income Subsidy (LIS).

This program is managed by the . It is not a separate insurance plan. Instead, it works with your existing Part D coverage to lower your out-of-pocket costs.

New 2026 Rules for Extra Help

Major changes have arrived for 2026 to help you save more:

• Full Benefits for All: In the past, some people only got "Partial" Extra Help. Now, if you qualify, you receive the full version of the program.

• Lower Spending Limits: There is a new $2,100 out-of-pocket cap on drug costs for everyone with Medicare. If you have Extra Help, your costs will likely be much lower than that.

• Beating Inflation: As , Extra Help provides a vital safety net for your budget.

Medicare Extra Help Qualifications and Income Limits

You may automatically qualify for Extra Help and do not need to apply if you:

• Have both Medicare and Medicaid ("Dual Eligible").

• Receive Supplemental Security Income (SSI).

• Are already enrolled in a Medicare Savings Program.

If you don’t fall into those groups, you can still qualify based on your yearly income and the things you own (assets).

2026 Federal Poverty Level for Medicare Extra Help

To qualify, your income must be at or below 150% of the Federal Poverty Level. Use this chart to see if you fit within the 2026 limits:

Resource and Asset Limits for 2026

Resources are things like money in the bank, stocks, or bonds. To get Extra Help in 2026, your total resources must be below these amounts:

• Individual: $18,090

• Married Couple: $36,100

If you need help paying for more than just drugs, you may also qualify for a Medicare Savings Program to help with your Part B premiums.

What items do not count toward the limit?

Don't worry—Social Security does not count everything you own. The following items do not count toward the asset limits:

• Your primary home

• One car or vehicle

• Furniture and personal household items

• Burial plots and up to $1,500 in burial expenses

Medicare Extra Help Benefits

If you qualify for the program, you will receive significant financial relief:

• $0 Monthly Premiums: You pay no monthly fee for your drug plan (up to the state benchmark).

• $0 Deductibles: You don't have to pay a yearly deductible before your coverage starts.

• Reduced Copays: You will pay a very small amount for each generic or brand-name drug.

• Flexible Switching: You can switch your drug plan once per quarter, from January through September, rather than waiting for the Annual Enrollment Period.

Get a Part D Late Enrollment Penalty Waiver with LIS

If you didn't sign up for drug coverage when you were first eligible, you might have a late enrollment penalty added to your bill. However, if you qualify for Extra Help, that penalty is waived. This can save you hundreds of dollars over time.

Help Paying for Medicare Part B Premiums

Many people who qualify for Extra Help are also eligible for Medicare Savings Programs. These programs are run by your state and can help pay for your monthly Part B doctor-visit fee ($185.00 or more per month for most).

How to Apply for Low-Income Subsidy

You can apply for Extra Help at any time. You do not have to wait for a specific enrollment window.

• Online: Visit

• By Phone: Call Social Security at 1-800-772-1213 (TTY 1-800-325-0778)

• In Person: Visit your local Social Security office

Documents Needed for Your LIS Application

To make your application go faster, have the items in the checklist below ready:

• [  ] Social Security card

• [  ] Bank statements (checking and savings)

• [  ] Tax returns from the most recent year

• [  ] Information on stocks, bonds, or IRAs

• [  ] Proof of any other income (like a pension or veteran’s benefits)

Does Extra Help renew every year?

Medicare reviews your eligibility every year to ensure you still qualify. If your income or assets change, your benefits might change. Look for a purple notice in your mail. This letter will let you know whether your Extra Help is changing or staying the same next year.

Understand Medicare Plan Costs with SelectQuote

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^Sources:

https://www.medicare.gov/basics/costs/help/drug-costs