If you have Medicare and struggle with prescription drug costs, you may qualify for programs that can dramatically lower what you pay at the pharmacy. The Medicare Extra Help program — also called the Part D Low-Income Subsidy — can reduce or eliminate Part D premiums, deductibles, and copays for eligible Medicare beneficiaries. Yet millions of people who qualify for Extra Help never apply. This guide explains exactly how the Extra Help program works, who qualifies, how to apply, and what additional discount programs are available to help lower your prescription drug costs in 2026.
For a free comparison of prescription drug discount card prices at pharmacies near you, visit RxDiff.com — though note that prescription discount cards cannot be used simultaneously with Medicare Part D at the pharmacy counter.
Important disclosure: RxDiff brand content. This article is for informational purposes only and does not constitute legal, financial, or medical advice. Prescription drug discount cards cannot be used simultaneously with Medicare Part D insurance at the point of sale. Not valid with Medicare or Medicaid. Program eligibility, income limits, and benefit amounts change annually — always verify current information at Medicare.gov or SSA.gov.
What Is the Medicare Extra Help Program?
The Medicare Extra Help program is a federal assistance program that helps people with Medicare pay for prescription drug costs associated with Medicare Part D — the prescription drug benefit. Also called the Part D Low-Income Subsidy (LIS), Extra Help is administered jointly by the Centers for Medicare & Medicaid Services (CMS) and the Social Security Administration (SSA).
The Extra Help program was created to ensure that people with limited income and resources can access their prescription medications without facing prohibitive out-of-pocket costs. Without Extra Help, Medicare Part D enrollees are responsible for monthly premiums, an annual deductible, and copays or coinsurance on each prescription drug fill. These costs can add up to thousands of dollars annually — a significant burden for older adults on fixed incomes.
With Extra Help, eligible Medicare beneficiaries may have their Part D premiums significantly reduced or eliminated, their deductible waived, and their drug copays reduced to minimal amounts. In 2026, the program can save qualifying individuals thousands of dollars per year on prescription drug costs.
Key distinction: Extra Help is a subsidy program — not insurance. It reduces what you pay for Medicare Part D coverage you already have (or need to enroll in). You must be enrolled in a Medicare Part D prescription drug plan to receive Extra Help benefits at the pharmacy.
Benefits of Medicare Extra Help — What It Covers
The benefits of Medicare Extra Help can be substantial for qualifying low-income Medicare beneficiaries. Here is what the program may cover in 2026:
Extra Help may pay some or all of your monthly Medicare Part D prescription drug plan premium, depending on your income and resource level. Full Extra Help recipients pay no Part D premiums above a benchmark amount.
For full Extra Help recipients, the Part D annual deductible is eliminated entirely. Partial Extra Help may reduce but not eliminate the deductible.
Extra Help significantly reduces copays for covered prescription drugs. In 2026, full Extra Help recipients pay small fixed copays per prescription — often just a few dollars for generic drugs.
Extra Help eliminates the Medicare Part D coverage gap (formerly called the donut hole) for qualifying beneficiaries — you pay reduced copays throughout the year without entering a higher-cost coverage phase.
Who Can Qualify for Extra Help?
To qualify for Extra Help with Medicare prescription drug costs, you must meet three basic requirements:
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01Be enrolled in Medicare
You must have Medicare Part A and/or be enrolled in Medicare Part B. You do not need to currently have Part D to apply for Extra Help, but you will need to enroll in a Part D plan to receive the benefits.
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02Meet income and resource limits
Your income and resources must fall below the program's annual limits, which are based on the federal poverty level and updated each year by the Social Security Administration. Income includes Social Security benefits, pensions, wages, and other sources.
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03Reside in the United States
You must live in one of the 50 states or the District of Columbia. The Extra Help program is not available in U.S. territories, though your state's Medicaid program may offer similar assistance.
Income and Resource Limits for Extra Help 2026
The Extra Help income and resource limits are updated annually. For 2026, the general eligibility thresholds are based on approximately 150% of the federal poverty level. Here is what the current income and resource limits look like:
| Household Size | Income Limit (Annual) | Resource Limit | Notes |
|---|---|---|---|
| Individual | ~$22,590–$23,475 | ~$17,600 | Higher limits for Alaska & Hawaii |
| Married couple | ~$30,660–$31,725 | ~$35,130 | Living together |
Income and resource limits updated annually by SSA. Resources include bank accounts, stocks, and bonds — but NOT your home, car, personal belongings, or life insurance. Always verify current limits at SSA.gov or by calling 1-800-772-1213.
