{"content_id":"3osfmmqqkh","slug":"2026-medicare-part-d-extra-help-income-resource-limits-application","locale":"en","schema_type":"HowTo","category":"policy_guide","category_name":"Policy Guide","title":"2026 Medicare Part D Extra Help Income and Asset Limits and How to Apply","summary":"2026 Medicare Part D Extra Help is a federal assistance program that reduces prescription drug premiums and out-of-pocket drug costs for Medicare enrollees who meet certain income and asset limits. Those who do not qualify automatically can apply at any time during the year online or by phone through SSA.","author":{"name":"Injoys Editorial Team","url":"https://injoys.com/ko/about"},"key_points":["The standard 2026 limits are $23,940 in annual income and $18,090 in assets for an individual, and a combined $32,460 in annual income and $36,100 in assets for a married couple living together.","Those approved for Extra Help in 2026 will have a $0 deductible and pay no more than $5.10 per prescription for generic drugs and $12.65 for other brand-name drugs.","People who receive Medicaid, a Medicare Savings Program, or both SSI and Medicare generally qualify automatically and do not need to submit a separate application to SSA.","Those who do not qualify automatically can apply to SSA at any time before or after enrolling in Part D, with no fixed annual deadline.","Even if you are slightly above the published limits, exceptions may apply based on earned income, dependents, or residence in Alaska or Hawaii, so you can request an individual review by SSA."],"content_markdown":"Medicare Part D Extra Help is a federal low-income subsidy program that lowers prescription drug costs for Medicare beneficiaries with limited income and assets. The Social Security Administration (SSA) handles applications and eligibility reviews, and approved assistance is applied to Medicare Part D premiums, deductibles, and prescription drug out-of-pocket costs.\n\n## 2026 Income and Asset Limits\n\nThe general limits for 2026 are as follows. The limit for married couples applies when two married individuals live together.\n\n| Household category | Annual income limit | Asset limit |\n|---|---:|---:|\n| Individual | $23,940 | $18,090 |\n| Married couple living together, combined | $32,460 | $36,100 |\n\nThe asset limits reflect amounts that may be excluded for funeral and burial expenses. The CMS figures of $18,090 and $36,100 each include a $1,500 funeral expense exclusion per person.\n\nThese limits are not used solely as absolute cutoffs that automatically disqualify every applicant. If any of the following applies, you may still apply to SSA for an individual determination even if your income is somewhat higher than the published amount.\n\n- You support family members who live with you\n- You or your spouse has earned income\n- You live in Alaska or Hawaii, where cost-of-living standards differ\n- Your current income has recently decreased because of retirement, job loss, divorce, the death of a spouse, or another reason\n\nYou must accurately report your current circumstances and expected annual income on the application. SSA determines final eligibility after reviewing the applicant’s household composition, types of income, allowable deductions, and assets.\n\n## What Assets and Income Are Reviewed\n\nSSA primarily reviews financial assets that can be converted to cash and used for living or medical expenses.\n\n### Assets Generally Reviewed\n\n- Checking and savings accounts and certificates of deposit\n- Cash, stocks, bonds, savings bonds, and mutual funds\n- Retirement accounts such as IRAs and 401(k)s\n- Real estate other than your primary residence\n- Other investment assets that can be converted to cash\n\n### Items Generally Excluded From Assets\n\n- The home in which you live\n- Vehicles\n- Household goods and personal belongings\n- Burial plots and certain funeral and burial expenses\n- Standard life insurance policies\n\nThe income review may include not only Social Security benefits but also wages, self-employment income, pensions, annuity payments, railroad retirement benefits, veterans’ benefits, and other recurring income. Because certain payments may be excluded or only partially counted under the law, it is safer not to omit them on your own and instead report everything as requested by the SSA application.