The short answer
The 2026 Extra Help limits are 23,940 dollars of income and 18,090 dollars of resources for an individual, or 32,460 and 36,100 dollars for a married couple, higher on income in Alaska and Hawaii. Under them, Part D costs flatten to zero premium, zero deductible, and small fixed copays.
Plan year 2026. Every figure on this page is the 2026 value, read from Medicare.gov's help-with-drug-costs page on August 7, 2026. The page states the limits may go up each year, and this page tracks the current plan year only.
Say your income lands just under the limit. What you pay for a covered drug is then exactly the same as somebody far below it. The line decides whether you are in. It does not decide what you pay once you are.
What are the Extra Help income limits this year?
The Extra Help income limits in 2026 are 23,940 dollars for an individual and 32,460 dollars for a married couple, per Medicare.gov's help-with-drug-costs page, with higher limits in Alaska and Hawaii. Income is half the test: resource limits apply alongside, and both sets may rise each year.
Extra Help itself is a Medicare program for people with limited income and resources, paying toward Part D premiums, deductibles, coinsurance, and other drug costs. One shield rides along: while you get Extra Help, you do not pay a Part D late enrollment penalty.
The page's own hedge is worth keeping: in most cases, qualifying means income and resources below the limits. The edge cases belong to the application, not to guesswork.
What are the Extra Help asset limits?
The Extra Help resource limits in 2026 are 18,090 dollars for an individual and 36,100 dollars for a married couple, on the same Medicare.gov table as the income limits. Resources are the second gate: qualifying in most cases means landing under both limits at once.
What counts inside the income and resource definitions is a detail this article deliberately routes to the application itself, which asks for your financial information and decides against the real rules rather than a summary.
Two different tests run at once, and passing one is not enough.
| The test | What it looks at | Why people trip on it |
|---|---|---|
| Income | What you receive in a year | Some income is not counted |
| Resources | What you own that counts | The home you live in is not counted |
The right hand column is the point. Both tests exclude things people assume are included, so the raw number in your head is rarely the number being tested.
The application's document list previews the scope: bank statements, tax returns, retirement account balances, and benefit statements, all covered in the companion article on applying.
How much does Extra Help save me?
Extra Help savings in 2026 are concrete: 0 dollars plan premium, 0 dollars deductible, at most 5.10 dollars per generic and 12.65 dollars per brand-name prescription. Call it the Flattener: plan-by-plan pricing becomes one flat national schedule, whatever plan carries your coverage.
The Flattener is an observation of Medicare.gov's own 2026 what-you-pay list, which prices Extra Help in fixed amounts where ordinary Part D varies by plan and pharmacy. The list is the government's. The naming is ours.
Two more rungs complete the 2026 schedule. Once total drug costs reach 2,100 dollars in 2026, including certain payments made on your behalf like Extra Help itself, covered drugs cost 0 dollars. And with full Medicaid plus the Qualified Medicare Beneficiary program, no covered drug costs more than 4.90 dollars in 2026.
The quiet fifth saving is the penalty shield: no Part D late enrollment penalty while Extra Help lasts.
How do I qualify for Extra Help?
Qualifying for Extra Help runs on two tracks: automatically, through full-benefit Medicaid, a Medicare Savings Program, or Supplemental Security Income, or by application through Social Security when income and resources sit under the limits, in most cases. Automatic qualifiers get a notice; everyone else applies.
Qualification comes with machinery attached: if you have no Medicare drug plan, one is assigned automatically so the savings can land, announced by notice, and you can pick a different plan if you want.
One geographic boundary is stated plainly: Extra Help is not available in Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands, or American Samoa, which run their own assistance programs through the State Medical Assistance office.
The application itself, documents and routes and contacts, is the companion article beside this one.
Do I qualify automatically if I have Medicaid?
Full-benefit Medicaid coverage qualifies you for Extra Help automatically, with no application, and the same is true of a Medicare Savings Program or Supplemental Security Income payments. A notice arrives in the mail stating what you will pay and naming your drug plan if you lacked one.
The Medicaid pairing goes one rung deeper: full Medicaid plus the Qualified Medicare Beneficiary program caps every covered drug at 4.90 dollars in 2026.
Flexibility rides along too. Most people with Medicare switch plans only at set times of year, but with Medicaid or Extra Help you may be able to change drug coverage once per month.
Do the limits differ in Alaska and Hawaii?
The limits differ in Alaska and Hawaii on the income side only. In 2026 Alaska's income limits are 29,925 dollars individual and 40,575 dollars for a couple, Hawaii's are 27,540 and 37,335 dollars, while the resource limits match the national figures of 18,090 and 36,100 dollars.