Important: Even if you think your income or resources are too high, it is worth applying. The Social Security Administration excludes certain assets from the resource calculation — including your primary home, one vehicle, life insurance policies, and personal possessions. Many people who initially think they don't qualify for Extra Help actually do after these exclusions are applied.
Who Gets Extra Help Automatically?
Some Medicare beneficiaries receive Extra Help automatically without needing to submit an Extra Help application. You may qualify for Extra Help automatically if you:
- Enrolled in full Medicaid (your state's Medicaid program)
- Receiving Supplemental Security Income (SSI) from Social Security
- Enrolled in a Medicare Savings Program that pays Part B premiums
- Enrolled in both Medicare and Medicaid (dual eligible)
- Limited income and resources but not enrolled in Medicaid or SSI
- Income recently changed making you newly eligible
- Just turned 65 and enrolled in Medicare for the first time
- Not currently in a Medicare Savings Program
If you receive Extra Help automatically, Social Security will notify you by mail. If you are not sure whether you qualify for Extra Help automatically, contact the Social Security Administration at 1-800-772-1213 or check your eligibility at SSA.gov.
How to Apply for Extra Help — Step by Step
Applying for Extra Help is free. You do not need a lawyer, a paid service, or any third party to submit your Extra Help application. Here is how to apply for Extra Help through the Social Security Administration:
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01Apply online at SSA.gov
Go to SSA.gov and search for "Apply for Medicare Part D Extra Help." The online Extra Help application takes approximately 15–20 minutes and allows you to submit documentation electronically. This is the fastest way to apply for Extra Help.
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02Apply by phone through Social Security
Call the Social Security Administration at 1-800-772-1213 (TTY: 1-800-325-0778) to apply for Extra Help by phone. Representatives can walk you through the Extra Help application and help determine your eligibility based on your income and resources.
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03Apply through your state Medicaid office
You can also apply for Extra Help through your state Medicaid office. In many states, applying for a Medicare Savings Program automatically triggers a review for Extra Help eligibility — you may be considered for both programs with a single application.
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04Get free help from SHIP
Your local State Health Insurance Assistance Program (SHIP) offers free one-on-one counseling to help Medicare beneficiaries apply for Extra Help, compare Part D plans, and understand their Medicare benefits. Find your local SHIP at shiphelp.org — completely free help from trained counselors.
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05Enroll in a Part D drug plan
Once approved for Extra Help, you must enroll in a Medicare Part D prescription drug plan to use the benefit. If you don't choose a plan, Medicare will enroll you in one automatically. Use the Medicare Plan Finder at Medicare.gov to find a Part D plan that covers your specific prescription drugs.
💊 Compare prescription drug discount card prices at pharmacies near you — free.
Compare Prices at RxDiff →Medicare Savings Programs — Four Types Explained
Medicare Savings Programs (MSPs) are state-run programs that help people with limited income pay Medicare costs including Part A and Part B premiums, deductibles, and copays. There are four types of Medicare Savings Programs:
| Program | Also Called | What It Covers | Who Qualifies |
|---|---|---|---|
| Qualified Medicare Beneficiary (QMB) | Basic Benefit | Part A & B premiums, deductibles, copays | Lowest income level |
| Specified Low-Income Medicare Beneficiary (SLMB) | SLMB | Part B premium only | Slightly higher income |
| Qualifying Individual (QI) | Additional Help | Part B premium only | Higher income, first-come basis |
| Qualified Disabled Working Individual (QDWI) | QDWI | Part A premium only | Disabled workers under 65 |
Eligibility for Medicare Savings Programs varies by state. Contact your state Medicaid office or call 1-800-MEDICARE to learn about your state's programs and income limits. Qualifying for a Medicare Savings Program may also automatically qualify you for Extra Help with Part D prescription drug costs.
Qualified Medicare Beneficiary (QMB) Program
The Qualified Medicare Beneficiary (QMB) program is the most comprehensive of the four Medicare Savings Programs. If you qualify as a Qualified Medicare Beneficiary, your state pays your Medicare Part A and Part B premiums, deductibles, and cost-sharing — meaning you pay little or nothing for Medicare-covered services.