\n\n## 2026 Costs Reduced by Extra Help\n\nThe general maximum costs that apply to Extra Help recipients in 2026 are as follows.\n\n| Cost item | 2026 amount |\n|---|---|\n| Monthly Part D premium | $0 within the benchmark premium range |\n| Annual deductible | $0 |\n| Generic and preferred multi-source drugs | Up to $5.10 per prescription |\n| Other brand-name drugs | Up to $12.65 per prescription |\n\nThe prescription drug amounts in the table are the maximum out-of-pocket costs for drugs covered by Medicare. Depending on income level, Medicaid eligibility, or residence in a long-term care facility, the actual cost may be lower or $0.\n\nThe $0 premium benefit applies when you select a Part D plan within the regional benchmark premium limit. If you choose a plan that costs more than the benchmark or includes additional benefits, you may have to pay the difference. You should also verify whether your medications are included in the plan’s formulary and whether your pharmacy is in the network.\n\n## Automatic Eligibility and Who Must Apply Separately\n\nIf you receive Medicare and meet any of the following conditions, you generally qualify for Extra Help automatically.\n\n- You receive full coverage from your state Medicaid program\n- Your state helps pay your Medicare premiums through a Medicare Savings Program\n- You receive both Supplemental Security Income (SSI) and Medicare\n\nPeople who qualify automatically do not need to submit a separate SSA Extra Help application. Medicare or Medicaid will verify eligibility information and send a notice, and will assist with enrollment in a Part D plan if necessary.\n\nThe following individuals must apply directly to SSA.\n\n- People who have Medicare but do not receive Medicaid, a Medicare Savings Program, or SSI\n- People who previously qualified automatically but whose eligibility has ended\n- People whose current income and assets have decreased to within the limits\n- People who have not received an automatic eligibility notice and believe they meet the requirements\n\nApproval for Extra Help and enrollment in a Part D plan are separate processes. To apply Extra Help to actual prescription drug costs, you must be enrolled in a Part D plan. If you do not yet have a plan, Medicare may assign one, but it is best to verify personally whether the plan is suitable based on the medications you take and the pharmacies you use.\n\n## Information to Prepare Before Applying\n\nYou do not have to upload all supporting documents immediately with the online application, but preparing the following information in advance will help you complete it accurately. SSA may request additional documentation during the review process.\n\n- Social Security numbers and Medicare information for you and your spouse\n- Recent checking and savings account balances\n- Current values of stocks, bonds, mutual funds, and other investment assets\n- Balances in retirement accounts such as IRAs and 401(k)s\n- The value of real estate other than your primary residence and any related debt\n- Income from Social Security, wages, self-employment, pensions, and annuities\n- Veterans’ benefits and other recurring payments\n- Income and asset information for a spouse who lives with you\n- Information about family members who live with you and whom you financially support\n\nIf you do not remember the exact amounts, review recent account statements, pension statements, pay stubs, and benefit determination notices. Intentionally omitting assets or income may delay the review or change the eligibility decision.\n\n## How to Apply for Extra Help Through SSA\n\n### 1. Check Whether You Qualify Automatically\n\nIf you receive Medicaid, a Medicare Savings Program, or SSI, first check whether you have received an automatic eligibility notice. People who qualify automatically do not need to submit another SSA application to receive the same benefits.\n\n### 2. Complete the SSA Online Application\n\nOn SSA’s official Extra Help application page, enter income, financial asset, pension, and household information for yourself and your spouse. Review the application before submitting it and retain the submission confirmation information.