Checking the Right Medicare Extra Help Income Limits for 2026

Do you qualify for Extra Help in 2026?

The Medicare Extra Help income limits for 2026 are $23,940 a year for one person and $32,460 for a married couple living together. Countable savings must also stay at or below $18,090 ($36,100 for a couple).

Social Security values the program at about $5,700 a year. It trims one of the five separate bills that make up Medicare costs: your Part D drug spending.

Seen different numbers elsewhere? The final section explains why.

If you’re helping a parent apply

Start with what counts as an asset, then the worked example. SSA lets family members help complete the application.

If you already have Medicaid or SSI

You likely qualify automatically; skip to the application steps.

ℹ️ Financial Disclaimer: This article is general education, not personalized insurance, benefits, tax, investment, lending, or debt-relief advice. Social Security and CMS alone decide Extra Help eligibility. Before choosing a drug plan, contact your State Health Insurance Assistance Program (SHIP); before moving or spending down assets, consult an elder law attorney; for tax questions, consult a CPA.

2026 Extra Help income and asset limits by household

Extra Help’s income limit is 150% of the 2026 federal poverty guidelines, paired with a separate cap on countable resources.

Sources: HHS’s 2026 poverty guidelines; Medicare Rights Center; CMS’s 2026 resource and cost-sharing limits.

Annual vs. monthly limits (and the $20 disregard)

🔍 How It Works: Social Security subtracts $20 from monthly unearned income, such as Social Security benefits, before comparing it with the $1,995 poverty-based limit. That’s why the monthly figure reads $2,015.

Larger households, Alaska, and Hawaii

Each additional relative you support at home adds $8,520 a year. Alaska’s limits are $29,925 single and $40,575 couple; Hawaii’s are $27,540 and $37,335.

Asset limits with and without burial funds

The higher resource limits apply only if you tell Social Security you expect to use some savings for burial. Couples should also see what Medicare costs a married couple.

What counts as income and assets for Extra Help

Social Security counts what you could turn into cash, not everything you own.

Assets that count

• Checking, savings, and certificates of deposit
• Stocks, bonds, U.S. Savings Bonds, and mutual funds
• Individual Retirement Accounts (IRAs)
• Cash, plus real estate other than your home

Assets SSA ignores

Your home, vehicles, personal possessions, life insurance policies, and burial expenses don’t count, per Social Security’s guide to Extra Help.

Income that doesn’t count

SNAP, housing assistance, energy assistance, disaster aid, and EITC payments are excluded.

When higher income can still qualify

You may still qualify with work earnings, relatives you support at home, or an Alaska or Hawaii address.

⚠️ Costly Mistake: Some guides say life insurance counts or IRAs don’t. Social Security says the reverse on both.

✅ Action Step: Before moving or spending savings to get under the limit, ask an elder law attorney: “How would this change my Extra Help and Medicaid eligibility?”

A worked example: checking one person’s eligibility

Here’s a hypothetical single applicant, measured against the 2026 limits above.

The income check

She receives $1,950 a month from Social Security and has no earnings. That’s under the $2,015 monthly limit, so she passes.

The resource check, and the burial-funds swing

Her checking account holds $12,000, and she owns a $5,000 CD, for $17,000 in countable resources.

🔍 How It Works: $17,000 is $410 over the $16,590 base limit. If she tells Social Security she expects to use some savings for burial, her limit becomes $18,090 and she qualifies.

✅ Action Step: Helping a parent file? Ask your local SHIP counselor: “How do I report savings set aside for burial on Form SSA-1020?”

What Extra Help pays for in 2026

Extra Help swaps Part D’s standard costs for a $0 deductible and small, capped copays.

Copays by group

Under CMS’s 2026 limits, most enrollees pay no more than $5.10 per generic and $12.65 per brand-name drug. Full Medicaid enrollees at or below 100% of the poverty level pay at most $1.60 and $4.90.

🔍 How It Works: Three brand-name fills a month at the $12.65 maximum cost at most $455.40 a year ($12.65 × 3 × 12). Without Extra Help, the standard benefit’s deductible alone can reach $615, per KFF.

Premiums and the benchmark

No premium applies if your basic plan costs at or below your state’s Extra Help benchmark.

The $2,100 cap and the late penalty

Everyone’s out-of-pocket drug costs stop at $2,100 in 2026 under the Part D $2,100 cap. Extra Help enrollees also avoid the Part D late enrollment penalty.

✅ Action Step: Ask your SHIP counselor: “Which no-premium plans in my state cover my drugs?”

How to apply, or check if you already qualify

You either get Extra Help automatically or apply free through Social Security.

Automatic eligibility (Medicaid, MSP, SSI)

With Medicaid, a Medicare Savings Program, or SSI, you’re enrolled automatically, and Medicare mails a purple notice confirming it.

Applying with SSA-1020

1. Gather bank statements, IRA or 401(k) balances, and pension statements.
2. Apply for Extra Help through Social Security online, by phone at 1-800-772-1213, or at a local office.
3. Keep the Medicare Savings Program referral; Social Security forwards it to your state.
4. Join a Part D plan once approved, or CMS will assign one.

Switching plans after approval

You can change drug coverage once a month to a stand-alone Part D plan, per Medicare’s Extra Help page. Without Extra Help, you’d wait for the October 15–December 7 window in our Medicare open enrollment dates guide.

Why you’ll see different 2026 limits online

Several widely shared figures are outdated or wrong.

Stale and wrong figures to ignore

Sources: HHS poverty guidelines; SSA Publication 05-10508; Medicare.gov.

Don’t miss the annual review letter

Social Security reviews eligibility each year, usually at the end of August, by mailing Form SSA-1026. Return it within 30 days: any change then starts in January, but an unreturned form ends your Extra Help the following year.

Frequently asked questions

Your next step

If your income and countable savings sit near these limits, apply: it’s free, and the burial-funds question alone can change the answer. Family members can help, and your local SHIP offers free application help.

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