Here's the short answer. Extra Help is a Medicare program that pays part of your Part D drug costs if your income and resources are low. It helps with premiums, deductibles, and copays. Some people get it automatically. Everyone else can apply with Social Security, any time. It is not the same as a Medicare Savings Program. Those help with other Medicare costs. Extra Help is for drugs.
Who gets Extra Help automatically
You get Extra Help with no application if you have any one of these:
- Full-benefit Medicaid coverage
- Help from your state paying your Part B premium through a Medicare Savings Program
- Supplemental Security Income (SSI) payments from Social Security
You will get a notice in the mail. It tells you what you will pay. It also names your new drug plan if you did not already have one. People who have both Medicare and Medicaid are called dual eligibles.
Who can apply
In most cases you must have income and resources below set limits. The limits may go up each year. These are the 2026 limits:
| Your situation | Income limit | Resource limit |
|---|---|---|
| Single | $23,940 | $18,090 |
| Married couple | $32,460 | $36,100 |
Income limits are higher in Alaska and Hawaii. Medicare.gov lists them separately. Extra Help is not offered in Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands, or American Samoa. Other programs help there, so call your State Medical Assistance (Medicaid) office.
What counts as income: wages, self-employment earnings, Social Security, pensions, Railroad Retirement benefits, Veterans benefits, alimony, annuities, rental income, and workers' compensation. States do not count things like SNAP, housing help, home energy help, and earned income tax credit payments.
What counts as resources: money in checking, savings, or retirement accounts, plus stocks and bonds. Your home, one car, a burial plot, and household items do not count.
How to apply
- Gather papers for you and your spouse. These include bank statements, tax returns, retirement account balances, and statements for pensions, Veterans' benefits, annuities, and Railroad Retirement benefits.
- Apply with Social Security. You can apply online. Or call 1-800-772-1213 (TTY 1-800-325-0778) and ask for an appointment to apply for Part D Extra Help.
- Apply any time. You can apply before or after you join a Part D plan.
- Ask for free help if you want it. Your local SHIP can help you apply.
You can apply for Extra Help and a Medicare Savings Program at the same time. Social Security sends your information to your state to start the savings program application unless you tell it not to on the Extra Help form.
Extra Help and Medicare Savings Programs: the difference
| Extra Help | Medicare Savings Programs | |
|---|---|---|
| What it pays for | Part D drug premiums, deductibles, and copays | Help with Medicare costs such as the Part B premium |
| Automatic? | Yes, if you have full Medicaid, an MSP, or SSI | No. You apply through your state |
| Where you apply | Social Security | Your state Medicaid agency |
If you qualify for an MSP, you get Extra Help automatically. Read Medicare Savings Programs to see the state rules.
What happens after you qualify
- Medicare enrolls you in a drug plan if you do not have one. You can pick a different plan if you want.
- You keep Extra Help through December 31, even if your income changes during the year.
- If you still meet the limits next year, you keep it. You get a letter only if you no longer qualify or your plan changes.
- You do not pay a Part D late enrollment penalty while you get Extra Help. If you had one before, it goes away. See late enrollment penalties.
- You may be able to change drug plans once a month.
If your Extra Help ends, join a drug plan within 2 months. That helps you avoid the penalty. You can apply again any time if your income or resources change.
If you are paying the wrong amount
Call your drug plan. It may ask for proof that you get Extra Help. Examples are your Medicare Extra Help letter, your SSI award letter, or a Medicaid card. Tell the plan how many days of medicine you have left. You can also call 1-800-MEDICARE (1-800-633-4227, TTY 1-877-486-2048).
If you qualify but are not in a plan yet, the LI NET program gives temporary drug coverage. Call 1-800-783-1307.
Common questions
Do I have to apply if I have Medicaid?
Usually not. Full-benefit Medicaid gets you Extra Help automatically. Your state can tell you if your Medicaid is full benefit.
Is Extra Help the same as the Low-Income Subsidy (LIS)?
Yes. Extra Help is the common name. Some forms and plans call it the Low-Income Subsidy, or LIS.
Does my home count against the resource limit?
No. Your home and one car do not count.
Can I apply if I do not have a drug plan yet?
Yes. You can apply before or after you enroll in Part D.
Related pages
- Medicare Savings Programs
- Getting Help Paying
- Medicare Part D
- Dual Eligibility
- Medicare Late Enrollment Penalties
- SSA: Apply for Extra Help
- Medicare.gov: Help with drug costs