\n\n### 3. Use Telephone Assistance\n\nIf applying online is difficult, call SSA’s main number at 1-800-772-1213 to request application assistance or a telephone appointment. The TTY number for hearing assistance is 1-800-325-0778. For counseling about Medicare plans, call 1-800-MEDICARE or contact the State Health Insurance Assistance Program where you live.\n\n### 4. Review SSA’s Decision Notice\n\nAfter reviewing the submitted information, SSA will provide notice of its approval or denial decision by mail or another method. If you receive a request for additional information, follow the deadline and submission instructions in the notice. Keep the approval notice because it may contain information needed to apply the benefit.\n\n### 5. Check Your Part D Plan Status\n\nAfter approval, check your Medicare account or plan notice to confirm that Extra Help has been applied. To estimate your actual costs, you must also review the prescription drug list, network pharmacies, and any premium difference.\n\n## Application Period and Reapplying\n\nExtra Help does not have a specific annual application deadline. If you believe you are eligible, you may apply to SSA at any time, either before or after enrolling in Part D.\n\nIf your income or assets decrease after a denial, you may reapply without waiting until the following year. For example, if your financial circumstances change because of retirement, job loss, the death of a spouse, divorce, or depletion of assets, reapply using your new current information.\n\nIf you believe SSA’s decision is factually incorrect, review the decision notice for the reconsideration or appeal procedures and deadlines. People who receive notice that their automatic eligibility is ending may also apply separately to SSA if they meet the current income and asset limits.\n\n## What to Check After Applying\n\n- Approval for Extra Help does not automatically cover every medication you take.\n- You must check the formulary and prior authorization requirements of your selected Part D plan.\n- A plan with a premium above the benchmark may result in a monthly premium difference.\n- If your address, marital status, income, or assets change significantly, update your information in accordance with guidance from SSA and the relevant agencies.\n- For people who qualify automatically, changes in Medicaid, Medicare Savings Program, or SSI eligibility may also affect Extra Help.\n\nExtra Help applications are not limited to the annual Medicare enrollment period. Medicare beneficiaries whose circumstances are close to the current limits should apply to SSA for an official determination rather than assuming on their own that they are ineligible.","content_html":"\u003cp\u003eMedicare Part D Extra Help is a federal low-income subsidy program that lowers prescription drug costs for Medicare beneficiaries with limited income and assets. The Social Security Administration (SSA) handles applications and eligibility reviews, and approved assistance is applied to Medicare Part D premiums, deductibles, and prescription drug out-of-pocket costs.\u003c/p\u003e\n\u003ch2\u003e\n\u003ca href=\"#2026-income-and-asset-limits\" class=\"anchor\" id=\"2026-income-and-asset-limits\"\u003e\u003c/a\u003e2026 Income and Asset Limits\u003c/h2\u003e\n\u003cp\u003eThe general limits for 2026 are as follows. The limit for married couples applies when two married individuals live together.\u003c/p\u003e\n\u003cdiv class=\"overflow-x-auto\"\u003e\u003ctable\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth\u003eHousehold category\u003c/th\u003e\n\u003cth\u003eAnnual income limit\u003c/th\u003e\n\u003cth\u003eAsset limit\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd data-label=\"Household category\"\u003eIndividual\u003c/td\u003e\n\u003ctd data-label=\"Annual income limit\"\u003e$23,940\u003c/td\u003e\n\u003ctd data-label=\"Asset limit\"\u003e$18,090\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd data-label=\"Household category\"\u003eMarried couple living together, combined\u003c/td\u003e\n\u003ctd data-label=\"Annual income limit\"\u003e$32,460\u003c/td\u003e\n\u003ctd data-label=\"Asset limit\"\u003e$36,100\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\u003c/div\u003e\n\u003cp\u003eThe asset limits reflect amounts that may be excluded for funeral and burial expenses. The CMS figures of $18,090 and $36,100 each include a $1,500 funeral expense exclusion per person.