Extra Help with Part D: lower drug costs and no late penalty
What the Part D Low-Income Subsidy covers in 2026, who qualifies, how to apply through Social Security, and how it interacts with the $2,100 cap.
Extra Help, officially the Part D Low-Income Subsidy, lowers drug plan premiums, deductibles and copays for people with limited income and resources. Since 2024, the full subsidy has been available to people up to 150% of the federal poverty level.
What it does
- Pays all or most of the Part D premium for benchmark plans in your region.
- Removes the Part D deductible.
- Sets low fixed copays for generic and brand-name drugs.
- Waives the Part D late enrollment penalty.
- Allows a monthly Special Enrollment Period to change drug plans in some situations.
Who qualifies automatically
People with full Medicaid, a Medicare Savings Program, or Supplemental Security Income (SSI) get Extra Help without applying.
Applying
Others apply through Social Security, online or by phone. You will be asked about income, savings and investments; your home, one car and burial plots are not counted. Approval is usually quick.
Extra Help and the cap
Extra Help payments count toward the $2,100 out-of-pocket cap, though most Extra Help enrollees pay far less than that in a year. See the 2026 cap explained.
Picking a plan with Extra Help
Benchmark plans have $0 premiums for full-subsidy enrollees. Other plans are allowed, but you pay the difference in premium. Check that your drugs are on the formulary before choosing.
Questions people ask
Who qualifies for Extra Help?
People with limited income and resources; full subsidy up to 150% of the poverty level.
Does Extra Help remove the Part D penalty?
Yes.
Where do I apply?
Through Social Security, unless you qualify automatically.
Does Extra Help pay premiums?
It covers all or most of the premium for benchmark plans.
Independent educational site. Not affiliated with or endorsed by the U.S. government, the federal Medicare program, or any insurance company. Figures are 2026 amounts published by CMS unless noted; check Medicare.gov for your situation.