Medicare Supplement

Extra Help With Medicare Drug Costs in 2026: Who Qualifies

SOUTHAVEN, Miss. — If paying for prescriptions each month feels like a stretch, there's a federal program that could ease the pressure. It's called Extra Help, and in 2026 it can meaningfully lower what people with Medicare pay for their Part D drug coverage. Here's a plain-English guide to who qualifies, what it does, and how to apply.

What Extra Help actually is

Extra Help — sometimes called the Low-Income Subsidy (LIS) — is a federal program run by Medicare and the Social Security Administration. It helps people with limited income and savings pay for Part D prescription drug coverage.

If you qualify, Extra Help can reduce or eliminate your Part D premium and deductible and cap what you pay at the pharmacy counter for covered drugs. As of 2024, the program was expanded so that everyone who qualifies gets the full benefit — there's no longer a partial tier.

How Extra Help fits into 2026 Part D

A few Part D facts to keep in mind for 2026, straight from Medicare's program rules:

• The out-of-pocket cap for covered Part D drugs is $2,100.
• The maximum Part D deductible a plan can charge is $615.
• The old coverage gap ("donut hole") is gone — Part D now has three simpler phases.
• Anyone can opt into the Medicare Prescription Payment Plan, which spreads drug costs across monthly bills instead of paying big amounts at the pharmacy.

Extra Help sits on top of all of that. If you qualify, your costs are lower than the standard limits above — often much lower.

Who qualifies in 2026

To get Extra Help, you generally need to:

• Have Medicare (Part A and/or Part B),
• Live in one of the 50 states or D.C., and
• Have income and resources below program limits set each year by Social Security.

Income limits are tied to the federal poverty level, and "resources" means things like money in checking, savings, stocks, and bonds. Your home, one car, burial plots, and household belongings don't count as resources.

You may qualify automatically — without applying — if you already have:

• Full Medicaid,
• A Medicare Savings Program (which helps pay Part B premiums), or
• Supplemental Security Income (SSI).

If that's you, Medicare will mail you a notice. If you're not sure, it's worth checking anyway — many people who qualify never apply.

What Extra Help covers in Southaven

Southaven is in DeSoto County, where Medicare beneficiaries choose from a range of stand-alone Part D drug plans and Medicare Advantage plans that include drug coverage. Extra Help can be used with either type of drug coverage — the subsidy travels with you, not with a specific plan.

One helpful feature: people with Extra Help get a Special Enrollment Period, meaning you can change your Part D or Medicare Advantage drug plan once per calendar quarter during the first three quarters of the year — you're not locked into the standard Oct. 15 – Dec. 7 Annual Enrollment Period like everyone else.

How to apply

There are three easy ways:

1. Online at ssa.gov/extrahelp (Social Security handles applications). 2. By phone at 1-800-772-1213 (Social Security). 3. In person at your local Social Security office.

The application is free and takes most people about 10 minutes. You'll be asked about income, savings, and household size. If you're denied, you can appeal — and you can reapply anytime your situation changes.

For free, unbiased help applying, Mississippi has a State Health Insurance Assistance Program (SHIP) with trained counselors who can walk you through it at no cost.

A quick word on IRMAA (the opposite end)

Extra Help is for people with lower incomes. On the other end, higher-income beneficiaries pay an IRMAA surcharge on Part B and Part D — that begins above $109,000 in income for a single filer in 2026. Most people are somewhere in the middle and pay standard rates.