Medicare Extra Help 2026 Income and Asset Limits and How to Apply

If Medicare Part D prescription drug costs are a burden, first check whether you automatically qualify. If you do not automatically qualify, prepare your bank, investment, retirement account, and income information and apply through Social Security. There is no set annual deadline, and you can apply at any time during the year or reapply after your income or assets decrease.

• Who should generally apply: Medicare beneficiaries who do not automatically qualify and may meet the income and asset requirements
• General 2026 limits: Individual annual income of $23,940 and assets of $18,090; married couple annual income of $32,460 and assets of $36,100
• Application period: Any time during the year
• Official application agency: Social Security
• Information to prepare: Bank accounts, investments, IRA·401(k), wages, pensions, and tax return information

1. Check Whether You Automatically Qualify First

If any of the following applies to you, you generally qualify automatically for Extra Help and do not need to submit a separate application to Social Security.

• You receive both Medicaid and Medicare
• You receive assistance from a Medicare Savings Program such as QMB, SLMB, or QI
• You are enrolled in Medicare and receive Supplemental Security Income, or SSI

Medicare sends a related notice to people who automatically qualify. Even if you automatically qualify, you must be enrolled in a Part D plan or a Medicare Advantage plan that includes prescription drug coverage for Extra Help to apply to your actual prescriptions.

Even if you receive notice that your automatic eligibility has ended, you can apply directly through Social Security if your income and assets are within the general limits.

2. Check the 2026 Income and Asset Limits

The general limits published for 2026 are as follows.

These amounts are useful for a quick self-check, but Social Security makes the final determination after reviewing the application and any applicable exclusion rules.

Points to Consider When Determining Income

In addition to wages, Social Security benefits, pensions, and other regular income may be used in the determination. However, exclusions may apply to earned income or certain assistance payments, so it is best not to give up on applying simply because your total is slightly above the limit.

Income limits may be higher in Alaska and Hawaii. Higher limits may also apply if you financially support family members who live with you, so you should confirm your circumstances with Social Security.

Items Included as Assets

The following types of liquid financial assets are generally reviewed.

• Checking and savings accounts
• Stocks, bonds, mutual funds, and other investment accounts
• Retirement accounts such as IRA and 401(k)
• Real estate other than your primary residence

Your primary residence, vehicles, household goods, personal belongings, and burial plots are generally excluded from the asset calculation. Exclusion rules may also apply to a certain amount set aside for burial expenses. Because the official asset limits account for the permitted burial-expense amount, accurately report the amount you actually own according to the questions on the application.

3. Prepare Information Before Applying

Gathering the following information before starting the online application can help you enter your income and assets more accurately.

• Recent bank statements and account balances
• Statements for investment accounts such as stocks, bonds, and funds
• Balances for IRA, 401(k), and other retirement accounts
• Recent tax returns
• Pay stubs or employment income records
• Records of regular income such as Social Security benefits, pensions, and veterans benefits
• Your spouse’s income and asset information if you live together

You do not need to attach all documents online. However, keep supporting records because Social Security may request additional verification or verify the amounts listed on your application.

4. Apply for Extra Help Through Social Security

If you do not automatically qualify, apply in the following order.

1. Go to Social Security’s official Medicare Part D Extra Help page.
2. Select the online application and enter information about yourself and your spouse who lives with you.
3. Answer questions about income, bank accounts, investments, retirement accounts, and real estate.
4. Confirm whether your information may be sent to the state for a Medicare Savings Program review.
5. Review and submit the application, and keep a record of the submission.
6. Check Social Security’s determination notice and submit any requested additional information within the stated deadline.

If using the online service is difficult, you can apply by calling Social Security or through a local office. If you need hearing assistance, you can use the official TTY channel.

There is no set annual application deadline. Even if you were previously denied because of your income or assets, you can reapply if your circumstances change because of job loss, retirement, a spouse’s death, decreased assets, or another reason.

5. Part D Costs Reduced After Approval

When Extra Help applies in 2026, Part D costs are generally reduced as follows.

The prescription drug amounts in the table are maximums. Depending on Medicaid eligibility, whether you live in a facility, and other assistance conditions, your actual cost may be lower or $0. After reaching Part D’s annual out-of-pocket limit phase, your out-of-pocket cost for covered prescription drugs becomes $0.

Premium assistance is based on a regional benchmark premium. If the premium for your selected plan exceeds the assistance benchmark or includes additional benefits, you may still owe the difference, so review both your approval notice and your plan bill.

6. How Application Information Is Sent to the Medicare Savings Program

An Extra Help application may lead to a Medicare Savings Program review. Unless you indicate that you do not want this during the application process, Social Security may send your application information to your state’s Medicaid agency to begin a Medicare Savings Program application.

Depending on eligibility, a Medicare Savings Program may help pay Part B premiums and some deductibles and coinsurance. Extra Help primarily reduces Part D prescription drug costs, so the two programs cover different expenses.

Having your information sent to the state does not guarantee approval for a Medicare Savings Program. The state applies separate income and asset limits and may require additional documents or an interview.

7. Why You Should Review Your Part D Plan Even After Approval

Approval for Extra Help does not mean that all prescription drugs are automatically covered at the same price. Your actual costs and access are also affected by the rules of your selected Part D plan.

Check the following:

• Whether the medications you currently take are included in the plan’s formulary
• Whether you can fill prescriptions at a preferred or network pharmacy
• Whether prior authorization, step therapy, or quantity limits apply
• Whether the plan premium exceeds the Extra Help assistance benchmark
• Whether you can switch to a generic or an alternative preferred by the plan

After receiving an approval notice, it is therefore advisable to review your plan again based on your prescription list, dosages, and pharmacy. Extra Help is a cost-assistance program and does not determine the medical suitability of a particular medication or replace a plan’s formulary rules.

8. Respond to the Decision Notice and Reapply When Needed

Social Security provides written notice of an approval or denial. Check the notice for the effective date, level of assistance, and any additional steps you must take.

If you believe the decision is incorrect, follow the appeal method and deadline stated in the notice. If your income or assets change, you can reapply separately from the previous decision.

Automatic eligibility or Extra Help eligibility may be reviewed again later. Ignoring an eligibility verification request from Medicare, Social Security, or a state agency may cause your assistance to change, so keep your address current and submit requested documents by the deadline.