Extra Help is a Medicare program that helps people with limited income and resources pay for Part D drug coverage: premiums, deductibles and copays. In 2027, someone with Extra Help pays no more than $5.80 for each generic drug and $14.40 for each brand-name drug at a participating pharmacy, with a $0 plan deductible. Compare that with a standard drug plan, which can charge a deductible of up to $700 in 2027 plus 25% of the drug’s cost.
If your income is under about $24,000 a year as a single person, it’s worth checking, even if you’re not sure you’ll qualify. Applying is free, you can do it online or by phone, and there’s no penalty if the answer is no.
I’m a researcher who reads Medicare’s rules closely, not a licensed agent or a benefits counselor. Everything below comes from Medicare.gov and Social Security, and I link to both. For free one-on-one help applying, contact your State Health Insurance Assistance Program (SHIP).
What Extra Help pays for in 2027
According to Medicare.gov’s Extra Help page, here’s what you’d pay in 2027 with Extra Help:
- Plan premium: $0, per Medicare.gov. In practice, plans priced above your region’s benchmark can still charge part of a premium, so check the plan you pick.
- Plan deductible: $0
- Generic drugs: up to $5.80 per prescription
- Brand-name drugs: up to $14.40 per prescription
- After $2,400 in total drug costs (counting what Extra Help pays for you), $0 for each covered drug for the rest of the year
People who also have full Medicaid and are in the Qualified Medicare Beneficiary (QMB) program pay no more than $4.90 per covered drug. And while you have Extra Help, you don’t owe a Part D late enrollment penalty.
To see why that matters, picture someone taking a brand-name drug that costs $500 a month. On a standard plan with the maximum deductible, they’d pay the full $700 deductible in January and then 25% of the drug’s cost after that, until they hit the $2,400 cap. With Extra Help, that same prescription costs no more than $14.40 a fill.
Who qualifies
Automatic qualification
You get Extra Help automatically, without applying, if you have:
- Full Medicaid coverage
- Help from your state paying your Part B premium through a Medicare Savings Program
- Supplemental Security Income (SSI) from Social Security
If that’s you, Medicare mails a notice telling you what you’ll pay. If you don’t already have a drug plan, Medicare enrolls you in one, and you can switch to a different plan if you prefer.
Income and resource limits for 2026
If you don’t qualify automatically, you generally need income and resources below these limits. Medicare.gov lists the 2026 figures:
| Your situation | Yearly income limit | Resource limit |
|---|---|---|
| Individual | $23,940 | $18,090 |
| Married couple | $32,460 | $36,100 |
Limits are higher in Alaska and Hawaii, and they usually go up each year. The 2027 limits haven’t been published yet, and I’ll update this table when they are.
“Resources” generally means things like money in the bank, stocks and bonds. The application from Social Security walks you through what counts and what doesn’t. If you’re close to the line, apply anyway and let Social Security make the call. It costs nothing, and there’s no penalty for being turned down.
How to apply, step by step
Social Security handles Extra Help applications. You can apply any time of year, before or after you join a Part D plan.
Step 1: Gather your numbers
Have these ready before you start:
- Your Medicare card
- Recent bank, investment and retirement account statements
- Income information: Social Security, pensions, wages, and anything else that comes in regularly
- If married and living together, the same information for your spouse
Step 2: Apply online or by phone
- Online: go to Social Security’s Extra Help page and choose “Apply online.” You can save and finish later.
- By phone: call Social Security at 1-800-772-1213 (TTY 1-800-325-0778), Monday through Friday, 8 a.m. to 7 p.m., and say you want an appointment to apply for Part D Extra Help.
- With help: your local SHIP counselor can sit with you and fill it out for free.
Step 3: Decide about the Medicare Savings Program referral
When you apply for Extra Help, Social Security sends your information to your state to start a Medicare Savings Program application, unless you tell them not to. Let it go through. Those state programs can help pay your Part B premium, which is $202.90 a month in 2026. My guide to Medicare Savings Programs for 2027 explains the four programs and their limits.
Step 4: Watch your mail
Social Security sends a decision letter. If you’re approved, Medicare follows up with details about your drug plan and what you’ll pay. Keep both letters. They’re your proof if a pharmacy charges the wrong amount.