Medicare.gov states the reason as plainly as the numbers: income limits are higher for people who live in Alaska and Hawaii. The resource test does not move with geography.
The territories sit outside the program entirely, with their own assistance routes, so the three geographies of Extra Help are the mainland table, the two higher-income states, and the territories' separate programs.
What changed this year
Every income and resource limit on this page is a 2026 plan year value. These limits are re-set for each year against figures that move annually, so a household that sat outside them last year is not automatically outside them now. The figures above are the current ones.
These limits are re-set for each year, and the figures above are the current ones rather than an archive of a past year. This page carries one address and is updated in place when they change.
This publication has not found published 2025 limits, so no change from last year is claimed here. If you were just over the line last year, that is a reason to check the 2026 figures above rather than to assume the answer is the same.
Where a limit is written on this page, the year is written inside the same sentence, so no figure here can be read as current when it is not.
One benefit of qualifying has nothing to do with money, and it is worth knowing before you decide whether the paperwork is worth it.
With Medicaid or Extra Help you may be able to change your drug coverage once per month. Most people with Medicare can only switch at certain times of the year, so this is a genuinely different set of rights rather than a discount on the same ones.
Free help with any of it is available. Your State Health Insurance Assistance Program gives free personalised counseling and is not connected to any insurance company or health plan.
What this means for you
The Extra Help limits are a 2026 fact pair, income and resources, with three geographies and one direction of drift: the limits may go up each year. Under them, the Flattener rewrites drug costs to a flat national schedule, and the two companion articles cover getting in and staying in.
If the pair fits your situation, the applying article is next. If a notice already made you automatic, the renewal article explains the calendar that keeps it.
FAQ
Does Extra Help remove the Part D late enrollment penalty?
Yes, while you have it. Medicare.gov states directly that you will not have to pay a Part D late enrollment penalty while you get Extra Help. That single sentence quietly resolves one of the harder situations in Medicare: someone who delayed drug coverage, accumulated penalty exposure, and now has limited income and resources.
For that person, qualifying for Extra Help does two jobs at once, flattening the drug costs going forward and silencing the penalty for as long as the help lasts. The penalty's own mechanics, how it builds and how it is normally permanent, live in the Enrollment section's Part D penalty article, which makes the contrast with this shield vivid.
What will each prescription cost me under Extra Help?
The 2026 schedule is short and fixed. Plan premium 0 dollars and plan deductible 0 dollars. After that you pay up to 5.10 dollars in 2026 for each generic and up to 12.65 dollars for each brand-name drug at your plan's participating pharmacies.
Two refinements sit on top. Once your total drug costs reach 2,100 dollars in 2026, counting certain payments made on your behalf including Extra Help itself, covered drugs drop to 0 dollars.
And if you have full Medicaid and are in the Qualified Medicare Beneficiary program, no covered drug costs more than 4.90 dollars in 2026. The word participating matters: the fixed prices attach to the plan's own pharmacies.
Is Extra Help available in Puerto Rico?
No. Medicare.gov states that Extra Help is not available in Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands, or American Samoa.
The same sentence closes the gap it opens: other programs exist in those areas to help people with limited income and resources, they vary by area, and the way in is the State Medical Assistance office, the Medicaid office for the territory.
For a reader in the states this is a footnote; for a reader in the territories it is the whole page, and the local Medicaid office replaces everything else this cluster describes.
The exclusion is not only Puerto Rico. Extra Help is unavailable in the U.S. Virgin Islands, Guam and the Northern Mariana Islands as well (H10). What exists there instead is a matter for the local program rather than this one.
Do the Extra Help limits change every year?
Medicare.gov says the limits may go up each year, and the page publishes each year's pair with the year attached, which is why every figure here carries 2026 inside the sentence. This page does not quote what the 2025 limits were, because the prior year's table was not read for this article, and it makes no projection of 2027.
The reliable habit is the same one the whole Costs section teaches. Read the year printed next to any limit before trusting it, and check the current pair on Medicare.gov's help-with-drug-costs page, which is where this article's figures were read on August 7, 2026.
What if my income is just over the limits?
Two facts keep the door from being fully closed. First, the page's own framing is hedged: in most cases qualifying requires income and resources below the limits, and the application, which asks for your actual financial information, is what decides.
Second, the standing invitation is explicit: even if you do not qualify now, you can reapply for Extra Help any time if your income and resources change.
Free help exists for exactly this boundary case: SHIP, the State Health Insurance Assistance Program, offers free help applying. The wrong move is self-rejecting from a summary table; the application is the real test.