Importantly, healthcare providers who accept Medicare are legally prohibited from billing Qualified Medicare Beneficiary enrollees for Medicare cost-sharing amounts. If you are enrolled in the QMB program and a provider attempts to bill you for Medicare copays or deductibles, you can report this to your state Medicaid office or 1-800-MEDICARE.
Enrollment in the QMB program also triggers automatic enrollment in Medicare Extra Help with your Part D prescription drug costs — meaning you receive both programs' benefits simultaneously to help lower your overall drug costs and medical costs.
Medicare Part D Prescription Drug Coverage
Medicare Part D is the prescription drug benefit for people with Medicare. Part D drug coverage is offered through private insurance companies approved by Medicare. You can get Part D coverage two ways: as a standalone Part D plan added to Original Medicare (Parts A and B), or as part of a Medicare Advantage plan that includes drug coverage (MAPD).
Without Extra Help, Medicare Part D costs in 2026 include a monthly premium (averaging $40–$60 for many standard plans), an annual deductible, and copays or coinsurance for each prescription drug fill. The actual costs depend on your specific plan and the medications you take.
People with Medicare who need help choosing a Part D plan can use the Medicare Plan Finder at Medicare.gov to compare plans based on your specific prescription drugs and preferred pharmacy. Your local SHIP counselor can also help you find the best Part D plan for your situation at no cost.
Part D Low-Income Subsidy (LIS) — Same as Extra Help
The Part D Low-Income Subsidy (LIS) and Medicare Extra Help are the same program — two different names for the same federal benefit. You may hear both terms used interchangeably by Medicare counselors, Social Security representatives, and insurance companies.
When people refer to the Part D Low-Income Subsidy or Part D LIS, they mean the Extra Help program. When you apply for Extra Help through the Social Security Administration, you are applying for the Part D Low-Income Subsidy. Both terms refer to the same financial assistance for Medicare Part D prescription drug costs.
Good to know: If you qualify for full Extra Help (the highest level of the Part D Low-Income Subsidy), you are entitled to a Special Enrollment Period that allows you to enroll in, switch, or disenroll from Part D plans at any time during the year — not just during the annual Open Enrollment Period in the fall.
Prescription Drug Discount Programs — What's Available
Beyond the official Medicare Extra Help program, several discount programs may help Medicare beneficiaries and other people with limited income lower their prescription drug costs:
State Pharmaceutical Assistance Programs (SPAPs): Many states operate their own pharmaceutical assistance programs for residents with limited income, particularly seniors. These state programs may supplement Medicare Extra Help or provide additional help for people who don't qualify for the federal program. Contact your state health department or local SHIP for information about programs in your state.
Manufacturer Patient Assistance Programs: Many pharmaceutical manufacturers offer patient assistance programs that provide brand-name medications at no cost or reduced cost to qualifying low-income patients. These programs are typically for people without insurance coverage for the specific drug, or in cases where the drug is not covered by their plan.
NeedyMeds: NeedyMeds.org maintains a free database of patient assistance programs, disease-specific assistance funds, and other discount programs for prescription medications. This is a valuable resource for Medicare beneficiaries looking for additional help beyond Extra Help.
Drug Discount Cards — How They Work With Medicare
Prescription drug discount cards and drug card savings programs like RxDiff, GoodRx, WellRx, and SingleCare offer negotiated cash prices on generic and brand-name medications at pharmacies nationwide. However, there are important rules about using drug discount cards alongside Medicare:
Critical rule: Prescription drug discount cards cannot be used simultaneously with Medicare Part D at the pharmacy counter. Federal law prohibits using a discount card together with Part D coverage for the same prescription at the same time. If you use a discount card, the cost typically does not count toward your Part D deductible or out-of-pocket maximum.
However, drug discount cards may still be useful for Medicare beneficiaries in specific situations:
If your Part D plan does not cover a specific medication, you may be able to use a prescription drug discount card for that drug. Compare the discount card price against paying the full cash price without any coverage.
Medicare beneficiaries who have not yet enrolled in Part D (or are in a coverage gap period) may use discount cards for their prescriptions. Always enroll in Part D if you regularly take prescription medications to avoid late enrollment penalties.
If you have both Medicare and Medicaid, you should generally use your Medicare Part D coverage for prescriptions — not a discount card. Contact your State Health Insurance Assistance Program for guidance on your specific situation.
