Health
Extra Help 2026: Income and Savings Limits for the Medicare Part D Low-Income Subsidy
Extra Help pays Medicare drug plan premiums, removes the deductible and caps copays. The 2026 limits, who gets it without applying, and how to apply.
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Extra Help pays most or all of a Medicare drug plan’s premium, removes the deductible and caps each prescription’s copay, at no more than $5.10 for a generic drug and $12.65 for a brand-name drug in 2026. In 2026 a person on Medicare qualifies with income under $23,940 a year ($32,460 for a married couple) and savings within $18,090 ($36,100 for a couple). People who get SSI, full Medicaid or a Medicare Savings Program get it without applying. Put your household in below, with “On Medicare” ticked, to see what the rules say for you.
What is Extra Help?
Extra Help is the low-income subsidy for Medicare Part D, the part of Medicare that pays for prescription drugs. It is run by Social Security and the state Medicaid offices. Since January 1, 2024, everyone who qualifies gets the full subsidy: help with the plan’s premium, no yearly deductible, and smaller copays (POMS HI 03001.020; 42 CFR 423.780). The partial subsidy that some people used to get has ended.
People who qualify also do not pay the Part D late enrollment penalty, the extra premium Medicare charges people who joined a drug plan late (42 CFR 423.780(e)).
What does Extra Help pay?
It pays the plan’s monthly premium up to your area’s benchmark amount, or the premium of the lowest-cost plan if that is higher. So in a plan that costs more than that, you pay the difference (POMS HI 03001.020). There is no deductible to pay before your plan starts paying (42 CFR 423.782).
Copays in 2026 are no more than $5.10 for each generic drug and $12.65 for each brand-name drug. People who also have full Medicaid and income at or under the poverty line pay no more than $1.60 and $4.90, and people with full Medicaid who live in a nursing home or get home and community services pay nothing (POMS HI 03001.005).
Without Extra Help, a Part D plan’s deductible in 2026 is up to $615, and the drug costs you pay stop for the year at $2,100 (POMS HI 03001.005). What Extra Help saves you depends on your plan and the drugs you take, which the calculator does not know, so it shows Extra Help on its card but does not count it as money in your month.
Who can get Extra Help?
You can get Extra Help if all of these are true (POMS HI 03001.020):
- you have Medicare Part A or Part B;
- you live in one of the 50 states or DC;
- you are not in jail or prison;
- your income, with your husband’s or wife’s if you live together, is under 150% of the poverty line for your family;
- your savings are within the limit;
- you apply, or you get it without applying because of other help you get;
- you are in a Medicare drug plan, or join one.
People in Puerto Rico and the territories are outside this rule.
What are the Extra Help income limits for 2026?
Your income must be under these amounts, not at them (POMS HI 03001.020). Your family here is you, your husband or wife if you live together, and relatives who live with you and depend on you for at least half of their support (42 CFR 423.772).
| Household | 48 states and DC | Alaska | Hawaii |
|---|---|---|---|
| 1 person | $23,940 | $29,925 | $27,540 |
| 2 people | $32,460 | $40,575 | $37,335 |
| 3 people | $40,980 | $51,225 | $47,130 |
| 4 people | $49,500 | $61,875 | $56,925 |
| 5 people | $58,020 | $72,525 | $66,720 |
| 6 people | $66,540 | $83,175 | $76,515 |
| 7 people | $75,060 | $93,825 | $86,310 |
| 8 people | $83,580 | $104,475 | $96,105 |
Income is counted as SSI counts it, so part of it is left out first. Savings limit in 2026: $16,590 for one person, $33,100 for a married couple, plus $1,500 each that SSA adds for burial unless you say none of it will pay for one.
Sources: POMS HI 03001.020, Eligibility for Extra Help (Social Security Administration); POMS HI 03030.025, Resource limits for Extra Help (Social Security Administration); POMS HI 03001.005, Extra Help charts (2026) (Social Security Administration); 42 CFR 423.772, Definitions (Part D premiums and cost-sharing subsidies for low-income individuals) (eCFR (Office of the Federal Register)). Checked November 1, 2026.
Extra Help counts income the way SSI does (42 CFR 423.772). So the first $20 a month of most income is left out, and of earnings from work, $65 and half of the rest are left out too (20 CFR 416.1112). Your husband’s or wife’s income counts whether or not they are on Medicare. Help from others with food or housing is not counted as income for Extra Help, though it can be for SSI (POMS HI 03001.020).
A state’s own more generous rules for its Medicare Savings Programs do not apply here: the definition rules them out (42 CFR 423.772).
How much savings can you have and get Extra Help?
In 2026 the limit is $16,590 for one person and $33,100 for a married couple living together. Social Security adds $1,500 a person for burial costs unless you say none of your savings will pay for a burial, which makes the limits $18,090 and $36,100 (POMS HI 03030.025).