\u003c/p\u003e\n\u003cp\u003eThese limits are not used solely as absolute cutoffs that automatically disqualify every applicant. If any of the following applies, you may still apply to SSA for an individual determination even if your income is somewhat higher than the published amount.\u003c/p\u003e\n\u003cul\u003e\n\u003cli\u003eYou support family members who live with you\u003c/li\u003e\n\u003cli\u003eYou or your spouse has earned income\u003c/li\u003e\n\u003cli\u003eYou live in Alaska or Hawaii, where cost-of-living standards differ\u003c/li\u003e\n\u003cli\u003eYour current income has recently decreased because of retirement, job loss, divorce, the death of a spouse, or another reason\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eYou must accurately report your current circumstances and expected annual income on the application. SSA determines final eligibility after reviewing the applicant’s household composition, types of income, allowable deductions, and assets.\u003c/p\u003e\n\u003ch2\u003e\n\u003ca href=\"#what-assets-and-income-are-reviewed\" class=\"anchor\" id=\"what-assets-and-income-are-reviewed\"\u003e\u003c/a\u003eWhat Assets and Income Are Reviewed\u003c/h2\u003e\n\u003cp\u003eSSA primarily reviews financial assets that can be converted to cash and used for living or medical expenses.\u003c/p\u003e\n\u003ch3\u003e\n\u003ca href=\"#assets-generally-reviewed\" class=\"anchor\" id=\"assets-generally-reviewed\"\u003e\u003c/a\u003eAssets Generally Reviewed\u003c/h3\u003e\n\u003cul\u003e\n\u003cli\u003eChecking and savings accounts and certificates of deposit\u003c/li\u003e\n\u003cli\u003eCash, stocks, bonds, savings bonds, and mutual funds\u003c/li\u003e\n\u003cli\u003eRetirement accounts such as IRAs and 401(k)s\u003c/li\u003e\n\u003cli\u003eReal estate other than your primary residence\u003c/li\u003e\n\u003cli\u003eOther investment assets that can be converted to cash\u003c/li\u003e\n\u003c/ul\u003e\n\u003ch3\u003e\n\u003ca href=\"#items-generally-excluded-from-assets\" class=\"anchor\" id=\"items-generally-excluded-from-assets\"\u003e\u003c/a\u003eItems Generally Excluded From Assets\u003c/h3\u003e\n\u003cul\u003e\n\u003cli\u003eThe home in which you live\u003c/li\u003e\n\u003cli\u003eVehicles\u003c/li\u003e\n\u003cli\u003eHousehold goods and personal belongings\u003c/li\u003e\n\u003cli\u003eBurial plots and certain funeral and burial expenses\u003c/li\u003e\n\u003cli\u003eStandard life insurance policies\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eThe income review may include not only Social Security benefits but also wages, self-employment income, pensions, annuity payments, railroad retirement benefits, veterans’ benefits, and other recurring income. Because certain payments may be excluded or only partially counted under the law, it is safer not to omit them on your own and instead report everything as requested by the SSA application.\u003c/p\u003e\n\u003ch2\u003e\n\u003ca href=\"#2026-costs-reduced-by-extra-help\" class=\"anchor\" id=\"2026-costs-reduced-by-extra-help\"\u003e\u003c/a\u003e2026 Costs Reduced by Extra Help\u003c/h2\u003e\n\u003cp\u003eThe general maximum costs that apply to Extra Help recipients in 2026 are as follows.\u003c/p\u003e\n\u003cdiv class=\"overflow-x-auto\"\u003e\u003ctable\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth\u003eCost item\u003c/th\u003e\n\u003cth\u003e2026 amount\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd data-label=\"Cost item\"\u003eMonthly Part D premium\u003c/td\u003e\n\u003ctd data-label=\"2026 amount\"\u003e$0 within the benchmark premium range\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd data-label=\"Cost item\"\u003eAnnual deductible\u003c/td\u003e\n\u003ctd data-label=\"2026 amount\"\u003e$0\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd data-label=\"Cost item\"\u003eGeneric and preferred multi-source drugs\u003c/td\u003e\n\u003ctd data-label=\"2026 amount\"\u003eUp to $5.10 per prescription\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd data-label=\"Cost item\"\u003eOther brand-name drugs\u003c/td\u003e\n\u003ctd data-label=\"2026 amount\"\u003eUp to $12.65 per prescription\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\u003c/div\u003e\n\u003cp\u003eThe prescription drug amounts in the table are the maximum out-of-pocket costs for drugs covered by Medicare. Depending on income level, Medicaid eligibility, or residence in a long-term care facility, the actual cost may be lower or $0.