Medicare · Low-income help

Medicare Extra Help / LIS — 2026 income limits and how to qualify

6 min read · Updated May 2026 · By licensed SilverEdge advisors

Extra Help (officially the Low Income Subsidy, or LIS) is a Medicare program that dramatically reduces your prescription drug costs. If you qualify, you'll pay no more than $4-$12 per generic and $11-$30 per brand-name drug — regardless of your plan's tier structure. Here's how to know if you qualify in 2026 and how to apply.

Key takeaways

  • 2026 income limit: Up to $23,895/year (single) or $32,335 (married). Higher in Alaska + Hawaii.
  • 2026 resource limit: Up to $17,600 (single) or $35,130 (married) in countable assets — your home and car don't count.
  • Benefit: Generic copays max $4-$12, brand-name copays max $11-$30, no Part D premium for benchmark plans.
  • Auto-enrollment: If you have Medicaid + Medicare (dual eligible), you're automatically enrolled in Extra Help.

What is Medicare Extra Help?

Extra Help — officially called the Low Income Subsidy (LIS) — is a federal program that helps Medicare beneficiaries pay for prescription drug coverage (Part D).

If you qualify, you get:

  • Reduced or zero premium for benchmark Part D plans in your state
  • Reduced or zero deductible
  • Capped copays: $4-$12 per generic, $11-$30 per brand-name drug regardless of the plan's normal tier structure
  • No coverage gap (the old "donut hole" doesn't apply)
  • Late enrollment penalty waived if you missed initial Part D enrollment

For someone on multiple expensive medications, Extra Help can be worth $5,000-$15,000/year in saved drug costs.

2026 Extra Help income limits

Income limits are based on the Federal Poverty Level (FPL):

  • Single, contiguous 48 states + DC: Up to $23,895/year ($1,991/month) qualifies for full LIS.
  • Married, contiguous 48 states + DC: Up to $32,335/year ($2,694/month) qualifies for full LIS.
  • Alaska: Income limits are ~25% higher to reflect cost of living.
  • Hawaii: Income limits are ~15% higher.
  • Partial LIS may be available for incomes between full-LIS limits and 150% FPL.

2026 Extra Help resource (asset) limits

Resource limits include your bank accounts, stocks, bonds, and other countable assets:

  • Single: Up to $17,600 in countable assets
  • Married: Up to $35,130 in countable assets

What doesn't count: Your primary home, one vehicle, household furnishings, life insurance with face value under $1,500, burial plots, and up to $1,500 set aside for burial expenses.

Who is automatically enrolled

You're automatically enrolled in Extra Help if any of these apply:

  • You have full Medicaid in addition to Medicare (dual-eligible).
  • You receive Supplemental Security Income (SSI) from Social Security.
  • You receive help paying Medicare premiums through a Medicare Savings Program (MSP) like QMB, SLMB, or QI.

If you're auto-enrolled, you'll get a notice in the mail. The benefit applies for the rest of the calendar year and renews automatically as long as you remain eligible.

How to apply if you're not auto-enrolled

Three ways to apply:

  • Online: ssa.gov/extrahelp — takes about 30 minutes, no documents to mail.
  • By phone: Call Social Security at 1-800-772-1213 (TTY 1-800-325-0778).
  • In person: Visit your local Social Security office (find it at ssa.gov/locator).
  • SHIP counselor: Free state-based Medicare counseling can walk you through the application — find your state's SHIP at shiphelp.org.

Have ready: your Social Security number, address, citizenship status, household income (last year's tax return helps), and a rough total of your countable assets. The application is free.

Common questions

What is Medicare Extra Help (LIS)?
Extra Help, also called the Low-Income Subsidy (LIS), is a federal program that helps Medicare beneficiaries pay Part D drug plan premiums, deductibles, and copays. Worth approximately $5,300/year on average.
Who qualifies for Medicare Extra Help in 2026?
In 2026, you qualify if your annual income is below $23,475 (single) or $31,725 (married couple), and your assets are below $17,600 (single) or $35,130 (married). The IRA expanded full benefits to 150% of FPL starting 2024.
How do I apply for Extra Help?
Apply online at SSA.gov, by mail (form SSA-1020), or in person at a Social Security office. Approval is automatic if you have Medicaid, SSI, or qualify for a Medicare Savings Program.
How much will I pay for drugs with Extra Help?
With full Extra Help in 2026, generic drugs cost up to $4.90 and brand-name drugs up to $12.15. Premiums and deductibles for benchmark plans are $0.

Questions about your specific situation?

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