Extra Help eligibility checker

What is Extra Help?

Extra Help (also called the Low-Income Subsidy or LIS) is a federal program administered by the Social Security Administration that helps people with limited income and resources pay Medicare Part D costs. It can save eligible beneficiaries thousands of dollars per year.

What Extra Help covers in 2026

If you qualify for Extra Help, you'll get:

• $0 or very low Part D premiums — many "benchmark" plans are completely free
• $0 deductible
• Capped copays — approximately $4.90 for generic drugs, $12.15 for brand-name drugs in 2026
• No coverage gap — Extra Help eliminates the donut hole
• No late enrollment penalty — even if you didn't enroll in Part D when first eligible
• Continuous Special Enrollment Period — you can change Part D plans once per calendar quarter (Jan-Mar, Apr-Jun, Jul-Sep)

For someone taking expensive medications, Extra Help can mean the difference between paying $2,100/year and paying just a few hundred dollars.

2026 Extra Help eligibility limits

To qualify, you must meet two tests: an income test and a resource test.

Income limits (2026 estimated)

• Single: $23,475 per year (approximately 150% of the federal poverty level)
• Married couple: $31,725 per year

Resource limits (2026 estimated)

• Single: $17,600
• Married couple: $35,130

Resources include cash, money in checking and savings accounts, stocks, bonds, and IRAs. Resources do not include your home, one vehicle, household items, burial plots, life insurance with face value under $1,500, and a few other excluded items.

You automatically qualify if you have:

• Medicaid (full or partial)
• Supplemental Security Income (SSI)
• A Medicare Savings Program (MSP) like QMB, SLMB, or QI

If any of these apply, you don't need to apply for Extra Help separately — you should already be receiving the benefit. If you're not sure whether you're getting Extra Help, call Social Security at 1-800-772-1213.

How to apply for Extra Help

If you don't automatically qualify, you can apply directly with the Social Security Administration. Applying is free, takes about 10 minutes, and there's no penalty for applying even if you don't qualify.

Three ways to apply:

1. Online — Apply at ssa.gov/medicare/part-d-extra-help (fastest)
2. By phone — Call Social Security at 1-800-772-1213 (TTY: 1-800-325-0778)
3. In person — Visit your local Social Security office (find yours at ssa.gov)

You can also get free help applying from your state's SHIP counselor.

What happens after you apply

Social Security will review your application and send a written decision within a few weeks. If approved, your Extra Help benefits typically start the month after approval, and continue indefinitely as long as you remain eligible.

Each year, Social Security automatically reviews your eligibility. You'll get a letter if anything changes. You only need to reapply if Social Security specifically asks you to.

Don't qualify for Extra Help? Other ways to lower your costs

If you don't qualify for Extra Help, the right Part D plan choice can still save you significant money. The same drug can cost dramatically different amounts on different plans. PlanMatch can compare Part D plans by your specific drugs, or a licensed Medicare agent can help walk you through the options for free.

Already have Extra Help? Make sure you're on the right plan

People with Extra Help are sometimes auto-enrolled in random Part D plans, which may not cover their specific drugs well. If you have Extra Help:

• You can change Part D plans once per calendar quarter — January through September
• Use the Medicare.gov Plan Finder to find the best plan for your specific medications
• Look for "benchmark" plans — these are plans where Extra Help covers 100% of the premium, leaving you with a $0 monthly premium

Frequently asked questions