If you're having trouble paying for prescriptions, the Medicare Extra Help Program may be the answer. It's a federal program that helps people with limited income and savings pay for Medicare prescription drug coverage, known as Part D. Part D is the part of Medicare that covers prescriptions you fill at a pharmacy or by mail, and Extra Help lowers what you pay for it. You'll often hear the program called just “Extra Help,” and its official name is the Part D Low-Income Subsidy, or LIS. It's part of Medicare, and you apply for it through Social Security, for free.

Extra Help isn't an insurance plan, and it isn't a card. It lowers what you pay for the drug plan you already have, or the one you choose.

Social Security estimates Extra Help is worth about $5,700 a year on average, yet CMS data shows millions of people who may qualify haven't enrolled. Many don't know it exists, or assume they won't qualify. This guide covers what it pays for, who qualifies, how to apply, and where to start.

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What is the Medicare Extra Help Program, and what does it cover?

Extra Help works alongside your Part D prescription drug coverage, whether that's a stand-alone drug plan or a Medicare Advantage plan with drug coverage.

What it is, and what it isn't:

• It is a program that lowers your Part D premium, deductible, and copays.
• It isn't a drug plan. You still need to be enrolled in one for it to work.
• It isn't the same as Medicare Savings Programs, which are separate state programs that help with Part B costs (more on those below).

What it pays for:

• Premium. Extra Help pays your Part D premium up to a regional benchmark amount. On lower-cost plans at or below that amount, your premium is $0. If you choose a plan that costs more, you pay the difference.
• Deductible. You pay $0.
• Copays. In 2026, you pay no more than $5.10 for a generic or preferred multi-source drug and $12.65 for other covered drugs. Some people pay less. In 2027, the maximums rise to $5.80 and $14.40.
• The yearly cap. Once your out-of-pocket drug costs reach the Part D cap ($2,100 in 2026, $2,400 in 2027), covered drugs cost $0 for the rest of the year. Payments Extra Help makes on your behalf count toward that cap.
• Late penalty. Extra Help also removes the Part D late enrollment penalty.

About $5,700 a year is what Social Security estimates Extra Help is worth on average.

Who qualifies for Extra Help?

You typically qualify if you meet both income and savings limits, or if you already have certain other coverage.

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The limits in 2026

• Income: At or below $23,940 for one person or $32,460 for a married couple living together. That's 150% of the federal poverty level, and the limits are higher in Alaska and Hawaii.
• Savings and investments: Up to $18,090 for one person or $36,100 for a married couple. These include bank accounts, stocks, bonds, mutual funds, IRAs, cash, and real estate other than your home.
• What doesn't count: Your home, your car, your personal belongings, and up to $1,500 per person set aside for burial expenses.

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You may qualify automatically

You don't have to apply if you have any of these:

• Full Medicaid
• Supplemental Security Income (SSI)
• A Medicare Savings Program, which helps pay your Part B premium

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Limits can be higher than they look

Not all income counts. If you or your spouse work, or you support family members who live with you, you may qualify even if your income is above the numbers. The limits also change each year, and the 2027 limits aren't published yet, so treat the 2026 numbers as a guide.

Extra Help isn't available in Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands, or American Samoa. Programs there differ, so call your state or territory's Medicaid office.

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Quick check

• Is your income at or below the limit for your household?
• Are your savings and investments under the limit, not counting your home and car?
• Do you have Medicaid, SSI, or a Medicare Savings Program?

If you answered yes to any of these, you may be a good candidate. A Solace advocate can check for you.

Think you don't qualify? Common myths

A lot of people rule themselves out before they ever apply. Here are the most common reasons, and why they may not hold up.