\u003c/p\u003e\n\u003cp\u003eThe $0 premium benefit applies when you select a Part D plan within the regional benchmark premium limit. If you choose a plan that costs more than the benchmark or includes additional benefits, you may have to pay the difference. You should also verify whether your medications are included in the plan’s formulary and whether your pharmacy is in the network.\u003c/p\u003e\n\u003ch2\u003e\n\u003ca href=\"#automatic-eligibility-and-who-must-apply-separately\" class=\"anchor\" id=\"automatic-eligibility-and-who-must-apply-separately\"\u003e\u003c/a\u003eAutomatic Eligibility and Who Must Apply Separately\u003c/h2\u003e\n\u003cp\u003eIf you receive Medicare and meet any of the following conditions, you generally qualify for Extra Help automatically.\u003c/p\u003e\n\u003cul\u003e\n\u003cli\u003eYou receive full coverage from your state Medicaid program\u003c/li\u003e\n\u003cli\u003eYour state helps pay your Medicare premiums through a Medicare Savings Program\u003c/li\u003e\n\u003cli\u003eYou receive both Supplemental Security Income (SSI) and Medicare\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003ePeople who qualify automatically do not need to submit a separate SSA Extra Help application. Medicare or Medicaid will verify eligibility information and send a notice, and will assist with enrollment in a Part D plan if necessary.\u003c/p\u003e\n\u003cp\u003eThe following individuals must apply directly to SSA.\u003c/p\u003e\n\u003cul\u003e\n\u003cli\u003ePeople who have Medicare but do not receive Medicaid, a Medicare Savings Program, or SSI\u003c/li\u003e\n\u003cli\u003ePeople who previously qualified automatically but whose eligibility has ended\u003c/li\u003e\n\u003cli\u003ePeople whose current income and assets have decreased to within the limits\u003c/li\u003e\n\u003cli\u003ePeople who have not received an automatic eligibility notice and believe they meet the requirements\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eApproval for Extra Help and enrollment in a Part D plan are separate processes. To apply Extra Help to actual prescription drug costs, you must be enrolled in a Part D plan. If you do not yet have a plan, Medicare may assign one, but it is best to verify personally whether the plan is suitable based on the medications you take and the pharmacies you use.\u003c/p\u003e\n\u003ch2\u003e\n\u003ca href=\"#information-to-prepare-before-applying\" class=\"anchor\" id=\"information-to-prepare-before-applying\"\u003e\u003c/a\u003eInformation to Prepare Before Applying\u003c/h2\u003e\n\u003cp\u003eYou do not have to upload all supporting documents immediately with the online application, but preparing the following information in advance will help you complete it accurately. SSA may request additional documentation during the review process.\u003c/p\u003e\n\u003cul\u003e\n\u003cli\u003eSocial Security numbers and Medicare information for you and your spouse\u003c/li\u003e\n\u003cli\u003eRecent checking and savings account balances\u003c/li\u003e\n\u003cli\u003eCurrent values of stocks, bonds, mutual funds, and other investment assets\u003c/li\u003e\n\u003cli\u003eBalances in retirement accounts such as IRAs and 401(k)s\u003c/li\u003e\n\u003cli\u003eThe value of real estate other than your primary residence and any related debt\u003c/li\u003e\n\u003cli\u003eIncome from Social Security, wages, self-employment, pensions, and annuities\u003c/li\u003e\n\u003cli\u003eVeterans’ benefits and other recurring payments\u003c/li\u003e\n\u003cli\u003eIncome and asset information for a spouse who lives with you\u003c/li\u003e\n\u003cli\u003eInformation about family members who live with you and whom you financially support\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eIf you do not remember the exact amounts, review recent account statements, pension statements, pay stubs, and benefit determination notices. Intentionally omitting assets or income may delay the review or change the eligibility decision.