Medicare’s Extra Help program will charge no more than $5.80 for each generic prescription and $14.40 for each brand-name drug in 2027, with a $0 plan premium and a $0 deductible, according to Medicare.gov. The eligibility cutoffs posted beside those prices are still the 2026 numbers: $23,940 in yearly income and $18,090 in resources for a single person. Anyone who clears both can apply with Social Security.
Extra Help is the federal program that helps pay for Medicare Part D, the prescription drug coverage. Social Security runs the application, and Medicare.gov publishes the limits and the copays. The two agencies describe it the same way: help with premiums, deductibles and copays for people with limited income and resources.
The year labels matter here. The copays, the $0 premium and the $0 deductible are listed for 2027. The income and resource limits are listed for 2026, and Medicare.gov says they “may go up each year.” No 2027 limits have been posted on that page, so anyone near the line should treat the 2026 figures as the current test, not a promise for next year.
That raises a plain question for people on a fixed income who pay full price at the pharmacy counter. Is their monthly Social Security check, pension or savings low enough to clear the limits? And if it is, why would anyone wait to apply when Social Security says an application can be filed “any time before or after” enrolling in a Part D plan?
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The 2026 income and resource limits
Medicare.gov lists the following 2026 limits. Income is counted per year. Resources are savings and investments, not the home a person lives in.
- Single person: income of $23,940 or less and resources of $18,090 or less.
- Married couple living together: income of $32,460 or less and resources of $36,100 or less.
Social Security’s Extra Help publication, dated August 2026, repeats the same figures. It adds that some people over those income amounts may still qualify, including people who support family members, people with work earnings and people who live in Alaska or Hawaii.
What counts as a resource
The Social Security publication says bank accounts, stocks, bonds, mutual funds, IRAs, cash and real estate other than the home all count. The home, vehicles, personal possessions, life insurance policies and burial expenses do not.
The application form, the Application for Extra Help with Medicare Prescription Drug Plan Costs, also leaves out burial plots, irrevocable burial contracts and back payments from Social Security or Supplemental Security Income (SSI). Anyone who sits just above $18,090 should look at which of their assets are actually on the list.
What a prescription costs under Extra Help
Medicare.gov lists these 2027 amounts for each covered drug:
- Up to $5.80 for each generic drug.
- Up to $14.40 for each brand-name drug.
- No more than $4.90 for each covered drug for people with full Medicaid coverage who also get help from the Qualified Medicare Beneficiary (QMB) program.
- $0 for each covered drug once total drug costs, including certain payments made on a person’s behalf, reach $2,400.
The plan premium and the plan deductible are both listed at $0 for 2027. Social Security puts the value of the program at about $5,700 a year in its publication, though what any one person saves depends on the drugs they take.
Who gets Extra Help without applying
Medicare.gov says three groups receive Extra Help automatically: people with full-benefit Medicaid, people whose state helps pay their Part B premium through a Medicare Savings Program, and people who get SSI from Social Security. The application form says the same about anyone with Medicare and SSI or Medicare and Medicaid.
Everyone else has to apply. Medicare.gov says people can apply for Extra Help and a Medicare Savings Program at the same time. Medicare.gov also says Extra Help continues through December 31 even if income changes during the year, and that people can reapply any time their income or resources change.
Where the Extra Help application goes
Social Security takes the application. The official route is ssa.gov/medicare/part-d-extra-help, where the online application is linked. The same page gives the phone number, 1-800-772-1213, open Monday through Friday from 8 a.m. to 7 p.m. in most time zones. People who are deaf or hard of hearing can use TTY 1-800-325-0778. Callers can ask the representative to set up an appointment to apply.
The application form lists no fee, and it comes with a postage-paid return envelope. Documents to gather for the applicant and a spouse include bank statements, tax returns, IRA or 401(k) balances, and statements for pensions, Veterans’ benefits, annuities and Railroad Retirement Board benefits, according to Social Security. The form does not enroll anyone in a drug plan. A person still has to be in a Part D plan to use the help.
Anyone who qualifies and does not pick a plan will be placed in one. The Social Security publication says the Centers for Medicare & Medicaid Services will do it for them. People who want help filling out the form can contact their State Health Insurance Assistance Program, known as SHIP, and Medicare.gov says that help is free. Medicare’s own line is 1-800-MEDICARE (1-800-633-4227).
Keeping Extra Help once it starts
Social Security reviews cases once a year, usually at the end of August, with a form called SSA-1026. The publication says people have 30 days to send it back. If Social Security’s records show someone no longer qualifies, they get a notice and 10 days to provide correct information.
A final decision can be appealed. The appeal form is SSA-1021, and it must be filed within 60 days of receiving the decision notice. Medicare.gov adds that people with Medicaid or Extra Help may be able to change their drug coverage once a month, which gives them room to move if a plan drops a medicine they take.
Is the 2026 limit the one that decides it?
For now, yes. Those are the newest limits Medicare.gov and Social Security have published. The 2027 copays are fixed, but the 2027 income and resource limits have not been posted. A single person at $24,500 a year or $19,000 in savings is over today’s line, but could land under a 2027 line if it moves up, and the reapply-any-time rule means a missed cutoff this year is not permanent.
Filing for Extra Help on a $23,940 limit?
People who sit near the $23,940 income line or the $18,090 resource line often guess wrong about what counts, skip the application, and keep paying full copays at the pharmacy while Extra Help would have cut a generic to $5.80.
Claim Every Benefit lays out nine programs, with the real limits, the office to call and the exact words to say. It covers “Extra Help: prescriptions for a few dollars each” and “the 2026 limits, one line per program,” plus an application tracker so each filing date and phone call is written down in one place.
Get the Extra Help limits and application tracker in Claim Every Benefit →
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This article was produced with AI assistance and edited for accuracy against the sources linked above.
David M. Keller is a finance writer based in Columbus, Ohio, covering personal finance and consumer-focused economic topics. He earned his degree in journalism from Ohio University and began his career reporting on local business and economic trends for a regional media outlet. Since then, he has contributed to a variety of online publications, focusing on clear, practical coverage of topics such as cost of living, debt, and everyday financial decision-making.
