Medicare Extra Help — also called the Low Income Subsidy (LIS) — is a federal program that reduces or eliminates the costs of Medicare Part D prescription drug coverage for people with limited income and resources. Premiums, deductibles, and copays can all be reduced or eliminated depending on your income level. About 14 million people are enrolled, but millions more may qualify without knowing it. This page explains what Extra Help covers, who qualifies, how to apply, and how it connects to Medicare Savings Programs.
What Medicare Extra Help Covers
Part D prescription drug coverage comes with costs most people pay out of pocket: a monthly premium, a yearly deductible before coverage kicks in, and copays or coinsurance at the pharmacy. Extra Help reduces or eliminates all three of these costs, depending on how your income and resources compare to the program limits.
Full Extra Help
People with the lowest incomes and resources qualify for full Extra Help, which eliminates the Part D deductible entirely, caps monthly drug copays at very low amounts (around $1 to $4 for generics and $4 to $10 for brand-name drugs in 2026), and pays most or all of the Part D premium. There is no coverage gap (the “donut hole”) for people with full Extra Help — the reduced cost structure applies throughout the year. Full Extra Help is automatically assigned to people who receive Medicaid, Supplemental Security Income (SSI), or are enrolled in a Medicare Savings Program.
Partial Extra Help
People who are above the threshold for full Extra Help but still within the program’s overall income and resource limits qualify for partial Extra Help. They pay a reduced premium and a sliding-scale deductible, and their copays are lower than standard Part D costs but higher than for full Extra Help recipients. The income limit for partial Extra Help is higher than for full Extra Help, so this tier covers a meaningful range of people with moderate limited income who would otherwise pay full Part D costs.
The Coverage Gap
One of the significant benefits of Extra Help for people who use many medications is protection from the coverage gap. Standard Part D plans have a coverage gap — historically called the “donut hole” — where the cost-sharing structure changes after you and your plan have spent a certain amount. People with Extra Help do not experience this gap: their low copay structure applies year-round regardless of how much they spend on prescriptions. For people managing multiple chronic conditions who fill many prescriptions, this protection can amount to thousands of dollars in savings annually.
Who Qualifies for Extra Help
Extra Help eligibility is based on income, resources, and Medicare enrollment status. You must be enrolled in Medicare Part A or Part B (or both) and live in the United States. Income and resource limits are set annually.
Income Limits (2026)
To qualify for any level of Extra Help, your annual income must be at or below approximately 150% of the federal poverty level. In 2026, that is roughly $22,590 for an individual and $30,660 for a married couple. The Social Security Administration counts most income sources, including Social Security benefits, pension income, wages, and investment income. Some income is excluded from the count, including certain types of assistance payments and a portion of earned income.
Resource Limits (2026)
Countable resources must fall at or below approximately $16,810 for an individual or $33,690 for a married couple. Resources include money in checking and savings accounts, stocks, bonds, and similar financial assets. The home you live in, one car, personal belongings, life insurance with low cash value, and burial funds up to certain amounts are excluded from the resource count. Retirement accounts (IRAs, 401(k)s) are also excluded for Extra Help purposes — which is an important distinction from some other means-tested programs.
Who Gets Automatic Enrollment
You do not need to apply for Extra Help if you already receive Medicaid benefits that cover prescription drugs, if you receive Supplemental Security Income (SSI), or if you are enrolled in a Medicare Savings Program (MSP). Social Security will automatically enroll these individuals in Extra Help and assign a benchmark Part D plan if they do not have one. The automatic assignment notice will arrive by mail. If you are automatically enrolled, you can keep the assigned plan or choose a different plan that better fits your medications — choosing your own plan is usually worth the effort.
How to Apply and Medicare Savings Programs
Applying for Extra Help is a separate process from enrolling in Medicare Part D. You apply once, and if approved, the benefit applies to whatever Part D plan you choose or are assigned to. The application does not affect your Medicare coverage in any other way.
How to Apply for Extra Help
The application for Extra Help is filed with the Social Security Administration, not with Medicare directly. You can apply online at ssa.gov, by calling Social Security at 1-800-772-1213, or by visiting your local Social Security office. The application asks about your income, resources, and household composition. Processing typically takes a few weeks. If approved, the benefit is retroactive to the beginning of the month you applied, so applying early in the year is worth doing if you know you are likely to qualify.
Medicare Savings Programs
Medicare Savings Programs (MSPs) are state-administered programs that pay some or all of the Medicare Part B premium — which is $185 per month in 2026 — and may also cover Part A premiums, deductibles, and coinsurance. There are four MSP tiers (QMB, SLMB, QI, and QDWI), each with different income limits and benefit levels. Enrollment in any MSP automatically qualifies you for full Extra Help. Applying for an MSP is done through your state Medicaid agency, not Social Security. Income limits for MSPs are generally similar to Extra Help limits but vary by state.
Choosing a Part D Plan with Extra Help
If you have Extra Help, you can enroll in any Medicare Part D plan that accepts Extra Help beneficiaries — and most plans do. Extra Help also gives you a Special Enrollment Period: you can switch Part D plans once per quarter from January through September, rather than being locked into annual open enrollment. This flexibility means that if a new medication you need is not covered well by your current plan, you can switch. Comparing plans using the Medicare Plan Finder at medicare.gov, filtering by your specific medications, can find the plan with the lowest total out-of-pocket cost given your Extra Help status.
Who This Page Is For
- Medicare beneficiaries with limited income who are paying full price for Part D coverage
- People with multiple prescriptions whose annual drug costs are substantial
- Those who are not sure whether they qualify — income and resource limits are higher than many people expect
- Seniors who applied years ago and were denied but whose income or resources have since decreased
- People helping an elderly parent or family member navigate Medicare costs
What to Do Next
- Check the Extra Help income limits — individuals earning up to roughly $22,590 per year may qualify, and retirement account balances are excluded from the resource count
- If you already receive Medicaid, SSI, or are in a Medicare Savings Program, you qualify for full Extra Help automatically — check your mail for an auto-enrollment notice or call Social Security to confirm
- Apply online at ssa.gov/extrahelp or call 1-800-772-1213 to apply by phone — the process takes about 20 to 30 minutes
- If your income is near the limit, also apply for a Medicare Savings Program through your state Medicaid agency — approval there automatically grants full Extra Help and may also pay your Part B premium
- After approval, use the Medicare Plan Finder at medicare.gov to compare Part D plans based on your specific medications and Extra Help status
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