{
  "title": "Extra Help Income Limits 2026: Medicare Part D Low-Income Subsidy",
  "canonical": "https://quantcalc.app/extra-help-income-limits-2026/",
  "status": "OFFICIAL",
  "license": "CC-BY-4.0",
  "date_modified": "2026-10-11",
  "sources": [
    {
      "label": "Medicare.gov, Help with drug costs (Extra Help limits for 2026)",
      "url": "https://www.medicare.gov/basics/costs/help/drug-costs"
    },
    {
      "label": "CMS, CY 2026 Resource and Cost-Sharing Limits for Low-Income Subsidy (LIS) (31 October 2025)",
      "url": "https://www.cms.gov/files/document/cy2026-lis-resource-limits-memo.pdf"
    },
    {
      "label": "CMS, CY 2027 Rate Announcement (6 April 2026), Table V-2 Part D benefit parameters",
      "url": "https://www.cms.gov/files/document/2027-announcement.pdf"
    },
    {
      "label": "HHS poverty guidelines for 2026 (91 FR 1797, 15 January 2026)",
      "url": "https://www.govinfo.gov/content/pkg/FR-2026-01-15/pdf/2026-00755.pdf"
    },
    {
      "label": "42 CFR §423.773 (eligibility: income below 150% of the poverty line; deemed groups)",
      "url": "https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-B/part-423/subpart-P/section-423.773"
    },
    {
      "label": "42 CFR §423.772 (income, resources and family size for the low-income subsidy)",
      "url": "https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-B/part-423/subpart-P/section-423.772"
    },
    {
      "label": "42 U.S.C. §1395w-114 (premium and cost-sharing subsidies)",
      "url": "https://www.law.cornell.edu/uscode/text/42/1395w-114"
    },
    {
      "label": "20 CFR §416.1124 (unearned income not counted: the first $20)",
      "url": "https://www.ecfr.gov/current/title-20/chapter-III/part-416/subpart-K/section-416.1124"
    },
    {
      "label": "20 CFR §416.1112 (earned income not counted: $65 and one half of the rest)",
      "url": "https://www.ecfr.gov/current/title-20/chapter-III/part-416/subpart-K/section-416.1112"
    },
    {
      "label": "SSA POMS SI 00810.420, the $20 general income exclusion",
      "url": "https://secure.ssa.gov/poms.nsf/lnx/0500810420",
      "verified": "2026-10-11: 'An eligible couple receives one $20 exclusion per month.' 'If an individual (or couple) has less than $20 of unearned income ... the remainder of the $20 exclusion reduces the amount of the earned income.'"
    },
    {
      "label": "SSA POMS HI 03020.055, Income limits for subsidy eligibility (2026 example)",
      "url": "https://secure.ssa.gov/poms.nsf/lnx/0603020055",
      "verified": "2026-10-11 (TN dated 03/05/2026): Example 1 'Jeremy lives alone and receives $1,300 per month in Social Security benefits before the Medicare Part B premium deduction, and a private pension of $550 per month ... Social Security $15,600 (12 x $1,300) Private pension + $6,600 (12 x $550) $22,200 - $240 (12 x the $20 general income exclusion) Total Countable Unearned Income = $21,960 ... applicable FPL for a one-person family is $15,960 (We used the 2026 FPL rates) ... $15,960 x 150% = $23,940.00 ... Jeremy will pay up to $5.10 for each generic drug or up to $12.65 for each brand-name drug until total out-of-pocket prescription drug spending reaches $2,100'. Example 2 earned income: '-$780 (12 x the $65 exclusion) ... X .5 (one-half exclusion)'."
    },
    {
      "label": "SSA, Apply for Extra Help",
      "url": "https://www.ssa.gov/medicare/part-d-extra-help"
    }
  ],
  "figures": {
    "income_below_pct_poverty_line": 150,
    "income_limits_annual_2026": [
      {
        "size": 1,
        "contiguous": 23940,
        "AK": 29925,
        "HI": 27540
      },
      {
        "size": 2,
        "contiguous": 32460,
        "AK": 40575,
        "HI": 37335
      },
      {
        "size": 3,
        "contiguous": 40980,
        "AK": 51225,
        "HI": 47130
      },
      {
        "size": 4,
        "contiguous": 49500,
        "AK": 61875,
        "HI": 56925
      },
      {
        "size": 5,
        "contiguous": 58020,
        "AK": 72525,
        "HI": 66720
      },
      {
        "size": 6,
        "contiguous": 66540,
        "AK": 83175,
        "HI": 76515
      }
    ],
    "published_by_medicare_gov": {
      "contiguous": {
        "individual": 23940,
        "couple": 32460
      },
      "AK": {
        "individual": 29925,
        "couple": 40575
      },
      "HI": {
        "individual": 27540,
        "couple": 37335
      },
      "_verified": "2026-10-11, medicare.gov 'Help with drug costs': 'Income and resource limits in 2026: Individual $23,940 $18,090 Married couple $32,460 $36,100'; Alaska/Hawaii drawer: 'Alaska: Individual $29,925 $18,090 Married Couple $40,575 $36,100'; 'Hawaii: Individual $27,540 $18,090 Married Couple $37,335 $36,100'. Each equals 150% of the 2026 HHS poverty guideline for 1 or 2 people (poverty-guidelines.js). Held equal by tests."
    },
    "resource_limits": {
      "2025": {
        "individual": 16100,
        "couple": 32130,
        "individual_with_burial": 17600,
        "couple_with_burial": 35130
      },
      "2026": {
        "individual": 16590,
        "couple": 33100,
        "individual_with_burial": 18090,
        "couple_with_burial": 36100
      }
    },
    "max_copays": [
      {
        "who": "Full Medicaid, in an institution or receiving home and community-based services",
        "deductible": 0,
        "generic_2026": 0,
        "brand_2026": 0,
        "generic_2027": 0,
        "brand_2027": 0
      },
      {
        "who": "Full Medicaid, income at or below 100% of the poverty line",
        "deductible": 0,
        "generic_2026": 1.6,
        "brand_2026": 4.9,
        "generic_2027": 1.65,
        "brand_2027": 5
      },
      {
        "who": "Everyone else with Extra Help (full Medicaid above 100%, a Medicare Savings Program, SSI, or approved on application)",
        "deductible": 0,
        "generic_2026": 5.1,
        "brand_2026": 12.65,
        "generic_2027": 5.8,
        "brand_2027": 14.4
      }
    ],
    "out_of_pocket_threshold_2026": 2100,
    "ssa_example_2026": {
      "gross_annual": 22200,
      "countable": 21960
    }
  }
}