Extra Help Medicare 2026: LIS Income Limits, Auto-Qualify Paths & How to Apply

Extra Help, also called the Medicare Part D Low Income Subsidy (LIS), is a federal program that covers your Medicare Part D drug plan premium, deductible, and most of your copays.

In 2026, eligible recipients pay $0 plan premium, $0 deductible, up to $5.10 per generic prescription, and up to $12.65 per brand-name prescription, with $0 cost after hitting $2,100 in total drug costs (Medicare.gov).

The Social Security Administration values the average Extra Help benefit at about $5,700 per year. About 13 million Medicare beneficiaries qualify, and roughly 3 million who would qualify never apply, according to SSA outreach data.

This guide explains the verified 2026 income and resource limits, the four auto-qualify paths that skip the application entirely, how to apply if you are not auto-qualified, and what changes once you are enrolled.

One thing to know up front. If you have full Medicaid, any Medicare Savings Program (QMB, SLMB, QI, QDWI), or SSI, you are automatically enrolled in Extra Help. You do not file the SSA application.

SSA pulls your status from your state Medicaid agency or its own SSI records and enrolls you on its end. Most people do not realize this. If you got Medicaid or an MSP this year, check your mail for the green Extra Help notice from SSA before paying any Part D copay.

Key Takeaways

• Extra Help (LIS) covers Medicare Part D drug costs for low-income beneficiaries, worth about $5,700/year (Medicare.gov, 2026).
• 2026 income limits: $23,940 single / $32,460 couple. 2026 resource limits: $18,090 single / $36,100 couple.
• You auto-qualify with no application needed if you have full Medicaid, any Medicare Savings Program, or SSI.
• If not auto-qualified, apply at ssa.gov/medicare/part-d-extra-help (free), by phone 1-800-772-1213, or via your local SHIP counselor.
• 2026 copays under Extra Help: $0 premium, $0 deductible, up to $5.10 generic, up to $12.65 brand-name, $0 after $2,100 in total drug costs.

What is Medicare Extra Help (LIS) in 2026

Extra Help is the Medicare program that pays for your Part D drug coverage costs. It is funded by Medicare and administered by the Social Security Administration in partnership with state Medicaid agencies. Medicare uses the formal name Low Income Subsidy (LIS); SSA marketing materials call it Extra Help. They are the same program.

The program does four specific things in 2026:

1. Covers your Part D plan premium. Most Part D plans charge a monthly premium of $25 to $90 in 2026. Extra Help pays this for you, up to a benchmark amount (usually $40-$45/month) depending on your state.
2. Eliminates your Part D deductible. Standard Part D plans have an annual deductible up to $590 in 2026. Extra Help recipients pay $0 deductible.
3. Caps your prescription copays. Generic drugs are capped at $5.10 per prescription in 2026. Brand-name drugs are capped at $12.65. After your total drug costs (including what Extra Help pays on your behalf) reach $2,100, you pay $0 for any covered drug for the rest of the calendar year.
4. Waives the Part D late enrollment penalty. If you delayed joining Part D after your initial Medicare enrollment, you would normally face a 1% premium surcharge per month delayed, for life. Extra Help waives this penalty entirely while you are enrolled.

Extra Help is available in all 50 states plus DC. It is not available in Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands, or American Samoa. Those areas have parallel low-income drug-cost help programs, contact your local Medicaid office to learn what is available.

Who auto-qualifies for Extra Help in 2026

This is the most underused part of the program. SSA automatically enrolls you in Extra Help, with no application required, if any of the following apply (Medicare.gov):

• You have full Medicaid coverage. If your state Medicaid agency has approved you for full Medicaid (not just an MSP), SSA gets the data and enrolls you in Extra Help.
• You have any Medicare Savings Program. Approval for QMB, SLMB, QI, or QDWI auto-qualifies you for Extra Help. See our Medicare Savings Programs guide for the 2026 income limits and how MSPs work.
• You receive SSI (Supplemental Security Income). SSA already has your record, so it auto-enrolls you in Extra Help when you become Medicare-eligible.

If any of these apply to you, watch for a green or yellow notice from SSA in the mail. Green means you have been auto-enrolled in both Extra Help and a Part D drug plan SSA picked for you. Yellow means you are being moved to a new plan because your current one no longer fits the program. You can change to a different Part D plan at any time, monthly, while you have Extra Help.

2026 Extra Help income and resource limits, if you need to apply

If you are not auto-qualified, you can still apply for Extra Help by submitting an application to SSA. The income and resource limits for 2026 are:

Situation	Income limit (annual)	Resource limit
Individual	$23,940	$18,090
Married couple	$32,460	$36,100

Source: Medicare.gov 2026 Extra Help limits. Limits may be slightly higher in Alaska and Hawaii.

What counts as income for Extra Help

Income includes Social Security retirement and disability, pensions, wages, interest, dividends, and most other regular monthly income. The application includes a few common deductions (work-related expenses if you are working, certain unreimbursed medical expenses), so your countable income may be less than your gross. SNAP food benefits, housing assistance, and energy assistance like LIHEAP do not count as income.

