Medicare Supplement

Extra Help in 2026: Who Qualifies for Medicare Drug Aid

COLUMBIA, Md. — If prescription costs are stretching your monthly budget, a federal program called Extra Help could take a big bite out of what you pay at the pharmacy in 2026 — and more people qualify than you might think.

Extra Help, also known as the Low-Income Subsidy (LIS), is run by Medicare and the Social Security Administration. It helps eligible people with Medicare pay for their Part D prescription drug plan premiums, deductibles, and copays. Here in Columbia, which sits in Howard County, local counselors say many people never apply because they assume they earn too much. That’s a costly assumption.

What Extra Help Actually Does

Extra Help lowers what you pay for your Medicare Part D prescription drug coverage. That includes your monthly plan premium (up to a benchmark amount), your yearly deductible, and the copays you pay when you fill a prescription.

This matters even more in 2026, because Part D is changing in ways that affect everyone. The new out-of-pocket cap for covered drugs is $2,100 for the year, and the maximum Part D deductible a plan can charge is $615. The old “donut hole” coverage gap was eliminated in 2025, so Part D now has three simpler phases. Extra Help can bring your share of those costs down significantly.

Who Qualifies in 2026

To get Extra Help, you must have Medicare and live in one of the 50 states or D.C. Eligibility is based on your income and your resources (things like money in the bank and investments — your home and car don’t count).

Thanks to changes from the Inflation Reduction Act, the program was expanded in 2024 so that everyone who qualifies now gets the full subsidy. There is no longer a partial benefit tier. That means if you qualify, you qualify all the way.

You may automatically qualify — with no application needed — if you already have:

• Full Medicaid coverage,
• A Medicare Savings Program (help paying your Part B premium), or
• Supplemental Security Income (SSI).

If any of those apply to you, Medicare will mail you a notice. Everyone else needs to apply.

The Income and Resource Limits (Rough Guide)

The Social Security Administration updates the limits each year, usually in the spring. For a general sense, in 2025 you could qualify with an annual income up to about $23,475 for an individual or $31,725 for a married couple living together, with resource limits around $17,600 and $35,130. The 2026 limits will be similar and slightly higher.

Even if you’re a little over these amounts, apply anyway. Certain income (like a portion of earnings) and certain assets are not counted, and Social Security will do the math for you.

How and When to Apply

There is no deadline to apply for Extra Help — you can apply any time of year. But timing matters if you also want to change your Part D plan. Once you’re approved for Extra Help, you get a Special Enrollment Period that lets you switch drug plans outside the normal windows.

For everyone else, remember the two big Medicare dates:

• Annual Enrollment Period: October 15 – December 7
• Medicare Advantage Open Enrollment Period: January 1 – March 31

You can apply for Extra Help three ways:

1. Online at ssa.gov/extrahelp 2. By calling Social Security at 1-800-772-1213 3. In person at your local Social Security office

A Note on Plan Choices in Howard County

Columbia is in Howard County, where Maryland residents can choose from a range of stand-alone Part D drug plans and Medicare Advantage plans that include drug coverage. Availability is set at the county level, so your neighbor across the county line may see a different list. You can compare what’s offered in your ZIP code using the Plan Finder tool at medicare.gov.

If you get Extra Help, pay attention to what Medicare calls benchmark plans — Part D plans with premiums low enough to be fully covered by the subsidy. Sticking with a benchmark plan can mean no premium out of your pocket.

What About Higher-Income Retirees?

Extra Help is for lower-income beneficiaries, but on the other end of the scale, higher earners pay more. In 2026, IRMAA surcharges — extra amounts added to your Part B and Part D premiums — begin for single filers with income above $109,000 (based on your 2024 tax return). This doesn’t affect Extra Help eligibility, but it’s useful context if you’re helping a parent or spouse review their overall Medicare costs.

Also worth knowing: the Medicare Prescription Payment Plan lets anyone with Part D spread their out-of-pocket drug costs across the calendar year in monthly installments. It doesn’t reduce what you owe, but it can make big pharmacy bills easier to manage. You can opt in through your drug plan.