Prescription costs

Extra Help with drug costs

Extra Help is a Medicare program that lowers what you pay for prescription drugs: your Part D premium, deductible and copays. It's for people with Medicare whose income and savings are limited. Some people get it automatically; others apply through Social Security.

Checked Oct 28, 2026

Rules set by the Social Security Administration

An older man's hands filling a weekly pill organizer next to prescription bottles

How to apply

Online: ssa.gov (official government site)
Who runs it: Social Security Administration (official government site)1-800-772-1213

Applying is free. Nobody should charge you to apply.

Apply on the official site

Who may qualify

Who may qualify for Extra Help with drug costs
	One person	Married couple
Yearly income limit (2026)	$23,940 a year	$32,460 a year Source: Medicare.gov (source 1)
Savings limit (2026)	$18,090	$36,100 Source: Medicare.gov (source 1)

Who gets it automatically	People with full Medicaid, a Medicare Savings Program, or SSI Source: Medicare.gov (source 1)
How the income limit is set	Below 150% of the federal poverty level, counting the income of a spouse you live with Source: Social Security Administration (source 2)
What doesn't count	The cash value of life insurance doesn't count as savings. Help with food or housing from others doesn't count as income. Source: Social Security Administration (source 2)
Medicare and where you live	Medicare Part A or Part B, and you live in one of the 50 states or DC Source: Social Security Administration (source 2)

What you may get

What Extra Help with drug costs pays
Most you pay for a generic drug (2026)	$5.10 Source: Centers for Medicare & Medicaid Services (source 6)
Most you pay for a brand-name drug (2026)	$12.65 Source: Centers for Medicare & Medicaid Services (source 6)
Most you pay for a generic drug (2027)	$5.80 Source: Medicare.gov (source 1)
Most you pay for a brand-name drug (2027)	$14.40 Source: Medicare.gov (source 1)
Plan deductible (2026 and 2027)	$0 Source: Centers for Medicare & Medicaid Services (source 6)
Plan premium (2027)	$0 Source: Medicare.gov (source 1)
Yearly out-of-pocket cap (2026)	$2,100 Source: Centers for Medicare & Medicaid Services (source 6)
After total drug costs reach the yearly cap (2027)	$0 for covered drugs once total costs reach $2,400 Source: Medicare.gov (source 1)
Part D late enrollment penalty	You don't pay it while you get Extra Help Source: Medicare.gov (source 1)

Dates, renewals and waiting lists

Dates and renewals
How long it lasts	Through December 31, even if your income changes during the year
The next year	It continues if you still meet the limits. You get a letter only if you no longer qualify or your plan changes.
Changing drug plans	You may be able to change your drug coverage once a month

Source: Medicare.gov (source 1)

Good to know

When you apply for Extra Help, Social Security also sends your information to your state to start a Medicare Savings Program application, unless you say no on the form.
Social Security prefers online applications, but you can also get help applying by phone or at a Social Security office.
Your State Health Insurance Assistance Program (SHIP) can help you apply for free.
If you qualify and don't have a Medicare drug plan, you'll be enrolled in one. You can pick a different plan.
If you choose a plan whose premium is above your area's benchmark amount, you may still pay part of the premium.
Income limits are higher in Alaska and Hawaii.
Extra Help isn't offered in Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands or American Samoa. Those areas have other programs; call the Medicaid office there.
If you qualify but aren't in a drug plan yet, Medicare's LI NET program gives temporary drug coverage. Call 1-800-783-1307.
If the pharmacy charges you the wrong amount, contact your plan first, then call 1-800-MEDICARE (1-800-633-4227).

Sources: Medicare.gov (source 1), Social Security Administration (source 3)

What people get wrong

MythI was turned down before, so it's no use applying again.
Not true. You can reapply any time your income or savings change.
MythMy life insurance puts me over the savings limit.
Not true. The cash value of life insurance doesn't count as savings for Extra Help.
MythI already have Medicaid, so I'll need to fill out another application.
Usually not. People with full Medicaid, a Medicare Savings Program or SSI get Extra Help automatically and get a letter in the mail.

Sources

Medicare.gov, Help with drug costs (official government site). Checked Oct 28, 2026.
Social Security Administration, POMS HI 03001.020: Eligibility for Extra Help (Prescription Drug Low-Income Subsidy) (official government site). Checked Oct 28, 2026.
Social Security Administration, POMS HI 03001.005: Medicare Part D Extra Help (Low-Income Subsidy or LIS) (official government site). Checked Oct 28, 2026.
Social Security Administration, POMS HI 03040.001: Overview of Appeal Process for Medicare Part D Subsidy Determination (official government site). Checked Oct 28, 2026.
Social Security Administration, POMS HI 03094.701: Hearing Appointment notice (Extra Help) (official government site). Checked Oct 28, 2026.
Centers for Medicare & Medicaid Services, Announcement of CY 2027 Medicare Advantage Capitation Rates and Part C and Part D Payment Policies (Table V-2) (official government site). Checked Oct 28, 2026.

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