Extra Help & Paying Less
What is Extra Help for Medicare drug costs?
Last reviewed: · Big Sioux Benefits Data Desk
Extra Help is a federal program, also called the Part D Low Income Subsidy, that pays most of your Medicare prescription drug costs if your income and resources fall below set limits (Medicare.gov). In 2026 that means a $0 plan premium, a $0 deductible, and fixed low amounts at the pharmacy: no more than $5.10 for each generic drug and no more than $12.65 for each brand-name drug.
The qualifier: Extra Help is dramatically underclaimed, and the usual reason is that people assume they earn too much or own too much to qualify. The 2026 income limit is $23,940 for an individual and $32,460 for a married couple, with resource limits of $18,090 and $36,100. Those resource limits are higher than most people expect, and your home and your car do not count. If you are anywhere near those figures, it costs nothing to apply and find out.
What Extra Help does in 2026
| Cost | With Extra Help |
|---|---|
| Plan premium | $0 |
| Plan deductible | $0 |
| Each generic drug | No more than $5.10 |
| Each brand-name drug | No more than $12.65 |
| After total drug costs reach $2,100 | $0 for each covered drug |
| Part D late enrollment penalty | None while you have Extra Help |
Two things people miss. The late enrollment penalty disappears entirely while you have Extra Help, and a penalty you already had goes away, which can be worth hundreds of dollars a year on its own. And if you also have full Medicaid and are in the Qualified Medicare Beneficiary program, your cost drops further, to no more than $4.90 per covered drug. The limits in detail are in the 2026 Extra Help income limits, and applying is covered in how to apply.
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
- Medicare.gov — Part D late enrollment penalty — accessed 2026-08-21
Related questions
Is Extra Help the same as Medicaid?
No, they are separate programs, though they interact. Extra Help pays Medicare drug costs specifically. Medicaid is broader state-administered health coverage. Having full Medicaid automatically qualifies you for Extra Help, but you can get Extra Help without Medicaid.
Does my house count against the resource limit?
No. The home you live in is not counted as a resource for Extra Help, and neither is your vehicle. Countable resources are generally things like bank accounts, stocks, and bonds. This is the single most common reason people wrongly assume they will not qualify.
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.