Extra Help & Paying Less
What are the Extra Help income limits for 2026?
Last reviewed: · Big Sioux Benefits Data Desk
For 2026 the Extra Help limits are $23,940 in annual income and $18,090 in resources for an individual, and $32,460 in income and $36,100 in resources for a married couple living together (Medicare.gov). These limits generally rise each year, so a person who did not qualify a few years ago may qualify now without anything about their situation changing.
The qualifier, and it is the reason so many eligible people never apply: what counts is narrower than people assume. The home you live in does not count as a resource. Neither does your vehicle. Countable resources are generally bank accounts, stocks, and bonds. On the income side, certain income is excluded, and the rules around tribal payments in particular are specific, with per capita funds held in trust by the Secretary of the Interior excluded while gaming distributions are not.
2026 limits
| Where you live | Situation | Income limit | Resource limit |
|---|---|---|---|
| 48 states and DC | Individual | $23,940 | $18,090 |
| 48 states and DC | Married couple | $32,460 | $36,100 |
| Alaska | Individual | $29,925 | $18,090 |
| Alaska | Married couple | $40,575 | $36,100 |
| Hawaii | Individual | $27,540 | $18,090 |
| Hawaii | Married couple | $37,335 | $36,100 |
Do not disqualify yourself on arithmetic. Social Security determines whether you qualify, applying exclusions that are difficult to apply correctly from the outside, and applying is free with no downside if the answer is no. If you are close to the line, apply. South Dakota residents can get free help with the application from SHIINE at 1-800-536-8197, and Extra Help is not available in Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands, or American Samoa, which have separate programs.
Sources
- Medicare.gov — Help with drug costs (Extra Help) — 2026 limits and amounts; accessed 2026-08-21
- Social Security Administration — Extra Help with Medicare prescription drug plan costs — accessed 2026-08-21
- SHIINE — South Dakota's State Health Insurance Assistance Program — accessed 2026-08-21
Related questions
What if my income is slightly over the limit?
Apply anyway. Social Security applies income exclusions that can bring your countable income below the figure you calculated yourself, and the limits rise most years. You can also reapply at any time if your income or resources change, so a no today is not permanent.
Do the limits change during the year?
The limits are set annually. If you qualify, you keep Extra Help through December 31 even if your income rises mid-year, and if you still meet the limits for the following year your Extra Help continues without you doing anything. You are notified only if you no longer qualify or are moved to a different plan.
Drug costs turn on your specific prescriptions, so the arithmetic is worth doing once, properly: book a free, no-pressure conversation, see your county's South Dakota plan lineup, or browse all answers. SHIINE, the state's free counseling program, is at 1-800-536-8197 and sells nothing.
Big Sioux Benefits is a licensed insurance agency, not affiliated with or endorsed by the U.S. government or the federal Medicare program. We do not offer every plan available in your area. Contact Medicare.gov, 1-800-MEDICARE, or SHIINE (South Dakota's SHIP) for all of your options.