What counts as resources

Resources are countable assets: money in checking, savings, CDs, stocks, bonds, mutual funds, and IRAs or 401(k) balances if you are not actively drawing from them. The following are excluded from the resource calculation:

• Your primary home and the land it sits on, regardless of value
• One vehicle
• Personal possessions and household goods
• Burial plots and pre-paid burial accounts up to a limit
• Life insurance with cash value under $1,500
• Property used in a trade or business you operate

How to apply for Extra Help in 2026

Three application paths, all free, all equally official. Pick whichever is most convenient.

Apply online via SSA

The fastest path. Go to ssa.gov/medicare/part-d-extra-help and click Apply Online. The form takes about 15-25 minutes. Have these ready before you start:

• Most recent bank statements (savings + checking)
• Most recent IRA, 401(k), or pension statements
• Annuity, Veterans benefit, or Railroad Retirement statements if applicable
• Tax return from last year (for income verification)

You can save and return to a partial application if you do not finish in one session. SSA processes applications within 4 to 6 weeks. You will receive a written decision letter and, if approved, your Extra Help benefits start the first day of the month after approval.

Apply by phone or mail

Call SSA at 1-800-772-1213 (TTY 1-800-325-0778) Monday through Friday, 8 AM to 7 PM in your local time zone. Tell the representative you want to apply for Part D Extra Help. They can take your application by phone or mail you a paper form. The phone application takes about 25-30 minutes.

Apply through your State Health Insurance Assistance Program (SHIP)

SHIP counselors are free Medicare advisors available in every state. They help with Extra Help applications, MSP applications, and Part D plan selection. Find your local SHIP at shiphelp.org or call 1-877-839-2675. SHIP is funded by the Administration for Community Living and is independent of any insurance company.

Apply for Extra Help and an MSP at the same time

The Extra Help application form has a checkbox that asks if you also want SSA to send your information to your state Medicaid agency to evaluate you for a Medicare Savings Program. Check this box. If you qualify for an MSP, your state will contact you and process the MSP application without you having to file separately. About 30% of Extra Help applicants also qualify for an MSP, and stacking the two adds another $2,400+ per year in Part B premium relief.

What changes once you are enrolled in Extra Help

Once approved, several things happen automatically:

• Your Part D drug copays drop immediately. Generic drugs become $5.10 max per fill. Brand-names $12.65 max. The full price your pharmacy was charging stops mattering as soon as your Extra Help status posts.
• You get auto-enrolled in a Part D plan if you do not have one. SSA picks a benchmark plan that covers most of your drugs at no premium. You can switch to a different plan immediately if your current one is not benchmark or does not cover a key drug.
• Your Part D late enrollment penalty disappears. If you had been paying a late enrollment surcharge, it stops the month your Extra Help starts. The penalty resumes only if you later lose Extra Help eligibility.
• You can change Part D plans monthly. Standard Medicare beneficiaries can only change drug plans during fall open enrollment. Extra Help recipients can switch monthly, year-round.
• You qualify for the Limited Income Newly Eligible Transition (LI NET) program. If you become Extra Help eligible mid-year and have not yet selected a Part D plan, LI NET provides temporary coverage so you can fill prescriptions immediately. You can also get reimbursed for covered Part D drugs you paid for after you qualified for Extra Help, if you keep receipts. Call LI NET at 1-800-783-1307.

Renewal and recertification

Extra Help is granted for the rest of the calendar year you applied. Going forward, SSA reviews your eligibility every August or September. If your income or resources are still below the limits, you keep Extra Help and your same Part D plan automatically. You will only get a notice if something changes (you no longer qualify, or you are being moved to a different plan for the next year). If you get no notice, your benefits continue without action.

If your income or resources rise during the year, you keep Extra Help through December 31 of that year, even if you are no longer eligible at recheck. The protection is calendar-year-locked once you are enrolled.

How Extra Help differs from Medicare, Medicaid, and the MSPs

These four programs are easy to confuse. Here is the short version:

• Medicare is federal health insurance for people 65+ or under 65 with a qualifying disability. Part A covers hospital, Part B covers outpatient and doctor visits, Part D covers prescription drugs (sold by private plans). No income limit to enroll.
• Medicaid is joint federal-state health insurance for low-income people of any age. Covers a broad range of medical services.
• Medicare Savings Programs (MSPs) are a subset of Medicaid that pays your Medicare Part B (and sometimes Part A) premiums and cost-sharing. See our 2026 Medicare Savings Programs guide for income limits and the four tiers (QMB, SLMB, QI, QDWI).
• Extra Help (LIS) covers Medicare Part D drug costs only. Different program from MSPs, but enrollment in any MSP auto-qualifies you for Extra Help.

The most powerful combination for a low-income Medicare beneficiary in 2026: get an MSP (saves $2,400+/yr on Part B premium and possibly cost-sharing) AND get Extra Help (saves $5,700/yr on drug costs). Total potential annual savings: $8,100+. Both programs use similar income limits, and applying for one usually triggers evaluation for the other.

For a wider look at all the cash-and-benefit programs available to low-income seniors in 2026, see our guide to senior benefits. To check the federal poverty line your eligibility is calculated against, our FPL calculator shows current 100%, 135%, and 150% FPL for any household size.

Not sure which programs you qualify for? Our free eligibility wizard cross-references federal and state programs in under a minute. No email required.