Written by Howard Yeh
Co-Founder & Chief Revenue Officer at HealthCare.com
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Key Takeaways
- Extra Help (the Part D Low-Income Subsidy) lowers Medicare drug costs for people with limited income and savings.
- The 2026 limits are $23,940 in yearly income and $18,090 in resources for one person, or $32,460 and $36,100 for a married couple.
- In 2027, most people with Extra Help pay a $0 deductible and no more than $5.80 for a generic or $14.40 for a brand-name drug.
- People with Extra Help can change drug coverage once a month, but not to switch into a regular Medicare Advantage plan.
- Apply at ssa.gov/medicare/part-d-extra-help or call 1-800-772-1213. Medicaid, MSP and SSI enrollees qualify automatically.
Extra Help, also called the Part D Low-Income Subsidy (LIS), lowers Medicare drug costs for people with limited income and savings. In 2026, you may qualify with yearly income up to $23,940 ($32,460 for a married couple) and resources up to $18,090 ($36,100 for a couple). In 2027, people with Extra Help pay a $0 Part D deductible and no more than $5.80 for a generic or $14.40 for a brand-name drug.
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Extra Help at a Glance
| Item | 2026 | 2027 |
|---|---|---|
| Income limit (individual / couple) | $23,940 / $32,460 a year | Not published yet |
| Resource limit (individual / couple) | $18,090 / $36,100 | Not published yet |
| Part D deductible with Extra Help | $0 | $0 |
| Maximum copay, generic drug | $5.10 | $5.80 |
| Maximum copay, brand-name drug | $12.65 | $14.40 |
| Copays after the out-of-pocket cap | $0 | $0 |
| Part D out-of-pocket cap (everyone) | $2,100 | $2,400 |
| Standard Part D deductible (without Extra Help) | $615 | $700 |
Sources: CMS CY 2027 Rate Announcement (April 6, 2026), Attachment V; Medicare.gov, Help with drug costs; SSA, Understanding the Extra Help With Your Medicare Prescription Drug Plan (August 2026). Resource limits include $1,500 per person for burial expenses.
What Extra Help Pays
Extra Help covers most of what you would normally pay for a Medicare drug plan:
- Premium. Medicare.gov lists the plan premium as $0. That holds when you are in a “benchmark” plan. KFF notes that if you pick a plan priced above your region’s benchmark, or one with extra benefits, you pay part of the premium.
- Deductible. You pay $0, compared with the standard $700 deductible in 2027.
- Copays. You pay a small fixed copay for each covered drug, instead of the plan’s normal cost sharing.
- Late enrollment penalty. You do not pay a Part D late enrollment penalty while you get Extra Help.
SSA estimates Extra Help is worth about $5,700 a year.
2026 Income and Resource Limits
Income must be at or below 150% of the federal poverty level. In 2026, that means $23,940 a year for one person and $32,460 for a married couple living together.
The resource limit is $18,090 for one person and $36,100 for a couple. Those figures include $1,500 per person for burial expenses. Without the burial allowance, the limits are $16,590 and $33,100.
SSA counts bank accounts, stocks, bonds, mutual funds, IRAs, cash and real estate other than your home. It does not count your home, your car, burial expenses, personal belongings or life insurance.
Your income can be above the limit and you may still qualify. SSA lists cases such as supporting family members who live with you, having work earnings, or living in Alaska or Hawaii. If you are close, apply.
When will the 2027 limits come out?
Not yet. The 2027 income limit depends on the 2027 poverty guidelines, which HHS usually publishes in January. CMS said in April it would release the 2027 resource limits in a memo after September 2026 inflation data came out. We could not find that memo published as of October 26, 2026. Until new limits are posted, use the 2026 numbers.
2026 and 2027 Extra Help Copays
CMS has published 2027 copays. Most people with Extra Help will pay up to $5.80 for a generic and $14.40 for a brand-name drug, up from $5.10 and $12.65 in 2026.
People with full Medicaid and income at or below 100% of the poverty level pay less: up to $1.65 for a generic and $5.00 for a brand-name drug in 2027, up from $1.60 and $4.90. People with full Medicaid who live in a nursing home, or who get certain home and community-based services, pay $0.
How Extra Help Works With the 2027 Part D Cap and Deductible
Every Part D plan has a yearly out-of-pocket cap. It is $2,100 in 2026 and $2,400 in 2027. Once you reach it, you pay $0 for covered drugs for the rest of the year. Payments Extra Help makes on your behalf count toward the cap.
The standard deductible rises to $700 in 2027. With Extra Help, you skip it. Your copays start with the first fill in January. For the full list of new figures, see 2027 Medicare plan costs.
Here is a simple example. Say you take 4 brand-name drugs each month at the $14.40 maximum. That is $57.60 a month, or $691.20 for the year. Without Extra Help, the same drugs could cost you up to $2,400 in 2027. Some drugs also get lower Medicare prices in 2027. See our guide to Medicare drug price cuts in 2027.
