Extra Help, also called the Low-Income Subsidy or LIS, helps low-income Medicare members pay for prescription drugs. The program expanded in 2024 to cover more people. For those who qualify, drug copays drop to a few dollars each, deductibles disappear, and the Part D out-of-pocket cap is removed entirely.
What is Extra Help?
Extra Help is a federal program run by the Social Security Administration. It helps pay for Medicare Part D prescription drug coverage. If you qualify, the program pays most or all of your Part D premium, deductible, and copays.
Extra Help works with any Part D plan or any Medicare Advantage plan with drug coverage. You pick a plan like everyone else, but Extra Help handles most of the cost.
Who qualifies for Extra Help?
You qualify if you have Medicare and your income and assets are below the program limits. The income limits are higher than people expect, especially since they expanded in 2024.
2026 income limits
For 2026, you qualify for Extra Help if your monthly income is below:
- About $2,030 for a single person
- About $2,740 for a married couple
That is 150 percent of the federal poverty level. If you live with other family members who depend on you, the limits go up.
2026 asset limits
Your assets must be below:
- About $17,600 for a single person
- About $35,130 for a married couple
These limits do not count your home, one car, household items, life insurance with limited cash value, or burial funds up to $1,500.
The 2024 expansion
Before 2024, there were two levels of Extra Help. People with the lowest incomes got full benefits. People in the middle got partial benefits. The middle level was less helpful and confusing.
Starting in 2024, the partial Extra Help level was eliminated. Now everyone who qualifies gets full benefits. This change brought an estimated 300,000 more seniors into the full Extra Help program.
What Extra Help covers
If you qualify for Extra Help, your costs look like this:
- Part D premium: Covered up to a regional benchmark. If you pick a plan at or below the benchmark, you pay $0 premium.
- Part D deductible: $0. You do not have to meet a deductible before drug coverage starts.
- Copays for generics: $1.55 in 2026 (or less)
- Copays for brand-name drugs: $4.60 in 2026 (or less)
- The Part D out-of-pocket cap: Does not apply because you are paying so little, the cap is unreachable
For most Extra Help recipients, total annual drug costs are under $100. That includes people taking expensive specialty drugs that would otherwise cost $5,000 or more per year.
Automatic enrollment
You are automatically enrolled in Extra Help if you have:
- Full Medicaid coverage
- A Medicare Savings Program (QMB, SLMB, or QI)
- Supplemental Security Income (SSI)
If you fall into any of those categories, you should already be getting Extra Help. Check your Medicare account online or call your Part D plan to confirm.
How to apply (if not automatic)
Apply through the Social Security Administration. You can apply:
- Online at ssa.gov/extrahelp
- By phone at 1-800-772-1213
- In person at your local Social Security office
The application is short, about 15 minutes. You will need proof of income, bank statements, and your Medicare card. Social Security processes the application and sends you a decision letter within 30 to 60 days.
If approved, the benefit starts the next month and continues as long as you qualify.
If you are denied
If Social Security denies your Extra Help application, you have the right to request a reconsideration. The form is on the SSA website.
You can also apply for state pharmaceutical assistance programs. Many states have programs that help with drug costs for people who do not qualify for federal Extra Help but still need help. Check your state's Department of Aging or pharmaceutical assistance office.
Yearly renewal
Extra Help can require yearly proof of income and assets in some cases. If you get a letter from Social Security asking you to verify, respond promptly. If you do not, your benefit will end.
If your income changes during the year (you start a part-time job, you sell a house), report it to Social Security within 10 days. This protects you from owing back benefits if your income increases.
Combining Extra Help with Medicare Savings Programs
If you qualify for Extra Help, you may also qualify for one of the Medicare Savings Programs that helps with your Part B premium and other Medicare costs. The two programs work together.
The MSP income limits are sometimes lower than Extra Help. So you might qualify for Extra Help but not an MSP. But if you qualify for an MSP, you automatically qualify for Extra Help. Read our MSP guide for more.
Why this matters
About half of the seniors who qualify for Extra Help are not signed up. That is roughly 3 million people leaving real help on the table.
If your income is on the lower side, it is worth filling out the application. The worst case is you get told no. The best case is you save several thousand dollars a year on prescriptions for the rest of your life.
How to start today
Three steps:
- Look at your income for the last 12 months. If single income is under $2,030/month or couple income is under $2,740/month, apply.
- Apply at ssa.gov/extrahelp. Takes 15 to 20 minutes.
- If approved, talk to your Medicare agent about which Part D plan to pick. Picking a plan at or below the regional benchmark gives you $0 premium.
For families who qualify, this program is one of the most underused benefits in Medicare. Worth the small effort to apply.
