Medicine can cost more than you expect, especially when you’re living on a fixed income. Medicare drug plans have premiums, deductibles, and copays that can add up quickly.
There is a federal program that can lower those costs. It is called Extra Help, also known as the Medicare Part D Low-Income Subsidy.
Some people get it automatically, without filling out an application. Here is how it works, who qualifies, and how to apply.
What Does Extra Help Save You?
Extra Help lowers the cost of Medicare prescription drug coverage.
According to Social Security, it helps pay for your Medicare Part D monthly premium, yearly deductible, and prescription copays.
Social Security estimates that Extra Help is worth about $5,700 per year. That is an estimated value of the assistance, not a guaranteed amount you will personally save.
You also do not have to pay a Part D late enrollment penalty while you qualify for Extra Help.
How Much Will Prescriptions Cost in 2027?
Medicare.gov lists these Extra Help costs for 2027:
- Monthly premium: $0 for a qualifying drug plan whose premium is covered by the subsidy.
- Yearly deductible: $0.
- Generic prescriptions: No more than $5.80 per covered drug.
- Brand-name prescriptions: No more than $14.40 per covered drug.
- After reaching $2,400 in total drug costs: $0 for covered Part D drugs for the rest of the year.
The $2,400 threshold includes certain payments made on your behalf. It does not mean you personally have to spend $2,400 before your prescriptions become free.
These are the published 2027 amounts, not the copays for 2026.
For 2026, Medicare says people who qualify for Extra Help through certain Medicare Savings Programs, including QMB, SLMB, and QI, pay no more than $12.65 for each covered prescription.
Keep in mind that not every Part D plan has a fully covered premium. If you choose a plan that costs more than the subsidy covers, you may have to pay the difference.
Who Qualifies for Extra Help?
Extra Help is for people with Medicare who have limited income and resources.
For 2026, Medicare.gov lists these annual limits:
| 2026 Limits | Single Person | Married Couple |
|---|---|---|
| Income | $23,940 | $32,460 |
| Resources | $18,090 | $36,100 |
These are the published 2026 limits. The income and resource limits for 2027 may be different when they are released.
Resources generally include money in bank accounts, investments, and other assets that can be converted to cash.
However, not everything you own counts.
According to Social Security’s Extra Help guide, resources that are not counted include:
- Your home.
- Your vehicle or vehicles.
- Burial plots and certain money set aside for burial expenses.
- Life insurance policies.
- Personal belongings, such as furniture and jewelry.
You may also qualify with income above the usual limits in certain situations.
For example, Social Security says different rules may apply if you support family members who live with you, have earnings from work, or live in Alaska or Hawaii.
If your income is close to the limit, it is worth checking rather than assuming you do not qualify.
Our federal poverty level guide can also help you understand how income limits are used in assistance programs.
Can You Get Extra Help Without Applying?
Yes. Some people qualify automatically.
According to Medicare.gov, you automatically qualify for Extra Help if you have any one of these:
- Full Medicaid coverage.
- Help from your state paying your Medicare Part B premium through a Medicare Savings Program.
- Supplemental Security Income (SSI) payments from Social Security.
You do not have to meet all three conditions. Any one of them can qualify you automatically.
Medicare or Social Security will notify you about your Extra Help status.
If you qualify automatically but do not have Medicare prescription drug coverage, Medicare can enroll you in a drug plan so you can use the benefit.
If you are unsure whether you already receive Extra Help, check your Medicare notices or ask a SHIP counselor for assistance.
How Do You Apply for Extra Help?
If you do not qualify automatically, you can apply through Social Security.
You can apply at any time, whether you already have Medicare prescription drug coverage or are preparing to enroll.
Here is how to get started.
- Gather your financial information. You may need information about bank accounts, retirement accounts such as IRAs or 401(k)s, pensions, annuities, and other income or resources. If you are married and living with your spouse, you may also need your spouse’s information.
- Visit Social Security’s Extra Help page. Select the online application to begin.
