Extra Help (LIS) Eligibility Calculator — Lower Medicare Drug Costs Up to $5,900/Year
Figures last verified against SSA and Medicare.gov sources in July 2026.
Quick Answer
Medicare Extra Help (officially the Low Income Subsidy or LIS) pays your Part D plan premium, eliminates the drug deductible, and caps copays at $4.90 generics / $12.15 brand-name drugs in 2026. Single filer income limit: ~$1,985/month. Married couple limit: ~$2,685/month. If you have Medicaid, SSI, or a Medicare Savings Program, you qualify automatically — no application needed.
Medicare Extra Help (LIS) Eligibility Calculator 2026
Enter your marital status, monthly income, and savings to check if you qualify for federal prescription drug assistance worth ~$5,900/year.
Millions of Medicare beneficiaries who qualify for Extra Help never apply — either because they don't know the program exists, or because they assume their income or assets are too high. The asset rules exclude your home, one car, and personal belongings. Even if you were previously denied, limits increase annually and a re-application takes 15 minutes. This free calculator applies the official 2026 SSA thresholds to your specific situation in seconds.
- Medicare beneficiaries spending more than $50/month on Part D prescriptions who want to check whether they qualify for drug cost reductions.
- Seniors who previously received a denial letter from SSA for Extra Help and want to re-check eligibility under updated 2026 income and asset thresholds.
- Caregivers helping a parent who has Medicaid or an MSP (Medicare Savings Program) and may already qualify automatically without knowing it.
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How to Use This Extra Help Eligibility Calculator
- Step 1 — Enter your household size and total monthly income. Select single or married. Enter your combined gross monthly income from all sources: Social Security benefits (full amount before Medicare deductions), any pension, wages, interest, dividends, and rental income. Do not subtract Medicare premiums — enter gross figures.
- Step 2 — Enter your countable assets. Add up cash, checking and savings balances, CDs, stocks, bonds, mutual funds, and IRA/401(k) values. Do not count your primary home, one vehicle, household furniture, personal belongings, or up to $1,500 per person designated for burial. These are excluded by SSA regulation.
- Step 3 — Read your eligibility result. The calculator compares your inputs to the official 2026 SSA income and asset thresholds and tells you whether you likely qualify for Full Extra Help, Partial Extra Help, or neither — along with the specific threshold you're above or below.
- Step 4 — Apply immediately if eligible. Apply online at ssa.gov/extrahelp, call 1-800-772-1213, or walk into any Social Security field office. The application is free, takes roughly 15 minutes, and requires no documents at the time of filing — SSA verifies income with the IRS directly.
💡 Pro Tip
If you have Medicaid, SSI, or a Medicare Savings Program (QMB, SLMB, or QI), you already qualify for Extra Help automatically — SSA is notified by your state and enrolls you without a separate application. Check your Medicare plan documents or call 1-800-MEDICARE to confirm your current LIS status before applying.
2026 Extra Help Income & Asset Limits — Quick Reference
| Household Size | Monthly Income Limit | Annual Income Limit | Asset Limit |
|---|---|---|---|
| Single individual | ~$1,985/month | ~$23,820/year | $17,220 ($18,720 with burial funds) |
| Married couple (living together) | ~$2,685/month | ~$32,220/year | $34,360 ($37,360 with burial funds) |
| Assets excluded: Primary home, one vehicle, personal belongings, up to $1,500/person for burial expenses. Source: SSA Extra Help Program Page. | |||
Real-Life Examples — How Extra Help Works in Practice
Maria receives $1,380/month Social Security and $320/month from a small pension — total $1,700/month. Her countable assets are $8,400 in a savings account (her home is excluded). She was unsure whether she qualified.
| Input | Value |
|---|---|
| Total monthly income | $1,700 |
| Countable assets | $8,400 |
| 2026 single income limit | ~$1,985/month |
| 2026 single asset limit | $17,220 |
| Eligibility result | ✅ Full Extra Help — Qualifies |
Key: Maria's home was worth $240,000 but was completely excluded from the asset calculation. She nearly self-disqualified by counting it. Check our Medicare Drug Coverage Gap Calculator to see how Extra Help interacts with the Part D catastrophic threshold.
