DokuDocsdokudocs.com- What it does
- Pays most or all of the Part D premium and deductible, and lowers copays
- 2026 copays
- No more than $5.10 for generics and $12.65 for brand-name drugs
- Income limit (2026)
- About $1,995 a month single, $2,705 married
- Resource limit (2026)
- $18,090 single, $36,100 married (includes $1,500 per person for burial)
- How to apply
- Online at ssa.gov/extrahelp or 1-800-772-1213
Drug costs are one of the main reasons older adults fall behind on bills. A parent on three or four brand-name medications can easily spend hundreds of dollars a month, even with Part D, especially early in the year before the out-of-pocket cap kicks in.
Extra Help, officially the Part D Low-Income Subsidy, is a federal program that does a lot of the heavy lifting. For people who qualify, it can make most prescriptions cost about the same as a sandwich.
What Extra Help pays for
For someone who qualifies, Extra Help:
- Pays all or most of the monthly Part D premium (fully, for many standard plans)
- Eliminates the Part D deductible
- Caps copays in 2026 at no more than $5.10 for generic drugs and $12.65 for brand-name drugs
- Gives more chances to change drug plans during the year
Copays are even lower for people with full Medicaid, and $0 for people getting Medicaid-covered long-term care in a nursing home or through a waiver.
Who qualifies in 2026
| Single | Married couple living together | |
|---|---|---|
| Monthly income, about | $1,995 | $2,705 |
| Resources | $18,090 | $36,100 |
Resource limits include $1,500 per person set aside for funeral or burial. Social Security doesn't count some income and assets, so people somewhat over these numbers may still qualify.
What generally doesn't count as a resource: the home your parent lives in, one car, household goods, life insurance policies, burial plots and some other items.
Automatic eligibility. Your parent doesn't need to apply if they already get full Medicaid, SSI, or help from a Medicare Savings Program. Medicare enrolls them automatically and sends a purple letter. If you think your parent qualifies for an MSP, applying for that first can bring Extra Help along with it.
How to apply
- Apply online. Go to ssa.gov and search for "Extra Help." The application takes about 15 minutes. You can help your parent fill it out.
- Or by phone. Call Social Security at 1-800-772-1213 and ask for the Extra Help application. You can request a paper form by mail.
- Answer the follow-ups. Social Security checks income and resources and may send a letter asking for more information. Answer it by the date given.
- Look for the decision letter. If approved, your parent's Part D plan will apply the lower costs, usually within a month or two.
- Pick the right plan. Extra Help pays the full premium only on certain "benchmark" plans. If your parent's plan costs more, they'll pay the difference. A free SHIP counselor can find the best fit.
Use Open Enrollment If your parent is approved during the year, it's still worth a plan review during Open Enrollment, October 15 to December 7. In Florida, SHINE counselors can compare plans with your parent's prescriptions and Extra Help status in mind.
The $2,100 cap and Extra Help
Since 2025, everyone with Part D has an annual cap on out-of-pocket drug costs, which is $2,100 in 2026. Extra Help is still worth applying for even with the cap. Someone on several brand-name drugs could otherwise spend close to the full $2,100 early in the year, plus premiums. With Extra Help, most people spend a small fraction of that.
What families get wrong
- Assuming savings disqualify them. The resource limit is $18,090 for one person, and the house, car and life insurance don't count.
- Not reapplying after a change. If your parent's spouse dies or income drops, check again even if they were denied before.
- Ignoring letters. Social Security reviews eligibility periodically. A missed review letter can cost the benefit.
Information to have handy
- Your parent's Social Security number and Medicare card
- Income: Social Security, pensions, annuities, any wages
- Bank, savings, CD and investment account balances
- Whether a spouse lives with them, and the spouse's income and resources
- Current Part D or Medicare Advantage plan card
Keep the approval letter with your parent's plan cards in a DokuDocs vault. It's the document that settles copay disputes at the pharmacy counter.
Small documents, big consequences A purple Medicare letter or a Social Security approval notice doesn't look important, and it's easy to toss. It's also proof that saves your parent money every month. DokuDocs gives you a single place to keep those letters.
Questions families ask
Is Extra Help the same as the Part D Low-Income Subsidy?
Yes. Extra Help is the everyday name for the Part D Low-Income Subsidy (LIS).
Does my parent need to apply if they have Medicaid?
No. People with full Medicaid, SSI or a Medicare Savings Program get Extra Help automatically. Medicare sends a purple letter confirming it.
What counts as a resource?
Bank accounts, stocks, bonds and similar assets. The home your parent lives in, one car, personal belongings and life insurance generally don't count.
Can my parent switch drug plans with Extra Help?
People with Extra Help have more chances to change plans than others. Current rules allow a once-a-month change into a standalone Part D plan. A SHIP counselor can confirm what applies to your parent.
What if the pharmacy charges the full price?
Show the pharmacy the Extra Help approval letter. Pharmacies can use it as proof of eligibility while Medicare's records catch up.
This guide explains public programs in plain language. It is not legal, medical or financial advice. Program rules, dollar amounts and phone numbers change, so confirm details with the agency before you apply. DokuDocs is not affiliated with any government agency.