Medicare Extra Help: 2026 income limits and what you pay in 2027
Extra Help is a Medicare program that lowers drug coverage costs for people with limited income and resources. For 2026 the limits are $23,940 of income and $18,090 of resources for an individual, and $32,460 and $36,100 for a married couple. In 2027, people who get it pay a $0 plan premium and deductible and up to $5.80 for a generic drug.
2026 limits
| Income limit | Resource limit | |
|---|---|---|
| Individual | $23,940 | $18,090 |
| Married couple | $32,460 | $36,100 |
What you pay with Extra Help in 2027
- Plan premium: $0. Plan deductible: $0.
- Up to $5.80 for each generic drug and up to $14.40 for each brand-name drug at a participating pharmacy.
- Once total drug costs reach $2,400, $0 for each covered drug.
- With full Medicaid and the Qualified Medicare Beneficiary program: no more than $4.90 for each covered drug.
Who gets it automatically
Medicare says you get Extra Help automatically if you get any of these, and you will receive a notice in the mail:
- Full-benefit Medicaid coverage.
- Help from your state paying your Part B premiums, through a Medicare Savings Program.
- Supplemental Security Income (SSI) payments from Social Security.
Everyone else: apply
You can apply with Social Security online, or by calling 1-800-772-1213 to make an appointment. You can apply any time, before or after you enroll in Part D. Medicare notes you can apply for Extra Help and the Medicare Savings Programs at the same time; Social Security will send your information to your state to start a Medicare Savings Program application unless you tell it not to. Your State Health Insurance Assistance Program (SHIP) can help for free.
Once you qualify
- If you do not have a drug plan, Medicare enrolls you in one, and you can pick a different one.
- You keep Extra Help through December 31 even if your income changes during the year.
- If you meet next year's limits you keep it; you get a notice only if you no longer qualify or are moved to a different plan.
- You may be able to change drug coverage once a month, unlike most people with Medicare.
- You do not pay the Part D late enrollment penalty while you get Extra Help; see the penalty guide.
If you are charged the wrong amount
Contact your drug plan, which may ask for proof that you get Extra Help, and tell it how many days of medication you have left. You can also call 1-800-MEDICARE (1-800-633-4227). Medicare's LI NET program gives temporary drug coverage to people who qualify for Extra Help or Medicaid but are not yet in a drug plan: 1-800-783-1307.
Where it is not available
Extra Help is not available in Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands or American Samoa; Medicare points people there to their state Medicaid office for other programs.
The Part D numbers everyone pays
Without Extra Help, Part D in 2027 has a deductible of up to $700 and an out-of-pocket cap of $2,400; see Part D costs.
Check our work
Every figure on this page was read from these official documents. Follow the links and compare.
- Help with drug costs (Extra Help)Medicare.gov. Read on November 12, 2026.
- Apply for Medicare Part D Extra Help programSocial Security Administration. Read on November 12, 2026.
- Announcement of Calendar Year 2027 Medicare Advantage Capitation Rates and Part C and Part D Payment PoliciesCenters for Medicare & Medicaid Services. Read on November 12, 2026.