Robert and Helen receive combined Social Security of $2,400/month and have $28,000 in a joint savings account. Robert takes three brand-name medications that previously cost $187/month combined.
| Input | Value |
|---|---|
| Combined monthly income | $2,400 |
| Countable assets (joint) | $28,000 |
| 2026 married income limit | ~$2,685/month |
| 2026 married asset limit | $34,360 |
| Eligibility result | ✅ Full Extra Help — Both Qualify |
Key: The married asset limit of $34,360 is more than double the single limit — couples often have more room than they expect. If Robert later qualifies for a Medicare Savings Program, Extra Help status becomes automatic and permanent while MSP continues.
Dorothy's Social Security is $2,200/month — $215 above the single Extra Help income limit. She doesn't qualify for Extra Help directly. But the screener surfaces an alternative.
| Input | Value |
|---|---|
| Monthly income | $2,200 |
| 2026 single income limit | ~$1,985 |
| Extra Help eligibility | ❌ Does not qualify |
| SLMB income limit (2026) | ~$2,270/month |
| SLMB eligibility | ✅ Qualifies — Part B premium paid ($185/mo) |
Key: A denial from Extra Help doesn't mean no help exists. Medicare Savings Programs have different (and sometimes higher) income limits. Always screen for MSPs separately using our Medicare Savings Programs Estimator.
These are representative examples using official 2026 SSA thresholds. Only SSA makes final eligibility determinations. Income and asset limits are updated annually. Apply at ssa.gov/extrahelp for an official determination.
Common Extra Help Mistakes — And How to Avoid Them
Not Knowing You Already Qualify Automatically
If you receive full Medicaid benefits, SSI, or are enrolled in a Medicare Savings Program (QMB, SLMB, or QI), you automatically qualify for Full Extra Help. SSA receives a notification from your state and typically enrolls you without any action on your part. Thousands of seniors who qualify this way still pay unnecessary Part D premiums and copays because they don't know their automatic status.
The fix is to call 1-800-MEDICARE (1-800-633-4227) and ask: "Do I currently have Extra Help or LIS status on my Medicare account?" If you qualify through Medicaid or an MSP but aren't receiving LIS benefits, SSA can correct this immediately. Check whether you have an MSP using our Medicare Savings Programs Estimator.
Counting Your Primary Home as a Countable Asset
SSA's Extra Help asset limits specifically exclude your primary residence — regardless of its value. A senior with a $400,000 home but only $12,000 in savings fully qualifies for Extra Help on the asset test. Yet many people look at their home equity and conclude they "have too much" and never apply.
The fix is to count only liquid financial assets: cash, bank accounts, stocks, bonds, and retirement account balances. Exclude: primary home, one vehicle (any value), personal belongings, and up to $1,500 per person set aside for burial. The official exclusion list is at SSA Extra Help Program Page.
Missing the Annual Re-Verification Notice From SSA
Extra Help is not a one-time approval. SSA sends a yellow re-verification notice each year — typically in September or October — asking you to confirm your income and assets haven't changed significantly. Many seniors miss this notice, fail to respond, and are disenrolled from Extra Help for the following year without realizing it.
The fix is to watch for the yellow SSA mailing each fall and respond promptly. If your income and assets haven't changed significantly, the form takes about 10 minutes to complete. If you missed last year's notice and lost Extra Help, you can re-apply immediately at ssa.gov/extrahelp — there is no waiting period for re-application.
Self-Disqualifying When Slightly Over the Income Limit
The Extra Help income limits are based on countable income — not your full gross income. SSA allows deductions for certain excluded income types. Additionally, if your income is only marginally above the Full Extra Help limit, you may qualify for Partial Extra Help, which still provides substantial savings. And if you're above both thresholds, a Medicare Savings Program often covers ground Extra Help doesn't reach.
The fix is to let this calculator run the actual numbers before concluding you don't qualify. Never self-disqualify based on a rough estimate. If borderline, always apply and let SSA make the determination. The application has no cost and no negative consequence if denied.
