Medicare Extra Help Income Limits for 2026 Explained

The Medicare Extra Help program, also called the Low Income Subsidy (LIS), helps pay for Part D prescription drug premiums, deductibles, and copays. Each year, the Social Security Administration (SSA) adjusts the income and resource limits that determine who qualifies, based on the Federal Poverty Guidelines. For 2026, eligibility still centers on two tiersfull subsidy for those near or below 135% of the federal poverty level, and a partial subsidy for those up to 150%, but the exact dollar thresholds shift slightly from 2025.

Because SSA typically finalizes these dollar amounts in the fall before the new plan year, this article explains the framework and how to confirm the current numbers directly through SSA.gov's Extra Help page and Medicare.gov so you're working from the most current figures.

How the Income Test Works

SSA counts your income and your spouse's income if you're married, minus certain exclusions. A standard income disregard applies, and if you're still working, some earned income is excluded as well. If your household income falls under the full-subsidy threshold, Extra Help can eliminate your Part D premium and deductible and cap your copays at a low, fixed amount. If your income lands between the full and partial thresholds, you may still get a partial subsidy that reduces, but doesn't eliminate, your out-of-pocket costs.

How the Resource Test Works

Resources include savings, checking accounts, stocks, and bonds. Your home, one vehicle, and personal belongings don't count. Life insurance policies and a small burial fund allowance are also typically excluded. Because Extra Help is a federal program, it's applied the same way in every state, unlike some Medicare savings programs run through your state's Medicaid agency, which can have different resource rules.

Full Subsidy vs. Partial Subsidy

The difference matters for your wallet. With the full subsidy, you typically pay $0 for a Part D premium (up to a benchmark amount), no deductible, and only a small copay per prescription. With a partial subsidy, you may still owe a reduced premium and deductible, plus a percentage-based copay instead of a flat dollar amount. Either way, Extra Help works alongside your Part D plan to lower your prescription coverage for seniors costs throughout the year.

What If You're Close to the Limit?

Many people assume they're disqualified because they were over the threshold in a previous year, but the limits typically rise a bit each year with inflation. It's worth applying even if you're uncertain, since SSA will calculate your specific eligibility rather than you having to self-determine it. If you don't qualify for full Extra Help, you may still qualify for a partial subsidy, or for a state Medicare savings program that helps with Part B premiums and other costs. Understanding how much does Medicare cost overall, and how Extra Help fits into your Medicare out of pocket costs, can help you see the full financial picture before you enroll or renew a plan.

If you're already close to qualifying, small changes, like an increase in a pension payment or a gift from a family member, can push you over the resource limit temporarily. It's worth tracking your accounts through the year, especially if you're near the threshold, and reapplying if your situation changes.