How much can you make on Social Security and still get extra help with prescription costs?

If you’re on Social Security and struggling to afford your medications, you’re not alone. Every year, millions of Americans rely on Social Security as their main source of income, but rising drug prices can make even basic prescriptions a financial burden. The good news? There’s a program designed to help - called Extra Help, or the Low-Income Subsidy (LIS) - that can slash your prescription costs by up to 90%. But how much can you earn and still qualify? The answer isn’t as simple as it sounds.

What is Extra Help?

Extra Help is a federal program run by Medicare that helps people with limited income and resources pay for Medicare Part D prescription drug plan costs. This includes monthly premiums, annual deductibles, copayments, and even the coverage gap (often called the "donut hole"). In 2026, if you qualify, you could pay as little as $4.70 for a generic drug and $11.20 for a brand-name drug at the pharmacy.

It’s not a one-time benefit. Once approved, Extra Help automatically renews each year unless your income or resources change significantly. You don’t need to reapply annually, which makes it one of the most reliable forms of prescription assistance available.

Income limits for Extra Help in 2026

The key to qualifying for Extra Help is understanding the income and resource limits set by the Social Security Administration (SSA). These numbers are updated yearly, and for 2026, they’re based on your annual income and total assets.

If you’re single, you can qualify if:

• Your annual income is below $22,590
• Your resources (like bank accounts, stocks, and property) are under $16,380

If you’re married and living with your spouse, the limits are higher:

• Your combined annual income must be under $30,810
• Your combined resources must be under $32,760

These limits include all sources of income - not just Social Security. That means if you’re also working part-time, receiving pension payments, or earning rental income, it all counts toward your total.

What counts as income and resources?

Not everything you own or earn is included in the calculation. Here’s what matters:

Income that counts:

• Wages from a job
• Social Security retirement or disability payments
• Pension payments
• Interest or dividends from investments
• Rental income
• Alimony or child support

Resources that count:

• Bank accounts (checking, savings, CDs)
• Stocks, bonds, mutual funds
• Real estate (other than your primary home)
• Second vehicles (if you own more than one)

What’s NOT counted:

• Your primary home
• One car (no matter the value)
• Household goods and personal items
• Life insurance policies with a cash value under $1,500
• IRA or 401(k) accounts (as long as you’re not taking withdrawals)

This means many retirees who own their homes and drive one car can still qualify - even if they have some savings. The program is designed to help those who live on fixed incomes, not those with significant wealth.

How Extra Help reduces your prescription costs

Let’s say you take three medications each month: one generic, one brand-name, and a specialty drug. Without Extra Help, you might pay $45 a month for the generic, $120 for the brand-name, and $300 for the specialty drug - totaling $465 a month, or over $5,500 a year.

With Extra Help, your costs drop dramatically:

• Generic drug: $4.70
• Brand-name drug: $11.20
• Specialty drug: $15.90 (capped amount)

Your monthly total? Just $31.80. That’s over $5,400 in savings per year - money that goes straight back into your budget for food, heating, or emergency repairs.

And if you hit the coverage gap (donut hole), Extra Help covers 75% of your drug costs during that phase. Most people without the subsidy pay 25% out-of-pocket in the donut hole - but with Extra Help, you pay nothing until you reach the catastrophic threshold.

How to apply for Extra Help

Applying is free and straightforward. You have three options:

1. Online: Visit the Social Security Administration’s website at ssa.gov/extrahelp and fill out the application. It takes about 10 minutes.
2. By phone: Call Social Security at 1-800-772-1213. Representatives can walk you through the process over the phone.
3. In person: Visit your local Social Security office. Bring your Social Security number, proof of income (like your most recent tax return or Social Security award letter), and bank statements.

You don’t need to be enrolled in a Medicare Part D plan to apply - you can apply first, then choose your drug plan later. Once approved, Social Security will notify your plan provider automatically.

What if you’re just over the income limit?

Many people think they’re disqualified if they earn $50 more than the limit - but that’s not always true. Some states offer additional programs that help bridge the gap. For example:

• State Pharmaceutical Assistance Programs (SPAPs): Many states run their own programs that help with drug costs for people who earn slightly above the federal limit.
• Manufacturer coupons: Drug companies often offer patient assistance programs that give free or discounted medications to those who qualify based on income.
• Community health centers: Federally funded clinics can provide prescriptions at reduced rates based on your ability to pay.

Even if you don’t qualify for Extra Help, it’s worth checking these alternatives. In 2025, over 2 million people used manufacturer assistance programs to lower their drug costs - and many of them didn’t realize they were eligible.

What happens if your income changes?

If your income goes up - say, you start working more hours or receive a one-time payment - you must report it to Social Security. They’ll review your case and may adjust your Extra Help level. But don’t panic: even if you lose full benefits, you might still qualify for partial help.

For example, if your income rises just above the limit, you might still get reduced premiums or lower copays. The program is designed to be flexible. And if your income drops again later (say, due to job loss or medical bills), you can reapply at any time.

Common mistakes people make

• Assuming they don’t qualify because they have savings. Many retirees think having $10,000 in a savings account disqualifies them - but that’s well under the $16,380 limit for singles.
• Not applying because they’re already on Medicare. Extra Help works with Medicare Part D - it doesn’t replace it.
• Waiting until they can’t afford meds. The application process takes 3-4 weeks. Don’t wait until your prescription runs out.
• Not checking for state programs. If you live in California, New York, or Florida, you may qualify for additional help even if you’re slightly over the federal limit.

Real-life example: Margaret’s story

Margaret, 72, lives in Ohio on Social Security and a small pension. She takes four medications for diabetes, high blood pressure, and arthritis. Before Extra Help, she was spending $410 a month on prescriptions - nearly half her monthly income. She applied online after a friend told her about the program. Within three weeks, she got approved. Now she pays $18 a month total. She uses the extra money to fix her furnace and buy groceries. "I didn’t know I could get help," she says. "I thought I was stuck paying whatever the pharmacy charged."

Final thoughts

Extra Help isn’t a handout - it’s a benefit you’ve earned through years of work and taxes. If you’re on Social Security and paying for prescriptions, you deserve to use every tool available to make those costs manageable. The income limits aren’t meant to exclude people who live modestly. They’re meant to ensure the program reaches those who need it most.

Don’t guess whether you qualify. Apply. It’s free, confidential, and could save you thousands each year. And if you’re unsure, call Social Security. They’ll help you figure it out - no judgment, no pressure.