- Complete the financial questions. Answer as accurately as you can using the information you have available.
- Review the Medicare Savings Program option. Social Security can send information from your application to your state to begin consideration for a Medicare Savings Program, unless you choose not to have that information shared.
- Submit your application. Social Security will review your information and notify you of its decision.
If you would rather not apply online, Social Security also offers options to apply by phone or through a paper application.
You can find those options on the same SSA Extra Help page.
What About Medicare Savings Programs?
Medicare Savings Programs are separate from Extra Help, but the two can work together.
These state-administered programs help eligible people pay certain Medicare costs, such as Part B premiums.
You can learn more about eligibility and how they work on Medicare.gov’s Medicare Savings Programs page.
Applying for Extra Help can be a useful starting point for finding out whether you might qualify for that additional assistance.
What Happens After You Apply?
Social Security reviews your application and lets you know whether you qualify.
If you are approved, you will need Medicare prescription drug coverage to use Extra Help. This can be a stand-alone Part D plan or a Medicare Advantage plan that includes prescription drug coverage.
If you do not choose a qualifying drug plan, Medicare may enroll you in one.
It is still worth comparing your options, because drug plans can have different covered medications, pharmacy networks, and premiums.
Can You Change Your Drug Plan?
People who qualify for Extra Help generally have a special enrollment opportunity to change their Medicare prescription drug coverage once per calendar month.
This can be useful if your current plan does not cover a medication you need or if another plan works better with your pharmacy.
However, the monthly special enrollment period has restrictions. It does not allow every type of Medicare Advantage plan change.
Before switching, check whether your medications and preferred pharmacy are covered under the new plan.
Will Social Security Review Your Eligibility Again?
Social Security periodically reviews whether people receiving Extra Help still qualify.
These reviews often take place around late August, but not everyone receives a review form every year.
If Social Security selects you for a review, it may send Form SSA-1026.
You generally have 30 days to complete and return that form. If you do not return a required review form, your Extra Help may end the following year.
Watch your mail for notices from Social Security, especially if your income or resources have changed.
If you lose Extra Help because your circumstances change, you can apply again if you believe you qualify.
What Are the Limits of Extra Help?
Extra Help can make prescriptions much more affordable, but there are a few important things to understand.
First, you must have Medicare prescription drug coverage to use the benefit. Extra Help does not replace Part D coverage or automatically pay for every medication outside your plan.
Second, the amount of assistance depends partly on your drug plan and the applicable program rules. A $0 premium applies to plans whose premiums are fully covered by the subsidy.
Third, Extra Help is not available in Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands, or American Samoa. Those territories have other assistance arrangements for eligible residents.
Finally, if your income or resources are too high for Extra Help, you may still have other options.
Medicare’s Extra Help information points to other assistance programs, including State Pharmaceutical Assistance Programs and help offered by some drug manufacturers.
You can also ask your doctor or pharmacist whether a lower-cost medication could meet your needs.
Who Can Help If You Are Doing This Alone?
You do not have to figure out Medicare Extra Help by yourself.
Your State Health Insurance Assistance Program, or SHIP, offers free, unbiased Medicare counseling.
A SHIP counselor can help you understand Extra Help, review your prescription drug coverage, and find out how to apply for assistance.
You can find your local program at SHIPHelp.org.
This can be especially helpful if you are overwhelmed by Medicare paperwork or unsure which drug plan is right for you.
Relief Recap
Prescription costs can take a painful bite out of a limited income, but Medicare Extra Help may reduce what you pay for drug plan premiums, deductibles, and covered prescriptions.
Some people qualify automatically through Medicaid, a Medicare Savings Program, or SSI. Others can apply directly through Social Security.
The income and resource limits matter, but some exceptions apply. If you are close to the limits, checking your eligibility could be worthwhile.
For more ways to stretch your budget, read our guide to 7 Powerful Programs That Can Save Seniors Over $5,000.
