Extra Help & Medicare Savings Programs in 2026: The Money Most People Leave on the Table

There are two federal programs that quietly cut Medicare costs for people on a modest income — Extra Help and the Medicare Savings Programs. Together they can erase your Part B premium, wipe out your Part D deductible, and drop prescription copays to pocket change. Millions of people who qualify have never applied, usually for one reason: nobody ever told them the numbers. Here they are for 2026.

People mix these up constantly, so let's separate them cleanly. They are run by different agencies, they pay different bills, and you can absolutely have both at the same time.

• Extra Help (its formal name is the Part D Low-Income Subsidy, or LIS) is run by Social Security. It pays for your prescription drug coverage.
• Medicare Savings Programs (MSPs) are run by your state Medicaid office. They pay your Medicare premiums — and for one program, your deductibles and coinsurance too.

That's the whole distinction. Extra Help is about the pharmacy counter. Savings Programs are about the premium coming out of your Social Security deposit. If your income is limited, you should be checking both.

Extra Help is for people enrolled in Medicare with limited income and resources. To qualify in 2026, your annual income generally must be at or below 150% of the federal poverty level — which works out to about $23,475 for one person or $31,725 for a married couple living together. Alaska and Hawaii use higher figures.

Your countable resources must be at or below $16,590 (single) or $33,100 (married couple). If you tell Social Security you've set aside money for burial expenses, those limits rise to $18,090 and $36,100 — the exclusion is up to $1,500 per person.

If you're approved, here is what 2026 looks like at the pharmacy:

• No monthly premium for a benchmark Part D drug plan in your area
• No deductible — coverage starts with your first prescription
• Copays capped at $5.10 for generics and $12.65 for brand-name drugs the plan covers
• No copays at all once your out-of-pocket drug spending reaches the 2026 cap of $2,100

This is where good candidates talk themselves out of applying. They hear "asset limit," think about the house, and stop reading. Don't. The list of what doesn't count is long.

• Not counted: the home you live in, one vehicle, household goods and personal belongings, a burial plot, and up to $1,500 per person set aside for burial expenses
• Counted: checking and savings balances, certificates of deposit, stocks, bonds, mutual funds, and IRAs

So a retiree with a paid-off house, a car in the driveway, and $12,000 in savings can be comfortably inside the 2026 limit — even though on paper their "net worth" sounds like it should disqualify them.

MSPs are the ones that put money back in your monthly check. There are four, and they're stacked by income — as income rises, the help narrows. The monthly figures below are the 2026 federal limits for the 48 contiguous states and Washington, D.C., and they already include the standard $20 income disregard. Alaska and Hawaii are higher.

QMB — Qualified Medicare Beneficiary

Up to $1,350/month single, $1,824/month married. This is the big one: QMB pays your Part B premium, your Part A premium if you owe one, and your Medicare deductibles, coinsurance, and copayments.

SLMB — Specified Low-Income Medicare Beneficiary

Up to $1,616/month single, $2,184/month married. SLMB pays your Part B premium — $202.90 a month in 2026.

QI — Qualifying Individual

Up to $1,816/month single, $2,455/month married. QI also pays the Part B premium, with two catches: funding is limited and awarded first-come, first-served, and you have to reapply every year. Apply early in the year.

QDWI — Qualified Disabled & Working Individual

Up to $5,405/month single, $7,299/month married. A narrow program for people under 65 who lost premium-free Part A because they returned to work. It pays the Part A premium. Its asset limits are different: $4,000 single, $6,000 married.

For QMB, SLMB and QI, the 2026 asset limits are $9,950 for an individual and $14,910 for a married couple.

If you have QMB, federal law prohibits Medicare providers from billing you for Medicare cost-sharing — deductibles, coinsurance, and copays on Medicare-covered services. Not "discourages." Prohibits.

It still happens, usually by mistake, when a billing system doesn't have your QMB status on file. If a bill shows up, don't pay it out of embarrassment. Call the provider, tell them you're in the QMB program, and ask them to refund anything you've already paid. If that doesn't fix it, call 1-800-MEDICARE. Keep your Medicaid or QMB approval letter somewhere you can find it — it ends most of these conversations in about a minute.

Extra Help and the Savings Programs are not tied to the Annual Enrollment Period. You can apply any time of year, and if your income drops — a spouse passes away, you stop working, a pension changes — you can apply the month it happens rather than waiting until October.

Getting approved also opens a Special Enrollment Period, which lets you change your Part D or Medicare Advantage plan outside the normal window — once per calendar quarter for the first three quarters of the year. That matters, because the cheapest plan for someone paying full price is often not the cheapest plan for someone with Extra Help.

These programs aren't charity and they aren't a loophole. They were written into Medicare on purpose, funded on purpose, and they exist for exactly the household that reads an article like this one and wonders whether it's really talking about them.

The cost of applying is an afternoon. The cost of not applying can be $2,435 a year in Part B premiums plus whatever you're overpaying at the pharmacy. If you're anywhere near the numbers above — or you're not sure, which is most people — it's worth twenty minutes with someone who reads these charts for a living. That conversation is free.

Want more plain-English guides like this? See what changed in Medicare for 2026, get ready for open enrollment, visit the blog, explore our free Medicare education center, or browse recursos en español.