Savings here means money you can get at within 20 days, such as bank accounts, stocks and bonds, and land or buildings other than the home you live in. Your home and the land it is on do not count, and neither does life insurance (42 CFR 423.772). The limit goes up each January with prices, rounded to the nearest $10, and the new figure is announced each December (42 CFR 423.773).
Who gets Extra Help without applying?
You get Extra Help without applying if you have Medicare and you get any of these (POMS HI 03010.005; 42 CFR 423.773(c)):
- SSI, including people whose SSI check has stopped but who keep Medicaid under section 1619(b);
- full Medicaid;
- a Medicare Savings Program: QMB, SLMB or QI. QDWI, the program for some working people with a disability, does not count.
People who get it this way should not apply: Medicare tells them. Someone who qualifies this way between January and June keeps Extra Help for the rest of that year; someone who qualifies between July and December keeps it for the rest of that year and all of the next. Each year Medicare writes to people who will lose it and sends them an application, which can go in from September to start on January 1 (42 CFR 423.773(c)(2); POMS HI 03010.005).
The Medicare Savings Programs page explains QMB, SLMB and QI, which also pay the Medicare Part B premium.
How do you apply for Extra Help?
There are two steps, and either can come first: apply for Extra Help, and be in a Medicare drug plan or a Medicare Advantage plan with drug coverage. If you are approved and are not in a plan, Medicare puts you in one (POMS HI 03010.005). You can apply with Social Security or at your state’s Medicaid office; whichever you apply to decides (42 CFR 423.774(a)). Extra Help starts on the first day of the month you apply (42 CFR 423.774(b)).
When you apply with Social Security, it sends your application details to your state’s Medicaid office to start an application for a Medicare Savings Program for you, unless you say no (POMS HI 03010.005). So one application can lead to help with both your drug costs and your Part B premium.
Applying is free. This website does not take applications, and it never asks for your name, Social Security number or Medicare number. The card in the calculator links to Social Security’s own page.
What happens to Extra Help when your income goes up?
If you qualify on income, Extra Help ends for you once your income reaches 150% of the poverty line for your family, or your savings go over the limit. In the calculator, the ruler marks the pay where it ends for your household. The figures do not count it as money, so the line of money left at every pay does not show what you would then pay for your drugs.
If you get it without applying, through Medicaid or a Medicare Savings Program, it lasts at least to the end of the year even when that other help ends, as the rule above says.
What about Extra Help in 2027?
The 2027 income limits need the 2027 poverty guidelines, which come out in January 2027, and the 2027 savings limits are announced around December 2026. Neither was published on November 1, 2026, and the 2027 copays are not in our files yet. So from January 1, 2027, the calculator says “Not checked yet” for anyone who would have to qualify on income, until the new figures are in. People who get Extra Help without applying still show as getting it.
How does the calculator work out Extra Help?
For each person on Medicare (65 or older, or with “On Medicare” ticked), the calculator first checks whether that person gets SSI, Medicaid or a Medicare Savings Program in its own answers. If so, it says they get Extra Help without applying, and in “What if you earn more?” a raise that ends that help does not end Extra Help before December 31 of the year. SSI or Medicaid ticked under “What you have now” does not say whose it is (it may be a child’s), so it does not bring Extra Help by itself: the card says that if it is the person’s own, Extra Help comes without applying (42 CFR 423.773(c)). Otherwise it counts their income, and their husband’s or wife’s, the way SSI does, and compares it with the limit for their family, counting your children as relatives who depend on you. Then it checks the savings you typed against the limit with the burial amount. Another adult on Medicare is worked out on their own income, and since only their own savings count, the answer is “Maybe” when the household’s savings are over their limit.
The calculator does not know what drug plan you are in or what it costs, so it does not put a dollar figure on Extra Help. Only Social Security or your state’s Medicaid office decides.
Figures checked October 31, 2026.
Questions people ask
What is the income limit for Extra Help in 2026?
Under $23,940 a year for one person and $32,460 for a married couple in the 48 states and DC, with part of income left out first. Alaska and Hawaii have higher limits; the table above has them.
Do I get Extra Help automatically with Medicaid?
Yes, with full Medicaid, and also with SSI or with QMB, SLMB or QI (POMS HI 03010.005). Medicare tells you, and you do not need to apply.
Does my house count as savings for Extra Help?
No. The home you live in and the land it is on do not count, and neither does life insurance (42 CFR 423.772).
Can I get Extra Help if I am still working?
Yes. Earnings count, but $65 and half of the rest of them are left out first, as SSI counts them. What matters is whether the income left is under the limit for your family.
When does Extra Help start?
On the first day of the month you apply, once you are approved (42 CFR 423.774(b)).
Does this website take Extra Help applications?
No. This is an independent calculator, not a government website. Apply with Social Security or your state’s Medicaid office.