Extra Help With Medicare Drug Costs: Limits and Copays
Extra Help (the Part D low-income subsidy) pays your drug plan premium, removes the deductible and caps each prescription at a few dollars. If your income is under about $23,940 a year, check whether you qualify.
Who qualifies
| 2026 limits | One person | Married couple |
|---|---|---|
| Yearly income | $23,940 | $32,460 |
| Resources | $18,090 | $36,100 |
Income up to 150% of the federal poverty level. The resource limits include $1,500 per person for burial expenses; without that, they are $16,590 and $33,100. Your home, one car and household goods don’t count. The 2027 limits haven’t been published yet; CMS sets them late in the year.
You get Extra Help automatically, without applying, if you have full Medicaid, Supplemental Security Income (SSI) or a Medicare Savings Program. Everyone else applies through Social Security, online or by phone. It’s free, and you can apply any time of year.
What you pay
| Per prescription | 2026 | 2027 |
|---|---|---|
| Generic drugs | Up to $5.10 | Up to $5.80 |
| Brand-name drugs | Up to $12.65 | Up to $14.40 |
| With full Medicaid, income at or under the poverty level | $1.60 / $4.90 | $1.65 / $5.00 |
| Living in a nursing home or getting home and community-based services through Medicaid | $0 | $0 |
No deductible with Extra Help. Copays stop once your drug costs reach the Part D out-of-pocket cap ($2,400 in 2027).
Your premium can be $0
Extra Help pays the full premium of any “benchmark” Part D plan: a basic plan priced at or below your region’s average. Our Part D rankings by state mark these plans “$0 premium with full Extra Help.” If you pick a pricier plan, you pay the difference.
You can switch plans more often. People with Extra Help can switch into a stand-alone Part D drug plan once a month, outside the usual fall Open Enrollment, so you’re not stuck if your drugs change. Check Medicare Plan Finder before you switch.
Questions
Does Extra Help affect my Social Security?
No. It doesn’t lower your Social Security benefit, and it isn’t counted as income.
Do I still owe the Part D late enrollment penalty?
No. People with Extra Help don’t pay the Part D late enrollment penalty.
Can I get Extra Help with a Medicare Advantage plan?
Yes, if the plan includes drug coverage. Extra Help applies to the drug part of the premium and your drug copays.
What if my income is a little over the limit?
Apply anyway. Social Security doesn’t count all income: some of your earnings and certain benefits are excluded, so you may qualify with income above the headline figure.
Sources
Official sources only, checked October 22, 2026.
- CMS, CY 2026 resource and cost-sharing limits for the low-income subsidy — cms.gov PDF.
- CMS, CY 2027 Rate Announcement, updated Part D benefit parameters (Extra Help copays) — cms.gov PDF.
- Medicare.gov, “Help with drug costs” (2026 income and resource limits) — medicare.gov.
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