• “I have a house and a car, so I won't qualify.” Neither counts toward the savings limit. Neither does up to $1,500 per person for burial expenses.
• “I got turned down years ago.” A lot has changed. The old partial tier ended in 2024, and everyone who qualifies now gets the full benefit. The limits also rise yearly, and your income or savings may have changed. Apply again.
• “I make a little too much.” Not all income counts, and the limits are higher if you work or support family members at home. If you're close, apply anyway.
• “I already have Medicaid, SSI, or a Medicare Savings Program, so I need to apply.” You don't. You qualify automatically. It's still worth confirming that your plan is the right one.
• “I'm in a Medicare Advantage plan.” Extra Help works with Medicare Advantage plans that include drug coverage.
• “I'd have to pay someone to help me apply.” You don't. Applying through Social Security is free.

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How do you apply for Extra Help? Step by step

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1. Gather your information

You'll need to share the value of your savings, investments, and real estate other than your home, plus your income. If you're married and living with your spouse, you'll need their information too.

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2. Apply through Social Security

Apply online at ssa.gov, call Social Security at 1-800-772-1213 (TTY 1-800-325-0778), or visit your local office. You can apply any time, before or after you enroll in a Part D plan.

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3. Let Social Security start your Medicare Savings Program application

When you apply, Social Security sends your information to your state to start an application for a Medicare Savings Program, unless you tell them not to. That means one application can open two doors.

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4. Choose a Part D plan

Extra Help only works once you're enrolled in a Part D plan. If you qualify and don't choose one, Medicare may pick a plan for you. That plan may not cover your drugs, so it's worth choosing yourself.

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5. Watch for notices

Social Security reviews eligibility every year, usually at the end of August. If you're asked for information, respond by the deadline. If your income changes mid-year, you keep Extra Help through December 31. If you're denied, you can appeal, and Social Security will review the decision with a phone hearing or a case review.

Choosing a plan once you have Extra Help

Extra Help lowers your costs, but the plan you choose still matters.

• Only some plans are $0. Extra Help covers your premium up to a regional benchmark. In 2026, there are typically between one and four stand-alone plans per state at no premium for Extra Help members. Which plans qualify can change from year to year, so don't assume yours will stay $0.
• Check your drug list. Make sure your medications and your pharmacy are covered before you enroll.
• You can switch more often. If you have Extra Help, you can change drug coverage once a month, though not into a regular Medicare Advantage plan.
• Open Enrollment is a good checkpoint. It runs October 15 through December 7. Read the notices Medicare sends you in the fall about your plan, copays, and premium.

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Don't stop at Extra Help: Medicare Savings Programs and Medicaid

Extra Help covers Part D drug costs only. Two other kinds of programs can lower your other Medicare costs, and many people qualify for more than one.

• Medicare Savings Programs. These state programs help pay your Part B premium ($202.90 a month in 2026) and may help with deductibles and coinsurance. Qualifying for one also qualifies you for Extra Help automatically. You apply through your state Medicaid office.
• Medicaid. If you have full Medicaid, you qualify for Extra Help automatically, and Medicaid may cover costs Medicare doesn't.
• State drug assistance. Many states have State Pharmaceutical Assistance Programs that help with drug plan premiums, copays, or coinsurance. Your State Health Insurance Assistance Program (SHIP) can tell you what's available.

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How can a Solace advocate guide you through Extra Help?

Between income rules, savings limits, and several overlapping programs, it's easy to miss savings you're entitled to. A Solace advocate can guide you through the process:

• Check whether you qualify for Extra Help
• Fill out the paperwork, since applying through Social Security is free
• Check for Medicare Savings Programs and Medicaid so you don't leave other savings on the table

Your advocate can't decide your eligibility. Social Security does that. What they can do is make sure nothing is missing when you apply.

Getting started takes three steps. You answer a few quick questions about your insurance and health situation, then meet with a Solace physician for a short virtual intro visit of about 20 minutes. Your advocate takes it from there, finding programs you may qualify for, handling the paperwork, and following up until it's resolved. For eligible patients, advocacy is covered by Medicare and many insurance plans.