How to Apply for Extra Help Through Social Security

If your Medicare Part D drug costs are squeezing your budget, Extra Help (also called the Low Income Subsidy) may be the single biggest money-saver available to you — and the application goes through Social Security, not your drug plan. Here's how it works, step by step.

What Extra Help actually gives you

Extra Help is a federal program run through Social Security that pays most of your Part D costs. In 2026, if you qualify, you get:

• A $0 annual Part D deductible (the standard deductible max is $615 for everyone else)
• A $0 premium in a plan at or below your region's benchmark premium
• Generic drugs at no more than $5.10 per prescription
• Brand-name drugs at no more than $12.65 per prescription
• No Part D late enrollment penalty

Your copays stay the same through every phase of your Part D coverage, and once your total drug costs reach the $2,100 out-of-pocket cap, you pay $0 for covered drugs the rest of the year. If you also have full Medicaid and income at or below 100% of the poverty level, 2026 copays are capped even lower: $1.60 generic / $4.90 brand. CMS estimates the program is worth thousands of dollars a year — and many eligible people never apply.

Step 1: Check whether you're likely eligible

You don't need to guess perfectly — there is no penalty for applying and being denied — but here's the ballpark for 2026:

• Income: below $23,940/year (individual) or $32,460/year (married couple), with higher limits for larger households. Alaska and Hawaii have higher thresholds.
• Resources: below $18,090 (individual) or $36,100 (married couple), counting savings, investments, and non-burial life insurance cash value. Your home, car, and personal belongings don't count.

Some people qualify automatically without applying: if you have full Medicaid, receive Supplemental Security Income (SSI), or are enrolled in a Medicare Savings Program. In that case Social Security enrolls you on its own and mails you a notice. Everyone else applies.

Step 2: Gather your documents

The application asks about your income and resources. Having these on hand makes it a 15–20 minute job:

1. Recent Social Security benefit statements and any pension or retirement income amounts
2. Bank and savings account balances
3. Stocks, bonds, mutual funds, IRAs, and other investment statements
4. Life insurance policies (face amount and cash value, excluding the $1,500-per-person burial allowance)
5. Proof of income from work, if you're still working

Step 3: Submit the application (Form SSA-1020)

You can apply any time of year — there is no enrollment period. The application is completely free, and there are four ways to file:

1. Online: Go to ssa.gov/extrahelp and complete Form SSA-1020 electronically. This is the fastest option.
2. By phone: Call Social Security at 1-800-772-1213 (TTY: 1-800-325-0778), Monday–Friday. A representative can take your application over the phone.
3. In person: Visit your local Social Security office. Bring your documents — and consider calling ahead for an appointment to shorten the wait.
4. Through your state Medicaid office: Your state can forward your application to Social Security.

Free, unbiased help is available from your State Health Insurance Assistance Program (SHIP) — a counselor can sit down with you and work through the form line by line.

Step 4: Wait for the decision

Social Security reviews your application and mails you a decision letter. If you're approved, Medicare automatically enrolls you in a qualifying Part D plan if you don't already have one — you don't have to pick a plan yourself to get the savings. Your Extra Help coverage lasts for the rest of the calendar year, and if you still meet the limits the following year, it continues automatically.

One thing to know: when you apply, Social Security may share your information with your state to start a Medicare Savings Program application unless you opt out on the form. That's a feature, not a catch — an MSP can pay your Part B premium too.

A warning about scams

Because Extra Help is free, anyone charging a fee to apply for you is not legitimate. Social Security will never call, email, or text asking for your Medicare number to "check whether you qualify." If someone contacts you this way, hang up and call 1-800-772-1213 yourself.

Bottom line: Applying for Extra Help through Social Security is free, takes about 20 minutes, and can be done online at ssa.gov/extrahelp at any time of year — and if you qualify, it wipes out your Part D deductible and caps your drug costs at a few dollars per prescription.