\u003c/p\u003e\n\u003ch2\u003e\n\u003ca href=\"#how-to-apply-for-extra-help-through-ssa\" class=\"anchor\" id=\"how-to-apply-for-extra-help-through-ssa\"\u003e\u003c/a\u003eHow to Apply for Extra Help Through SSA\u003c/h2\u003e\n\u003ch3\u003e\n\u003ca href=\"#1-check-whether-you-qualify-automatically\" class=\"anchor\" id=\"1-check-whether-you-qualify-automatically\"\u003e\u003c/a\u003e1. Check Whether You Qualify Automatically\u003c/h3\u003e\n\u003cp\u003eIf you receive Medicaid, a Medicare Savings Program, or SSI, first check whether you have received an automatic eligibility notice. People who qualify automatically do not need to submit another SSA application to receive the same benefits.\u003c/p\u003e\n\u003ch3\u003e\n\u003ca href=\"#2-complete-the-ssa-online-application\" class=\"anchor\" id=\"2-complete-the-ssa-online-application\"\u003e\u003c/a\u003e2. Complete the SSA Online Application\u003c/h3\u003e\n\u003cp\u003eOn SSA’s official Extra Help application page, enter income, financial asset, pension, and household information for yourself and your spouse. Review the application before submitting it and retain the submission confirmation information.\u003c/p\u003e\n\u003ch3\u003e\n\u003ca href=\"#3-use-telephone-assistance\" class=\"anchor\" id=\"3-use-telephone-assistance\"\u003e\u003c/a\u003e3. Use Telephone Assistance\u003c/h3\u003e\n\u003cp\u003eIf applying online is difficult, call SSA’s main number at 1-800-772-1213 to request application assistance or a telephone appointment. The TTY number for hearing assistance is 1-800-325-0778. For counseling about Medicare plans, call 1-800-MEDICARE or contact the State Health Insurance Assistance Program where you live.\u003c/p\u003e\n\u003ch3\u003e\n\u003ca href=\"#4-review-ssas-decision-notice\" class=\"anchor\" id=\"4-review-ssas-decision-notice\"\u003e\u003c/a\u003e4. Review SSA’s Decision Notice\u003c/h3\u003e\n\u003cp\u003eAfter reviewing the submitted information, SSA will provide notice of its approval or denial decision by mail or another method. If you receive a request for additional information, follow the deadline and submission instructions in the notice. Keep the approval notice because it may contain information needed to apply the benefit.\u003c/p\u003e\n\u003ch3\u003e\n\u003ca href=\"#5-check-your-part-d-plan-status\" class=\"anchor\" id=\"5-check-your-part-d-plan-status\"\u003e\u003c/a\u003e5. Check Your Part D Plan Status\u003c/h3\u003e\n\u003cp\u003eAfter approval, check your Medicare account or plan notice to confirm that Extra Help has been applied. To estimate your actual costs, you must also review the prescription drug list, network pharmacies, and any premium difference.\u003c/p\u003e\n\u003ch2\u003e\n\u003ca href=\"#application-period-and-reapplying\" class=\"anchor\" id=\"application-period-and-reapplying\"\u003e\u003c/a\u003eApplication Period and Reapplying\u003c/h2\u003e\n\u003cp\u003eExtra Help does not have a specific annual application deadline. If you believe you are eligible, you may apply to SSA at any time, either before or after enrolling in Part D.\u003c/p\u003e\n\u003cp\u003eIf your income or assets decrease after a denial, you may reapply without waiting until the following year. For example, if your financial circumstances change because of retirement, job loss, the death of a spouse, divorce, or depletion of assets, reapply using your new current information.\u003c/p\u003e\n\u003cp\u003eIf you believe SSA’s decision is factually incorrect, review the decision notice for the reconsideration or appeal procedures and deadlines. People who receive notice that their automatic eligibility is ending may also apply separately to SSA if they meet the current income and asset limits.\u003c/p\u003e\n\u003ch2\u003e\n\u003ca href=\"#what-to-check-after-applying\" class=\"anchor\" id=\"what-to-check-after-applying\"\u003e\u003c/a\u003eWhat to Check After Applying\u003c/h2\u003e\n\u003cul\u003e\n\u003cli\u003eApproval for Extra Help does not automatically cover every medication you take.\u003c/li\u003e\n\u003cli\u003eYou must check the formulary and prior authorization requirements of your selected Part D plan.\u003c/li\u003e\n\u003cli\u003eA plan with a premium above the benchmark may result in a monthly premium difference.\u003c/li\u003e\n\u003cli\u003eIf your address, marital status, income, or assets change significantly, update your information in accordance with guidance from SSA and the relevant agencies.