If you find that your Medicare prescription copays and deductibles are more than your wallet can manage, one federal program may offer some relief. Known as Extra Help, or Part D Low-Income Subsidy (LIS), the program covers some out-of-pocket drug costs for Medicare beneficiaries with lower incomes and limited resources.
The Part D LIS program is estimated to save cost-conscious Medicare consumers more than $5,000 a year in prescription costs. It does this by reducing what you pay for premiums, deductibles, and drug copays. If you qualify for Medicare Extra Help in 2026, the amount you pay will vary, but most members see out-of-pocket expenses drop to:
In 2025, Medicare also ended what was known as the “donut hole,” where people had to pay more for prescription drugs until they reached their catastrophic coverage limit. Now, once you hit your out-of-pocket spending limit – $2,100 in 2026 – you pay nothing for covered medications. If you are eligible for Extra Help, your payments and those paid by the program go toward your spending limit.
Some people will receive Extra Help coverage without having to apply. If you receive full Medicaid coverage, Supplemental Security Income (SSI), or have income that is lower than 150% of the federal poverty limit, you will likely qualify automatically. The Centers for Medicare and Medicaid Services (CMS) will send you a letter notifying you of your eligibility.
If you don’t meet these requirements, you can apply for the program through the Social Security Administration (SSA). To take part in the LIS program, you have to meet the income and resource limits set each year. The Extra Help income limits for 2026 are $23,475 for an individual, and $31,725 if you are married and living with your partner.
There is also a limit to the value of the things you own, known as your resources. The upper limits for these are $18,090 for an individual and $36,100 if you are married and living with your spouse.
Some examples of the types of resources that Medicare considers when you apply for the prescription drug assistance program are:
Medicare won’t consider assets like your vehicle, jewelry, life insurance policies, and burial expenses.
If you don’t automatically qualify for the prescription drug assistance program, you can apply online, by phone, or in person. First, you can enroll on the SSA’s website. Documents you will need to have on hand are:
If you need assistance with the application process, you can contact the Social Security Administration. If you prefer to apply in person, you can do that at your local Social Security office.
If you apply and are accepted, you’ll get a notice in the mail about your Extra Help. It provides information about how much you’ll pay for prescriptions, and it will direct you to your new Medicare drug plan if you don’t have one. If you already have a plan, CMS will notify them of your eligibility.
If you apply for the program and are denied by the SSA, you can ask for reconsideration. If you receive a notice that you are going to be denied, you have 10 days to fix any errors in your online application. If you receive a Notice of Denial, you have 60 days to request a case review or a hearing by calling the SSA or downloading an online form and mailing it to the SSA.
The SSA also chooses beneficiaries who may have had changes in income, marriage status, or other life events for redetermination each year in August. If you’re chosen for redetermination, you’llreceive a document saying your eligibility is being reviewed. You must complete this and return it to the SSA. If you aren’t chosen for redetermination, your benefits will stay the same for the next year. It is also up to you to inform the SSA if you have a change in income or household status throughout the year that may affect your eligibility in the program.
The Medicare Part D Low-Income Subsidy is a valuable benefit for those who need assistance with prescription costs. If you think you may be eligible for prescription drug assistance, you can apply on the Social Security Administration’s website. If you aren’t eligible for Extra Help, contact a SmartMatch agent to see if your current plan is a cost-effective solution for your specific prescription needs.
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