Extra Help vs. Medicare Savings Programs
People mix these up all the time, and many qualify for both.
| Extra Help | Medicare Savings Programs | |
|---|---|---|
| What it pays | Part D premiums, deductibles and drug copays | Part B premium (and for QMB, Part A and B cost-sharing) |
| Who runs it | Social Security and Medicare | Your state Medicaid agency |
| Where to apply | Social Security | Your state, or through the Extra Help application referral |
| Limits | Federal limits, the same in all states except Alaska and Hawaii | Set by each state; some states are far more generous than the federal minimum |
If you’re approved for any Medicare Savings Program, you get Extra Help automatically. So applying for an MSP first can make sense if your state’s limits are generous. My guide to Medicare Savings Programs has the 2026 limits.
After you qualify
- You keep Extra Help through December 31, even if your income changes mid-year.
- It usually renews automatically. If you still meet the limits, you’ll keep Extra Help for the next year. Medicare only mails a notice if you no longer qualify or you’re moved to a different plan.
- You can change drug plans more often. Medicare says people with Extra Help or Medicaid may be able to change drug coverage once a month, instead of waiting for Open Enrollment.
- If a pharmacy charges you too much, ask your plan to fix your Extra Help status, tell them how many days of medication you have left, and call 1-800-MEDICARE if it isn’t resolved.
LI NET: if you qualify but don’t have a plan yet
Medicare’s Limited Income Newly Eligible Transition (LI NET) program gives temporary drug coverage to people who qualify for Extra Help or Medicaid but aren’t yet in a drug plan. If you paid for covered drugs after qualifying, keep your receipts and call LI NET at 1-800-783-1307 (TTY 711). You may get some money back.
What can cost you Extra Help
- Resources creeping over the limit. An inheritance, a property sale or a large IRA withdrawal held in the bank can push you over.
- Ignoring a review form. Social Security periodically mails a redetermination form. If you don’t return it, Extra Help can end.
- Losing Medicaid or an MSP. If you got Extra Help automatically through Medicaid, an MSP or SSI and lose that coverage, Medicare mails a notice, usually on gray paper, in the fall. You’ll need to apply directly with Social Security to keep Extra Help for the next year.
- Not reporting changes. Tell Social Security if you marry, divorce, are widowed or move, since those can change your limits.
If you don’t qualify
You still have options:
- Compare drug plans during Open Enrollment, October 15 to December 7. My Part D 2027 guide covers the new $2,400 cap and $700 deductible.
- Spread out your costs with the Medicare Prescription Payment Plan, which turns big pharmacy bills into monthly payments.
- Check manufacturer and state programs. Medicare.gov suggests checking whether your drug’s manufacturer or your state offers help.
- Reapply if things change. You can apply again any time your income or resources drop.
For the bigger picture on what changes next year, see Medicare changes for 2027.
FAQ
What is the income limit for Extra Help in 2026?
$23,940 a year for an individual and $32,460 for a married couple, with resource limits of $18,090 and $36,100. Limits are higher in Alaska and Hawaii.
How much will I pay for drugs with Extra Help in 2027?
No more than $5.80 per generic and $14.40 per brand-name drug at participating pharmacies, with a $0 deductible. People with full Medicaid who are in QMB pay no more than $4.90.
Does my house count as a resource?
Medicare and Social Security count things like bank accounts, stocks and bonds. The Social Security application explains what counts and what’s excluded. If you’re unsure, apply and let Social Security decide.
Can I apply for Extra Help at any time?
Yes. There’s no enrollment period for Extra Help. Apply whenever you think you qualify, and reapply if your situation changes.
Can I have Extra Help with a Medicare Advantage plan?
Yes, as long as your Medicare Advantage plan includes Part D drug coverage. Extra Help lowers the drug part of your costs. It doesn’t pay medical copays.
Will Extra Help reduce my Social Security check?
No. If anything, your check can go up. When your Part D premium is lower or zero, less is taken out of your Social Security payment.
Do I have to reapply every year?
Usually not. If you still meet the limits, Extra Help continues automatically. You’ll get a notice only if you no longer qualify or your plan changes.