\u003c/li\u003e\n\u003cli\u003eFor people who qualify automatically, changes in Medicaid, Medicare Savings Program, or SSI eligibility may also affect Extra Help.\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eExtra Help applications are not limited to the annual Medicare enrollment period. Medicare beneficiaries whose circumstances are close to the current limits should apply to SSA for an official determination rather than assuming on their own that they are ineligible.\u003c/p\u003e\n","tags":["Medicare","Part D","Extra Help","SSA","Prescription Drug Assistance"],"faqs":[{"question":"What are the 2026 Extra Help income limits?","answer":"The general limits are $23,940 in annual income for an individual and a combined $32,460 for a married couple living together. Depending on individual circumstances, such as earned income, dependents, or residence in Alaska or Hawaii, you may still qualify even if your income is slightly above the limit, so you can apply with SSA for a determination."},{"question":"What are the 2026 Extra Help asset limits?","answer":"The limit is $18,090 for an individual and a combined $36,100 for a married couple living together. These amounts reflect an exclusion of $1,500 per person for funeral and burial expenses, and assets such as your primary residence and vehicle are generally excluded from the calculation."},{"question":"If I am approved for Extra Help, will all costs be reduced to $0?","answer":"Generally, the deductible is $0, and the monthly premium is also $0 for plans within the benchmark premium amount. However, if you choose a plan that costs more than the benchmark, you may have to pay the premium difference. In 2026, prescription drug copayments are at most $5.10 for generic and preferred generic drugs and at most $12.65 for other brand-name drugs."},{"question":"Do Medicaid recipients also need to apply separately for Extra Help?","answer":"People who have Medicare along with full Medicaid coverage, a Medicare Savings Program, or SSI generally qualify automatically and do not need to apply separately through SSA. If you have not received an automatic eligibility notice, it is advisable to check your status with your Medicaid agency, Medicare, or SSA."},{"question":"Can I apply for Extra Help even if I have not yet enrolled in Part D?","answer":"Yes. You can apply for Extra Help at any time before or after enrolling in Part D, but you must enroll in a Part D plan to apply the assistance to your actual prescription drug costs."},{"question":"Is there an application deadline for Extra Help?","answer":"There is no set annual deadline. If you believe you are eligible, you can apply at any time during the year using SSA's online application or by phone."},{"question":"Can I reapply after my income or assets decrease?","answer":"Yes. Even if a previous application was denied, you can reapply at any time with your current information if your circumstances have changed due to retirement, job loss, divorce, the death of a spouse, or a decrease in assets."},{"question":"What information should I prepare before applying online through SSA?","answer":"It is advisable to prepare information about bank account balances, stocks, bonds, mutual funds, IRAs, 401(k)s, real estate other than your primary residence, Social Security benefits, wages, pensions, annuities, veterans' benefits, and your spouse's income and assets. SSA may request additional supporting documentation during its review."},{"question":"If I am approved for Extra Help, can I use any Part D plan I want?","answer":"Extra Help recipients must also choose from the available Medicare Part D plans. However, each plan has a different drug list, pharmacy network, and premium, and if you choose a plan that costs more than the regional benchmark premium, you may have to pay the difference."