Extra Help

Extra Help (the Part D Low-Income Subsidy) may lower prescription costs for people who qualify.

What Extra Help may pay for

Extra Help can reduce or eliminate the Part D premium, deductible, and copays for covered drugs, depending on your eligibility level. It does not change the fact that still matter. The 2026 copay amounts are on Extra Help copay levels.

Who should look into it

People with limited income and resources should ask whether Extra Help applies. Income and resource limits are set each year. How Extra Help differs from a Medicare Savings Program and from Medi-Cal is on Can I pay less for Medicare?.

How to apply

Use the Extra Help screener for a 2026 estimate, then apply at SSA.gov/extrahelp or call Social Security at 1-800-772-1213 (TTY 1-800-325-0778). A Medisure Agency review can help you understand whether it may be worth applying; it cannot determine eligibility.

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Screener

Extra Help screener

See whether 2026 Extra Help income and resource limits might apply. Social Security decides.

Read: Can I pay less for Medicare?

Extra Help is Medicare’s Part D Low-Income Subsidy. It may lower or eliminate the drug-plan premium and deductible, cap many copays, and pause a Part D late-enrollment penalty while you have Extra Help. Social Security decides. This website cannot say that you qualify.

2026 income limit (individual): $23,940.00 a year ($1,995.00 a month)
2026 resource limit (individual): $18,090.00 (includes the usual burial set-aside on the Medicare.gov postcard)
2026 Extra Help copay maximums: up to $5.10 generic / $12.65 brand per covered 30-day fill, then often $0 after the yearly Part D out-of-pocket cap

HouseholdIncome periodYearly income (before taxes)Social Security, pensions, wages, and similar countable income. Confirm what Social Security counts.Countable resourcesBank accounts, stocks, and extra property usually count. Home, household items, and usually one car do not. Confirm with Social Security.I have Medi-Cal / Medicaid or a Medicare Savings Program (QMB, SLMB, or QI).

Enter income and resources — or check Medi-Cal / MSP — to see this 2026 estimate. Leave a field blank to treat it as $0.

How to apply. Use SSA.gov/extrahelp, call Social Security at 1-800-772-1213 (TTY 1-800-325-0778), or visit Medicare.gov/extrahelp. For QMB, SLMB, or QI (which often lead to Extra Help), use the Medicare Savings Programs screener.

Screener

Extra Help copay estimate

2026 Extra Help is generally full Extra Help. Compare copay levels — including $0 after the cap.

Read: Extra Help copay levels in 2026

Since 2024, Extra Help at the usual income limits is generally full Extra Help — the old “partial Extra Help” 15% coinsurance was replaced. What still differs is the copay level. Confirm on Medicare.gov.

Which Extra Help level?Extra Help (most people) — $5.10 generic / $12.65 brandFull dual eligible, income at or under 100% FPL — $1.60 / $4.90Nursing home or certain home-and-community care — $0 / $0No Extra Help — standard 2026 Part D ($615 deductible, then 25% until the cap)

Generic fills this yearBrand fills this year

Extra Help copay estimate: $137.10 for those fills ($5.10 generic / $12.65 brand). Deductible $0.00. After you reach the $2,100.00 out-of-pocket threshold, Extra Help copays for covered Part D drugs are generally $0 for the rest of the year. Institutional / HCBS stays at $0. This is not a determination that you qualify.

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