In short
- 2026 limits: income under $23,940 and resources under $18,090 for one person; $32,460 and $36,100 for a married couple.
- In 2027, Extra Help caps copays at $5.80 per generic and $14.40 per brand-name drug, and $0 after $2,400 in drug costs.
- Full Medicaid, a Medicare Savings Program or SSI qualifies you automatically. Everyone else applies through Social Security, any time of year.
- Your home, car, burial plot, life insurance and up to $1,500 per person set aside for burial do not count as resources.
- With Extra Help you can change drug plans once a month and you owe no Part D late enrollment penalty.
Extra Help, also called the Low-Income Subsidy (LIS), is a federal program run by Social Security and Medicare. It pays most of the cost of Part D prescription drug coverage for people with limited income and savings. It is not a Nebraska program, so the rules are the same in Lincoln as anywhere else in the country.
The help is real money. CMS's 2027 Nebraska fact sheet reports that 16.70% of Nebraskans in standalone Part D plans get Extra Help. Plenty of others probably qualify and have never applied.
Who qualifies for Extra Help in 2026?
You qualify if your yearly income and your resources are both under the limits below. These are the 2026 figures from Medicare.gov. The 2027 limits had not been announced as of October 2, 2026. CMS releases the new resource limits in the fall and the income limits follow the federal poverty guidelines, which usually come out in January.
| 2026 limit | Single person | Married, living together |
|---|---|---|
| Yearly income | Less than $23,940 | Less than $32,460 |
| Resources | Less than $18,090 | Less than $36,100 |
The income limits can be higher if you still work, have dependents living with you, or live in Alaska or Hawaii. If you are anywhere near the line, apply. Social Security makes the call, not a website calculator.
What counts as a resource, and what doesn't?
Resources are things you could turn into cash. The rule surprises people in both directions, so here is the list from the Medicare & You 2027 handbook.
Counts as a resource:
- Money in checking and savings accounts
- Stocks, bonds and mutual funds
- Individual Retirement Accounts (IRAs)
Does not count:
- Your home
- Your car
- Household items
- A burial plot
- Up to $1,500 per person set aside for burial expenses
- Life insurance policies
So a widow with a paid-off house in Lancaster County, a car and $12,000 in savings could fall under the 2026 resource limit even though she owns a home worth far more.
Do you qualify for Extra Help automatically?
Yes, if you have Medicare and any one of these:
- Full Medicaid coverage
- Help from Nebraska paying your Part B premium through a Medicare Savings Program (QMB, SLMB or QI)
- Supplemental Security Income (SSI) from Social Security
Medicare mails a purple letter saying you qualify automatically. You do not need to apply. If you don't have drug coverage yet, Medicare may place you in a Part D plan and send a yellow or green letter with the start date. You can switch to a different plan if that one doesn't cover your medications well.
The Medicare Savings Program route matters in Nebraska. For 2026, Nebraska DHHS lists the QMB income limit at $1,330 a month for one person and the QI limit at $1,796, with a $9,950 resource limit. Qualify for one of those and Extra Help comes with it. Our Medicare Savings Programs in Nebraska guide walks through those limits.
What does Extra Help pay in 2027?
Extra Help lowers almost every cost in a drug plan. Here are the maximum copays CMS set in the 2027 Rate Announcement, next to 2026.
| Cost | 2026 with Extra Help | 2027 with Extra Help |
|---|---|---|
| Generic or preferred multi-source drug | Up to $5.10 | Up to $5.80 |
| Brand-name and other drugs | Up to $12.65 | Up to $14.40 |
| Full Medicaid, income at or under 100% of poverty: generic | Up to $1.60 | Up to $1.65 |
| Full Medicaid, income at or under 100% of poverty: brand | Up to $4.90 | Up to $5.00 |
| After the yearly drug cost cap | $0 after $2,100 | $0 after $2,400 |
Medicare.gov says people with Extra Help pay a $0 plan premium and a $0 deductible in 2027 for plans that qualify, but you still owe your Part B premium unless a Medicare Savings Program pays it. Not every drug plan qualifies for the full premium help, so check the premium shown for Extra Help members before you pick a plan. People with full Medicaid who live in a nursing home pay nothing for covered drugs.
Extra Help payments also count toward the yearly cap. Our guide to the Part D out-of-pocket cap explains how that cap works for everyone else.
How do you apply for Extra Help in Nebraska?
If you didn't qualify automatically, you apply through Social Security. There is no deadline and no enrollment window.
- Gather your income figures (Social Security, pensions, wages) and your bank, IRA and investment balances.