Use RxDiff's free price comparison tool to see current discount card prices at pharmacies near you — then compare against your Part D copay to determine which option is lower for each specific prescription.
Where to Get Help — SHIP and Free Assistance Programs
Navigating Medicare Extra Help, Medicare Savings Programs, and Part D drug coverage can be complex. The good news: free help is available through several trusted programs:
State Health Insurance Assistance Program (SHIP): Every state has a SHIP program that offers free, unbiased Medicare counseling from trained volunteers. SHIP counselors can help you apply for Extra Help, compare Part D plans, understand your Medicare Savings Program options, and review your current coverage. Find your local state health insurance assistance program at shiphelp.org or call 1-800-MEDICARE.
Social Security Administration: Apply for Extra Help through Social Security online at SSA.gov, by calling 1-800-772-1213, or by visiting your local Social Security office. The Social Security Administration also administers SSI (Supplemental Security Income) — qualifying for SSI may automatically qualify you for Extra Help.
BenefitsCheckUp: The National Council on Aging operates BenefitsCheckUp.org — a free online tool that helps older adults identify all federal, state, and local benefit programs they may be eligible for, including Medicare Extra Help, Medicare Savings Programs, and state prescription assistance programs.
1-800-MEDICARE: Call 1-800-633-4227 (TTY: 1-877-486-2048) 24 hours a day, 7 days a week for help with Medicare questions including Extra Help eligibility, Part D enrollment, and Medicare Savings Programs. Available to help you understand your options at no cost.
FAQ — Medicare Extra Help and Prescription Drug Discount
Medicare Extra Help is a federal program that helps people with Medicare pay for prescription drug costs including Part D premiums, deductibles, and copays. Also called the Part D Low-Income Subsidy (LIS), it is run jointly by Medicare and the Social Security Administration. Eligible Medicare beneficiaries may save thousands of dollars per year on prescription drug costs through the Extra Help program. The program is free to apply for and requires no paid service or representative to submit an Extra Help application.
To qualify for Extra Help, you must be enrolled in Medicare Part A and/or Part B, live in the United States, and have limited income and resources that fall below the program's annual limits. Income and resource limits are updated annually by the Social Security Administration. Some Medicare beneficiaries qualify for Extra Help automatically — including those enrolled in Medicaid, receiving SSI benefits from Social Security, or enrolled in a Medicare Savings Program. Apply through Social Security at SSA.gov or call 1-800-772-1213 for free help.
You can apply for Extra Help through the Social Security Administration at SSA.gov or by calling 1-800-772-1213. You can also apply through your state Medicaid office — in many states, applying for a Medicare Savings Program automatically considers you for Extra Help eligibility. Free one-on-one help applying for Extra Help is available through your local State Health Insurance Assistance Program (SHIP) at shiphelp.org. The Extra Help application is free and you do not need a paid service or lawyer to apply.
Prescription drug discount cards cannot be used simultaneously with Medicare Part D at the pharmacy counter — federal rules prohibit using both at the same time for the same prescription. However, discount cards may be used for medications not covered by your Part D plan, or by Medicare beneficiaries who have not yet enrolled in Part D. Use RxDiff's free price comparison tool to compare discount card prices against your Part D copay to find the best option for each medication. Always check with your pharmacist and consult your State Health Insurance Assistance Program for guidance specific to your situation.
Medicare Savings Programs (MSPs) are state-run programs that help people with limited income and resources pay Medicare Part A and Part B premiums, deductibles, and copays. There are four types: Qualified Medicare Beneficiary (QMB), Specified Low-Income Medicare Beneficiary (SLMB), Qualifying Individual (QI), and Qualified Disabled Working Individual (QDWI). Qualifying for a Medicare Savings Program may also automatically qualify you for Extra Help with Part D prescription drug costs. Contact your state Medicaid office or call 1-800-MEDICARE to learn about Medicare Savings Programs in your state.
Compare Prescription Drug Prices at Pharmacies Near You
Use RxDiff's free price comparison tool to see discount card prices at 70,000+ pharmacies — compare against your Part D copay to find the best price for each prescription.
Compare Prescription PricesPrescription discount cards cannot be used simultaneously with Medicare Part D. Not valid with Medicare or Medicaid. Prices vary by pharmacy, drug, and dosage.