If you have ever stood at a pharmacy counter in Dallas or Fort Worth doing math in your head, deciding which prescription can wait until the next Social Security check, this piece is for you. There is a federal program built for exactly that squeeze, it is called Extra Help, and a lot of North Texans who qualify have simply never heard of it.
Extra Help, also called the Low-Income Subsidy, works alongside Medicare Part D drug coverage. Qualify, and your drug plan premium and deductible drop to zero and your copays get capped at a few dollars per prescription. Here is who qualifies in 2026, what it actually pays, and how to apply through Social Security without leaving the house.
What Extra Help pays in 2026
The numbers are worth spelling out, because they are dramatic. According to Medicare.gov’s Extra Help page, in 2026 a person with Extra Help pays:
A $0 plan premium and a $0 plan deductible, plus no more than $5.10 for each generic drug and $12.65 for each brand-name drug at a participating pharmacy. And once your total drug costs for the year reach $2,100, counting amounts the program pays on your behalf, covered drugs cost you nothing for the rest of the year.
You also do not pay the Part D late-enrollment penalty while you have Extra Help, which matters for anyone who put off signing up for drug coverage and has been dreading the catch-up cost. For someone on several maintenance medications, the combined savings can easily run into thousands of dollars a year.
The 2026 income and resource limits
Eligibility comes down to two tests, and both are more forgiving than most people assume. For 2026, Medicare.gov lists the limits as $23,940 in yearly income for an individual and $32,460 for a married couple living together. The resource limit, meaning countable assets like bank accounts, stocks and bonds, is $18,090 for an individual and $36,100 for a couple.
Before you rule yourself out, know what does not count. Your home does not count against the resource limit. Neither does your car or your household belongings. And Social Security applies certain income exclusions when it does the math, so being close to the line on paper is a reason to apply, not a reason to skip it. The worst outcome of an application is a no, and you can reapply any time your income or resources change.
Some Texans get it automatically
You do not need to apply if you already get full Medicaid coverage, Supplemental Security Income, or help from a Medicare Savings Program paying your Part B premium. In those cases you get Extra Help automatically and a notice arrives in the mail explaining your costs.
That last category deserves a Texas-sized underline. The Medicare Savings Programs in Texas run through the Health and Human Services Commission, and qualifying for one of them, such as QMB or SLMB, brings Extra Help along with it at no extra paperwork. If your income is low enough that both programs are in reach, applying for the Medicare Savings Program can raise your Social Security check and cut your pharmacy bill in one stroke. The Extra Help application even asks whether you want your information sent to the state to start an MSP application, so you can work both at once.
How to apply from your kitchen table
Social Security, not Medicare, handles Extra Help applications. The online route is the SSA’s Extra Help page, which walks you into the application itself. If you would rather talk to a person, call Social Security at 1-800-772-1213 (TTY 1-800-325-0778) and tell the representative you want to set up an appointment to apply for Part D Extra Help. Phone help is available Monday through Friday, 8 a.m. to 7 p.m.
SSA suggests gathering a few documents for you and your spouse before you start: bank statements and tax returns, IRA or 401(k) balances, and statements for pensions, veterans benefits, annuities or Railroad Retirement benefits. Most people finish the application in well under an hour.
If forms are not your thing, free and unbiased help exists. Texas’s State Health Insurance Assistance Program counselors, reachable through the national SHIP locator, work with Medicare beneficiaries across Dallas, Tarrant and the surrounding counties and can complete the application with you. They do not sell anything, and the service costs nothing.
What happens after you qualify
If you qualify and do not already have a Part D plan, Medicare will enroll you in one so the savings can start, and you can switch to a different plan if you prefer. You keep Extra Help through December 31 even if your income rises mid-year, and if you still meet the limits for next year, it simply continues. One more perk: people with Extra Help can generally change drug plans once a month, instead of waiting for fall open enrollment, which is useful if your pharmacy or your prescriptions change.
The application takes an evening. The savings last all year. If your income is anywhere near those limits, or if you are helping a parent or neighbor who keeps splitting pills to stretch a refill, this is one of the highest-return phone calls in the entire benefits system.
This article was produced with AI assistance and reviewed by a human editor. Figures are linked to their primary sources; where a claim could not be verified from the public record, we say so.
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