If you have Medicare and cannot afford your prescription drugs, Extra Help can pay most of the cost
This page covers Extra Help — the federal program that dramatically reduces what Medicare beneficiaries with limited income pay for prescription drugs through Part D. The guide below goes over what the program pays for, who qualifies, how to apply, and what else may be available in your state.
- BE SURE TO APPLY: The federal government estimates that up to 2 million people who are eligible for Extra Help are not enrolled — either because they do not know it exists or because they assumed they would not qualify.
Extra Help, also called the Low-Income Subsidy or LIS, is run jointly by the Social Security Administration and the Centers for Medicare and Medicaid Services. If you want to understand how Part D works before reading about Extra Help, see the page on how to choose a Medicare Part D plan guide.
What Extra Help Pays For
Extra Help covers most of the out-of-pocket costs that come with a Medicare Part D prescription drug plan. For people who qualify, the program eliminates or greatly reduces the monthly Part D premium, wipes out the Part D deductible, and caps what you pay for each prescription at the pharmacy. In 2026, most Extra Help members pay no more than $12.65 per fill for brand-name drugs and $5.10 for generics. Once your total drug costs reach the catastrophic coverage threshold for the year, you pay nothing for covered drugs for the rest of the year.
Extra Help also eliminates the Part D late enrollment penalty — the permanent surcharge added to premiums when someone delays signing up for Part D coverage.
The estimated average value of Extra Help is around $5,500 to $6,000 per person per year, though the actual savings depend on which drugs you take.
Who Qualifies Automatically
Some people qualify for Extra Help automatically and are enrolled without needing to apply. You qualify automatically if you have Medicare and also receive Medicaid, receive Supplemental Security Income (SSI) from Social Security, or are enrolled in a Medicare Savings Program (such as QMB, SLMB, or QI). If you fall into one of these groups, you should receive a notice from Medicare — typically a purple-colored letter — confirming you have Extra Help and do not need to apply.
Who Can Apply
If you do not automatically qualify per above, you may still be eligible by applying. To qualify, you generally need to have income at or below 150% of the federal poverty level and have limited assets. Asset limits also apply — the calculation excludes your home, one car, and certain other items, so the limits are less restrictive than they may sound.
Some income is also excluded from the calculation, which means some people who are initially above the limit still qualify after the exclusions are applied. SSA reviews each application individually. If you are unsure whether you qualify, apply anyway — there is no cost and no penalty for applying and being turned down.
If your income or financial situation changes during the year — a job loss, a reduction in retirement income, the death of a spouse — you can reapply for Extra Help at any time.
How to Apply
You can apply for Extra Help a few different ways. There is no fee to apply. They include:
When you apply, Social Security will ask about your income and assets. With your permission, SSA will also share your information with your state, which may contact you about additional state programs that could help with other Medicare costs.
If you want free help with the application, your State Health Insurance Assistance Program — known as SHIP — provides one-on-one counseling at no cost. SHIP counselors can also help you compare Part D plans, understand your Medicare rights, and find other savings programs in your state. Call 1-877-839-2675 or visit https://www.shiphelp.org/ to reach your local SHIP program.
Medicare Savings Programs
Applying for Extra Help at the same time as a Medicare Savings Program is worth doing, because many people qualify for both. Medicare Savings Programs are state-run programs that help pay Medicare Part B premiums — and in some cases Part A premiums, deductibles, and copays as well. There are several types depending on income level:
- The Qualified Medicare Beneficiary (QMB) program covers Part A and Part B premiums, deductibles, and cost-sharing.
- The Specified Low-Income Medicare Beneficiary (SLMB) program covers the Part B premium.
- The Qualifying Individual (QI) program also helps with Part B premiums for people with slightly higher incomes. Enrollment in any of these programs also qualifies you for Extra Help automatically.
Your state Medicaid office handles Medicare Savings Program applications. SHIP counselors can help you apply.
State Pharmaceutical Assistance Programs
Many states have their own prescription drug assistance programs that go beyond what Extra Help covers. These State Pharmaceutical Assistance Programs, or SPAPs, vary by state in who they help and what they pay. Some help with costs that Extra Help does not cover. Ask your SHIP counselor or check with your state Medicaid office about what is available in your state. We also have a page expanding on state programs that help with medications.
Other Programs That Help With Drug Costs
If you have Medicare and Medicaid together, you are considered dual eligible, and your drug coverage costs are generally very low. Contact your state Medicaid office to understand how your coverage coordinates.
Many pharmaceutical companies also run patient assistance programs that provide free or discounted medications to people who meet income requirements. These can sometimes be used alongside Part D and Extra Help. Find information on the patient assistance program page.
This page provides general information about the Extra Help program based on 2026 figures. Income limits, copay amounts, and program details are updated each year by the Social Security Administration. Contact SSA at 1-800-772-1213 or visit ssa.gov for current eligibility information before applying.
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