Medicare Extra Help 2026: The $1,500 Most People Leave Behind
● ACTIVE ◐ REVISED EACH YEAR NATIONAL
Three resource limits circulate for 2026: $16,590, $18,090, and figures in between. Three income limits too. None of them are typos.
The resource gap is $1,500 per person, and it depends on one thing: whether you told Social Security you expect to use some savings for burial expenses. The $20 income gap is the standard disregard. A third set of figures is simply last year's poverty guideline.
CMS publishes both resource limits in the same memo. The higher one is not an error. It is a limit you have to ask for.
Extra Help pays most of your Medicare Part D drug costs. In 2026 it removes the deductible entirely and caps generics at $5.10 and brand-name drugs at $12.65.
Above $2,100 in out-of-pocket spending for the year, you pay nothing at all.
2026 resource limits
These come from the memo Social Security and CMS issued to Part D plan sponsors on October 31, 2025.
| Status | 2026 limit | If you told SSA about burial expenses |
|---|---|---|
| Single | $16,590 | $18,090 |
| Married | $33,100 | $36,100 |
→ swipe the table sideways · Source: CMS CY2026 LIS memo, issued 2025-10-31
Resources means checking and savings accounts, stocks, bonds, anything you could turn into cash within twenty days, and real estate that is not your home. Your house, one car, and household belongings do not count.
These limits rose 3.01% from 2025, tied to the change in the Consumer Price Index between September 2024 and September 2025.
2026 income limit
Extra Help is available at incomes up to 150% of the federal poverty level — roughly $1,995 a month for one person and $2,705 for a couple.
You will also see $2,015 and $2,725. That is the same threshold with the standard $20 general income disregard added. Charts showing $23,475 a year are using the 2025 guideline, not the 2026 one.
Apply even if you are over. Social Security applies exclusions the published limits do not show, and the limit rises if you support dependent relatives living with you. There is no penalty for being turned down.
What you pay in 2026
| Situation | Deductible | Generic | Brand |
|---|---|---|---|
| Medicaid + Medicare, in a facility or on HCBS | $0 | $0 | $0 |
| Medicaid + Medicare, at or below 100% FPL | $0 | $1.60 | $4.90 |
| Medicaid + Medicare, 100–150% FPL | $0 | $5.10 | $12.65 |
| QMB, SLMB, QI, or SSI without Medicaid | $0 | $5.10 | $12.65 |
| Applied directly, at or below 150% FPL | $0 | $5.10 | $12.65 |
→ swipe the table sideways · Source: CMS CY2026 LIS memo
Once your out-of-pocket spending reaches $2,100 in a calendar year, cost sharing stops.
How to get it
Social Security handles Extra Help — not Medicare, and not your state. Applying is free and takes about half an hour online.
Two things decide whether the application works: the burial expense question, and one box near the end that quietly starts a second application in your state. Both are easy to get wrong.
Next stepHow to apply — and the box you should never check→Traps
The higher resource limit only applies if you say so. The $1,500 per person burial allowance is not automatic. You have to tell Social Security you expect to use some resources for burial expenses. People a few hundred dollars over the limit are turned down without ever hearing this exists.
If you have QMB, SLMB, or QI, do not apply. You already have Extra Help. Those programs qualify you automatically, and Social Security notifies you by mail each fall. A second application is wasted effort.
QDWI does not carry Extra Help. The CMS list of automatic categories names QMB, SLMB, and QI. The fourth Medicare Savings Program, QDWI, is not on it. If QDWI is what you have, you still need to apply for Extra Help separately.
Partial Extra Help no longer exists. Until 2024 there was a reduced subsidy for people between 135% and 150% of the poverty level. The Inflation Reduction Act removed it. Everyone who qualifies now gets the full benefit. Pages describing a partial subsidy are out of date.
Extra Help alone does not give you drug coverage. It reduces the cost of a Part D plan. You still have to be enrolled in one. If you do not choose a plan, one may be assigned to you — and an assigned plan may not cover the drugs you actually take.
Related programs
Step by stepHow to apply for Extra Help→ Gets you this automaticallyMedicare Savings Programs 2026: All 50 States→ Where to ask about thatHow to reach your state Medicaid office→ State guideMedicare Savings Programs in California→Tools you'll need anyway
Nobody here charges a fee. Applying is always free.
- Centers for Medicare & Medicaid Services — Calendar Year 2026 Resource and Cost-Sharing Limits for Low-Income Subsidy. Issued October 31, 2025.
- Social Security Administration — Extra Help with Medicare prescription drug plan costs.
- HHS Office of the Assistant Secretary for Planning and Evaluation — 2026 poverty guidelines, used to derive the 150% threshold.
CMS releases the annual income standards separately from the resource limits. The monthly income figures above are derived from the 2026 federal poverty guideline. Confirm with Social Security before you apply. Benefit Almanac is not a government agency and cannot determine your eligibility.
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