- Apply online at SSA.gov/extrahelp, or call 1-800-MEDICARE (1-800-633-4227) for help. Medicare's line is open 24 hours a day, 7 days a week. TTY users can call 1-877-486-2048.
- Decide whether to let Social Security start a Medicare Savings Program application with Nebraska. It does this automatically unless you say no, and for most people it is worth letting it go through.
- Watch the mail for the decision letter and keep it with your Medicare papers.
You don't have to do it alone. Nebraska SHIP, the state's Medicare counseling program, helps people with limited income apply for these programs at no charge. Call 1-800-234-7119. In Lincoln, Aging Partners benefits counselors (402-441-7070) do the same for people 60 and older.
Medicaid and Medicare Savings Program applications go to Nebraska DHHS through iServe Nebraska or (855) 632-7633. Bill doesn't enroll anyone in Medicaid, but he can explain how it fits with your Medicare and help with the Medicare side.
What changes after you get Extra Help?
A few rules work in your favor once you're approved.
- You can change drug plans once a month. Most people can only switch during set windows. With Extra Help or Medicaid, you can join or switch a standalone Part D plan once per calendar month, effective the first of the next month. Our guide to special enrollment periods has the details.
- No Part D late enrollment penalty while you get Extra Help.
- You still need the right plan. Different plans cover different drugs. Check that your medications are on the plan's list and that your pharmacy is in network.
- The payment plan usually isn't for you. CMS says the Medicare Prescription Payment Plan may not be the best choice if you get or qualify for Extra Help, because your costs are already low.
How does Extra Help fit with Medicaid and D-SNPs?
People with full Medicaid and Medicare are "dual eligible." They get Extra Help automatically and may also qualify for a Dual Eligible Special Needs Plan, a Medicare Advantage plan built to coordinate with Medicaid. If you are trying to sort out which program does what, start with Medicare vs Medicaid in Nebraska.
If Extra Help is new to you this fall, the 2027 Annual Enrollment Period (October 15 to December 7, 2026) is a good time to check your drug plan against your medications. Talk to me and we'll go through it together, at no cost to you.
Frequently asked questions
For 2026, yearly income must be less than $23,940 for a single person or less than $32,460 for a married couple living together with no other dependents. Resources must be under $18,090 for one person or $36,100 for a couple. Limits can be higher if you still work or have dependents living with you. The 2027 limits had not been announced as of October 2026.
No. If you have full Medicaid, get help from a Medicare Savings Program such as QMB, SLMB or QI, or receive Supplemental Security Income, you qualify for Extra Help automatically. Medicare mails a purple letter confirming it. Keep that letter. You still need to be in a Part D plan or a Medicare Advantage plan with drug coverage to use the help.
Your home does not count, and neither do your car, household items, burial plot, life insurance policies or up to $1,500 per person set aside for burial expenses. Money in checking and savings, stocks, bonds, mutual funds and IRAs does count toward the resource limit. If you are close to the line, apply anyway and let Social Security make the decision.
In 2027, people with Extra Help generally pay no more than $5.80 for each generic drug and $14.40 for each brand-name drug filled at a participating pharmacy. Once total covered drug costs reach $2,400, you pay $0 for covered drugs for the rest of the year. People with full Medicaid who live in a nursing home pay nothing for covered drugs.
Yes. There is no enrollment window for Extra Help. You can apply any time at SSA.gov/extrahelp. When you apply, Social Security also sends your information to Nebraska to start a Medicare Savings Program application unless you tell it not to. Nebraska SHIP counselors at 1-800-234-7119 can help you fill out the forms at no charge.
An agent can explain how Extra Help works, check whether your current drug plan is a good fit once you qualify, and help you change plans using the monthly special enrollment period. The application itself goes to Social Security. Medicaid and Medicare Savings Program applications go to Nebraska DHHS through iServe Nebraska. Bill Jurey does not enroll people in Medicaid.
Sources
- Medicare.gov: Help with drug costs (Extra Help) (opens in a new tab)
- Medicare & You 2027 handbook (CMS Product No. 10050) (opens in a new tab)
- CMS: CY 2027 Medicare Advantage and Part D Rate Announcement (opens in a new tab)
- CMS: 2027 Medicare Advantage and Part D state-by-state fact sheets (opens in a new tab)
- Nebraska DHHS: Income levels and resources (477-000-012) (opens in a new tab)
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. 1-800-MEDICARE (1-800-633-4227) is available 24 hours a day, 7 days a week. TTY users can call 1-877-486-2048.