Official Sources Used in This Tool
| Source Name | What We Used It For | Direct Link |
|---|---|---|
| SSA Extra Help (LIS) Program Page | Official 2026 income and asset thresholds, excluded asset list, automatic qualification criteria, and application process | SSA Extra Help |
| Medicare.gov — Extra Help for Drug Costs | 2026 copay caps ($4.90 generics, $12.15 brand-name), deductible amounts, benchmark premium data, and SEP rules for plan switching | Medicare.gov Drug Cost Help |
| Social Security POMS SI 01120.215 | Asset exclusion rules for Extra Help: primary home, vehicle, burial fund, and personal effects exclusions under federal policy operations guidance | SSA POMS SI 01120.215 |
| 42 USC § 1395w-114 | Federal statutory authority for the Low Income Subsidy program — the legal foundation for all Extra Help eligibility rules and benefit amounts | 42 USC § 1395w-114 — Cornell LII |
Seniors Audit is an independent educational platform. We are not affiliated with, endorsed by, or connected to the Social Security Administration, CMS, or Medicare. All calculations use official 2026 SSA thresholds published by the agencies above.
Frequently Asked Questions About Medicare Extra Help (LIS)
What is the Medicare Extra Help (LIS) program?
Medicare Extra Help — officially known as the Low Income Subsidy (LIS) — is a federal program administered by Social Security that helps Medicare beneficiaries with limited income and resources pay for Medicare Part D prescription drug costs, including plan premiums, deductibles, and copayments. In 2026, it is worth an estimated $5,900 per year per beneficiary.
What are the 2026 income and asset limits for Medicare Extra Help?
In 2026, to qualify for Full Extra Help: A single individual must have gross monthly income under ~$1,985 ($23,820/year) and countable assets under $17,220 (or $18,720 including burial funds). A married couple living together must have monthly income under ~$2,685 ($32,220/year) and countable assets under $34,360 (or $37,360 including burial funds).
What assets count toward the Medicare Extra Help resource limit?
Countable assets include cash, bank checking and savings accounts, stocks, bonds, mutual funds, and IRAs/401(k)s. The IRS and SSA do NOT count your primary home, one vehicle, household items, personal effects, or up to $1,500 per person set aside for burial expenses.
How much does Extra Help save on Medicare prescription drugs?
If you qualify for Full Extra Help in 2026: Your monthly Part D plan premium is reduced to $0 (for benchmark plans), your annual drug deductible is $0, and your prescription copays are capped at no more than $4.90 for generic drugs and $12.15 for brand-name drugs. Once your out-of-pocket costs reach the catastrophic phase, your copays drop to $0 for the rest of the year.
Do I automatically qualify for Extra Help if I have Medicaid or MSP?
Yes. If you are enrolled in Full Medicaid, a Medicare Savings Program (QMB, SLMB, or QI), or receive Supplemental Security Income (SSI), you automatically qualify for Medicare Extra Help without needing to file a separate application.
How do I apply for Medicare Extra Help?
You can apply for Extra Help online at ssa.gov/extrahelp, call Social Security at 1-800-772-1213 (TTY 1-800-325-0778), or visit your local Social Security field office. The application is completely free and takes about 15 minutes to complete.
Does Extra Help eliminate Part D late enrollment penalties?
Yes. If you delayed enrolling in Medicare Part D and accrued a late enrollment penalty, qualifying for Extra Help permanently waives your Part D penalty for as long as you maintain Extra Help status.
Can I switch Medicare Part D plans if I have Extra Help?
Yes. Beneficiaries with Extra Help receive a Special Enrollment Period (SEP) that allows them to switch Medicare Part D prescription drug plans or Medicare Advantage plans once per calendar quarter during the first nine months of the year (Jan–March, April–June, July–Sept).
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About This Educational Estimate: This tool is for educational purposes only. Seniors Audit uses the official formulas published by Social Security Administration (SSA), but results are estimates based on the information you entered. Rules, rates, and eligibility thresholds change annually and vary by individual circumstance.
Always verify your specific result directly with Social Security Administration (SSA) at 1-800-772-1213 or at www.ssa.gov/benefits/medicare/prescriptionhelp.html before making enrollment, coverage, or financial decisions.
If you have Medicare questions, a free SHIP counselor in your state can review your specific situation at no cost — find yours at shiphelp.org.
Seniors Audit is independent and not affiliated with any government agency or insurance company. We are not affiliated with, endorsed by, or connected to any government agency, insurance company, or financial services firm. All calculations use the official formulas and current figures published by the agencies listed above. We do not receive payment for referrals, leads, or any action taken by visitors to this site. Last reviewed: July 2026.