Open enrollment runs October 15 to December 7. Check which plans cover your drugs.
Who Gets Extra Help Automatically
You do not need to apply if you already get any of these:
- Full Medicaid coverage
- A Medicare Savings Program, where your state helps pay your Part B premium
- Supplemental Security Income (SSI)
If your income is low but you do not have one of these, check whether you qualify for a Medicare Savings Program too. It can pay your $202.90 monthly Part B premium. Read our guide to Medicare Savings Programs in 2027. If you have Medicare and Medicaid, see how the two work together.
Changing Plans: The Monthly Special Enrollment Period
Since January 1, 2025, people with Extra Help or Medicaid can change drug coverage once each calendar month. This replaced the old once-per-quarter rule. A change takes effect the first day of the next month.
The monthly period lets you:
- Switch from one standalone Part D plan to another
- Leave a Medicare Advantage plan with drug coverage and go back to Original Medicare with a standalone Part D plan
It does not let you join or switch between regular Medicare Advantage plans. For that, use open enrollment, October 15 to December 7, 2026, or, if you are already in a Medicare Advantage plan, the Medicare Advantage Open Enrollment Period, January 1 to March 31.
If you have full Medicaid, a second monthly period lets you join an integrated dual eligible special needs plan, if one is available where you live. Learn more about a dual eligible Medicare Advantage plan.
Two limits apply. You cannot use the monthly period if you have been identified as a “potential at-risk” or “at-risk” beneficiary under a Part D drug management program. And if you lose Extra Help, you get 3 full months to change plans, starting from the later of the date you lose it or the date you are notified.
How to Apply for Extra Help
Apply through Social Security, using Form SSA-1020. You can apply any time, before or after you join a Part D plan.
- Online: go to ssa.gov/medicare/part-d-extra-help.
- By phone: call Social Security at 1-800-772-1213 (TTY 1-800-325-0778), Monday through Friday, 8 a.m. to 7 p.m. in most time zones.
- In person: visit your local Social Security office.
Have recent bank statements, tax returns, and any IRA, 401(k), pension, annuity or Veterans benefit statements ready. Your Extra Help application also starts a Medicare Savings Program application with your state, unless you tell SSA not to send it.
If you qualify and do not pick a drug plan, Medicare picks one for you. Use our Medicare open enrollment guide to compare plans that cover your drugs before December 7.
Frequently Asked Questions
What is the income limit for Extra Help in 2026?
The 2026 income limit is $23,940 a year for one person and $32,460 for a married couple. Resources must be $18,090 or less for one person and $36,100 or less for a couple. The 2027 limits are not published yet.
How much are Extra Help copays in 2027?
Most people with Extra Help will pay up to $5.80 for a generic drug and $14.40 for a brand-name drug in 2027. People with full Medicaid and income at or below the poverty level pay up to $1.65 and $5.00.
Does Extra Help pay my Part D premium?
Yes, in a benchmark plan your premium is $0. If you choose a plan priced above your region’s benchmark, or one with extra benefits, you may pay part of the premium.
Can I change plans if I get Extra Help?
Yes. You can change drug coverage once each calendar month. You can switch standalone Part D plans or leave Medicare Advantage for Original Medicare with a Part D plan. You cannot use it to switch to a regular Medicare Advantage plan.
How do I apply for Extra Help?
Apply online at ssa.gov/medicare/part-d-extra-help or call Social Security at 1-800-772-1213. You get Extra Help automatically if you have full Medicaid, a Medicare Savings Program or SSI.
A licensed Medicare agent can check which plans cover your drugs before the December 7 deadline.
Sources
- CMS, Announcement of CY 2027 Medicare Advantage Capitation Rates and Part C and Part D Payment Policies (April 6, 2026), Attachment V
- Medicare.gov, Help with drug costs
- SSA, Understanding the Extra Help With Your Medicare Prescription Drug Plan (August 2026)
- SSA, Apply for Part D Extra Help
- SSA POMS HI 00815.025, SSA Outreach to Low-Income Medicare Beneficiaries
- Medicare.gov, Special Enrollment Periods
- CMS, New Special Enrollment Periods for Dually Eligible and LIS Individuals (job aid)
- Medicare.gov, Medicare’s Extra Help Program fact sheet
- KFF, Medicare Part D Enrollment, Premiums, and Cost Sharing in 2026 (June 11, 2026)
- CMS, Medicare Advantage and Medicare Prescription Drug Programs Expected to Remain Stable in 2027 (September 28, 2026)
- CMS, 2026 Medicare Parts A & B Premiums and Deductibles
- HHS ASPE, Poverty Guidelines
The views and opinions expressed are those of the authors and do not necessarily reflect the official policy or position of MedicareGuide.com or HealthCare, Inc.
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