}],"sources":[{"url":"https://secure.ssa.gov/i1020/Ee001View.action","title":"Social Security Administration Application for Extra Help with Medicare Prescription Drug Plan Costs","type":"source"},{"url":"https://www.ssa.gov/medicare/part-d-extra-help","title":"Social Security Administration: Medicare Part D Extra Help","type":"source"},{"url":"https://www.medicare.gov/basics/costs/help/drug-costs","title":"Medicare.gov: Help with drug costs","type":"source"},{"url":"https://www.cms.gov/files/document/cy2026-lis-resource-limits-memo.pdf","title":"CMS CY 2026 Low-Income Subsidy Resource Limits Memo","type":"data_point"}],"images":[{"id":545,"url":"https://injoys.com/rails/active_storage/blobs/proxy/eyJfcmFpbHMiOnsiZGF0YSI6NjUwMSwicHVyIjoiYmxvYl9pZCJ9fQ==--e2e2667e086f48c65c0cb24e36da7db238b4ef70/ai-a00c5f56.webp","is_representative":true,"generation_method":"ai_image","license":"ai_generated","mime_type":"image/webp","translations":{"ko":{"alt":"노인 여성과 약병, 동전, 방패, 집과 의료품을 저울질하는 저울, 자동차 일러스트","caption":"노인 여성 주변의 약품과 동전, 주택과 자동차가 의료비와 재정 자원의 균형을 나타낸다.","description":null},"en":{"alt":"Older woman beside medicine bottles, coins, a shield, a car, and scales balancing a home and health care","caption":"Medicines, coins, a home, and a car represent health costs and financial resources for an older adult.","description":null},"ja":{"alt":"高齢女性と薬瓶、硬貨、盾、家と医療品を載せた天秤、車のイラスト","caption":"高齢女性を囲む薬や硬貨、家、車が、医療費と財産のバランスを表している。","description":null},"es":{"alt":"Mujer mayor junto a medicamentos, monedas, un escudo, un auto y una balanza con una casa y artículos médicos","caption":"Los medicamentos, las monedas, la vivienda y el auto representan los gastos de salud y los recursos económicos.","description":null},"id":{"alt":"Perempuan lansia di samping obat, koin, perisai, mobil, dan timbangan berisi rumah serta perlengkapan medis","caption":"Obat, koin, rumah, dan mobil melambangkan biaya kesehatan serta sumber daya keuangan seorang lansia.","description":null},"pt":{"alt":"Idosa ao lado de remédios, moedas, escudo, carro e balança com uma casa e itens médicos","caption":"Remédios, moedas, casa e carro representam os custos de saúde e os recursos financeiros de uma pessoa idosa.","description":null},"zh-hant":{"alt":"老年女性站在藥瓶、硬幣、盾牌、汽車及放有房屋與醫療用品的天平旁","caption":"藥品、硬幣、房屋與汽車象徵老年人的醫療支出和財務資源。","description":null},"de":{"alt":"Ältere Frau neben Medikamenten, Münzen, Schutzschild, Auto und Waage mit Haus und Gesundheitsartikeln","caption":"Medikamente, Münzen, Haus und Auto stehen für Gesundheitskosten und finanzielle Mittel im Alter.","description":null}}},{"id":546,"url":"https://injoys.com/rails/active_storage/blobs/proxy/eyJfcmFpbHMiOnsiZGF0YSI6NjUwNywicHVyIjoiYmxvYl9pZCJ9fQ==--6f131f83169b0c682a56eadf7038c1dae919e13e/ai-22499450.webp","is_representative":false,"generation_method":"ai_image","license":"ai_generated","mime_type":"image/webp","translations":{"ko":{"alt":"노부부가 노트북으로 의료비 지원을 확인하는 모습과 달력, 약, 보호 방패, 동전 일러스트","caption":"Medicare Part D Extra Help 신청과 처방약 비용 절감 과정을 나타낸 일러스트입니다.","description":null},"en":{"alt":"Older couple using a laptop with a calendar, medicine, health shield, and stacks of coins","caption":"The illustration represents applying for Medicare Part D Extra Help to reduce prescription costs.","description":null},"ja":{"alt":"高齢の夫婦がパソコンを見ている様子と、カレンダー、薬、医療の盾、硬貨のイラスト","caption":"Medicare Part DのExtra Help申請と処方薬費の軽減を表したイラストです。","description":null},"es":{"alt":"Pareja mayor ante una computadora con calendario, medicinas, escudo médico y monedas","caption":"La ilustración representa la solicitud de Extra Help de Medicare Part D para reducir el costo de medicamentos.","description":null},"id":{"alt":"Pasangan lansia melihat laptop dengan kalender, obat, perisai kesehatan, dan tumpukan koin","caption":"Ilustrasi ini menggambarkan pengajuan Medicare Part D Extra Help untuk mengurangi biaya obat resep.","description":null},"pt":{"alt":"Casal idoso usando um notebook com calendário, remédios, escudo de saúde e pilhas de moedas","caption":"A ilustração representa a solicitação do Extra Help do Medicare Part D para reduzir os custos de medicamentos.","description":null},"zh-hant":{"alt":"老年夫妻查看筆電，周圍有月曆、藥品、醫療盾牌與成疊硬幣","caption":"插圖呈現申請 Medicare Part D Extra Help 以降低處方藥費用的過程。","description":null},"de":{"alt":"Älteres Paar am Laptop mit Kalender, Medikamenten, Gesundheitsschild und Münzstapeln","caption":"Die Illustration zeigt die Beantragung von Medicare Part D Extra Help zur Senkung der Arzneimittelkosten.","description":null}}}],"published_at":"2026-08-09T01:42:04+09:00","updated_at":"2026-08-09T01:42:04+09:00","license":"cc_by","translation_status":"reviewed","available_locales":["ko","en","ja","es"],"data_locales":["ko","en","ja","es","id","pt","zh-hant","de"],"url":"https://injoys.com/en/articles/2026-medicare-part-d-extra-help-income-resource-limits-application"}