Prescription costs have climbed to the point where many people are choosing between their medications and their groceries. There's a program built to fix exactly that — and it's shockingly underused. Medicare Extra Help, also called the Low-Income Subsidy (LIS), is a federal program run by Social Security that helps people with limited income and resources pay for their Part D prescriptions. The Social Security Administration estimates it's worth an average of about $5,700 a year to those who qualify — yet an estimated two million eligible people have never signed up. Let's make sure you're not one of them.
What Extra Help Does for You
For those who qualify, Extra Help isn't a small discount — it's a major reduction in what you pay for prescriptions. It works in four powerful ways:
Pays Your Premium
Covers your Part D plan premium up to a regional benchmark amount — often bringing it to $0.
Eliminates Your Deductible
Your Part D deductible is reduced or wiped out entirely, so coverage starts right away.
Caps Your Copays
Your cost per prescription drops to just a few dollars, based on your level and the drug.
Removes the Late Penalty
If you had a Part D late-enrollment penalty, Extra Help eliminates it going forward.
What You'd Pay at the Pharmacy
With Extra Help, your prescription copays are capped at just a few dollars. The exact amounts are set by Medicare each year. For 2026, the general figures look like this:
| Your Situation | Generic Drugs | Brand-Name Drugs |
|---|---|---|
| Full Extra Help | Up to $5.10 | Up to $12.65 |
| Also have Medicaid / QMB level | Up to $1.60 | Up to $4.90 |
| After you reach the yearly cap | $0 | $0 |
Who Qualifies
Eligibility comes down to two tests — your income and your resources (assets). The limits are tied to the Federal Poverty Level and are updated every year, so treat the figures below as general 2026 guidance:
| 2026 Limit (general) | Single | Married (living together) |
|---|---|---|
| Annual income (about 150% FPL) | Around $23,000–$24,000 | Around $31,000–$32,000 |
| Countable resources | Around $17,000–$18,000 | Around $35,000–$36,000 |
What counts as a "resource": money in checking, savings, CDs, stocks, bonds, and most retirement accounts. What doesn't count: your home, one vehicle, personal belongings, and certain burial funds.
You May Already Qualify Automatically
Here's something many people don't realize — if you're in any of these groups, you're automatically enrolled in Extra Help and don't need to apply at all:
- You have full Medicaid along with your Medicare (see dual-eligible coverage).
- You're in a Medicare Savings Program — such as QMB, SLMB, or QI — where the state helps pay your Part B premium.
- You receive Supplemental Security Income (SSI) from Social Security.
How to Apply
If you're not auto-enrolled, applying is free, straightforward, and there's no downside to trying even if you're unsure you'll qualify. You have three easy options:
- Apply online at the Social Security Administration's secure site: ssa.gov/medicare/part-d-extra-help (or start the application directly at secure.ssa.gov/i1020).
- Apply by phone by calling Social Security at 1-800-772-1213 (TTY 1-800-325-0778).
- Apply in person at your local Social Security office.
A Bonus: More Chances to Switch Plans
Extra Help comes with one more perk worth knowing. While most people can only change their drug plan during the fall Annual Election Period, those who qualify for Extra Help get additional opportunities to change plans during the year.
Common Questions
What is Medicare Extra Help?
How much can Extra Help save me?
Who qualifies for Extra Help in 2026?
How do I apply for Extra Help?
Do I have to reapply for Extra Help every year?
Your Next Step
Extra Help is one of the most valuable — and most overlooked — programs in all of Medicare. If there's any chance you qualify, it's worth five minutes to find out:
- Watch the video above — we explain Extra Help in plain English.
- Check the official limits — use the government links in the sidebar, or Medicare.gov.
- Book a Blueprint consultation — we'll help you check eligibility and apply, free.
Your blueprint is waiting. Let's build it together.