Medicare Extra Help and Medicare Savings Programs, Explained

Medicare Extra Help is a program for people with limited income and resources that helps pay for Medicare prescription drug coverage (Part D). The Medicare Savings Programs are run by your state and help pay other Medicare costs, starting with the Part B premium. You may qualify for one or both, and people who get a Medicare Savings Program get Extra Help automatically.

Extra Help and the Medicare Savings Programs at a glance

Program	Who runs it	What it helps pay	Where to apply
Extra Help (Part D Low-Income Subsidy)	Medicare; you apply through Social Security	Part D premiums, deductibles, coinsurance and copays	Social Security
QMB (Qualified Medicare Beneficiary)	Your state (Medi-Cal in California)	Part B premium, plus Medicare deductibles, coinsurance and copays; also the Part A premium if you pay one	County social services office
SLMB (Specified Low-Income Medicare Beneficiary)	Your state (Medi-Cal in California)	Part B premium	County social services office
QI (Qualifying Individual)	Your state (Medi-Cal in California)	Part B premium (you reapply every year)	County social services office

The three Medicare Savings Programs differ mainly in their income limits and in how much they pay. The Qualified Medicare Beneficiary program is for people with the most limited incomes and covers the most. SLMB and QI are for people with somewhat higher incomes and help with the Part B premium only.

What Medicare Extra Help pays for

Extra Help, also called the Part D Low-Income Subsidy, lowers what you pay for prescription drug coverage. According to Medicare.gov, it helps with Part D premiums, deductibles, coinsurance and other drug costs. It works with a stand-alone Part D plan or a Medicare Advantage plan that includes drug coverage.

A few things to know:

• Full benefit for everyone who qualifies. Since 2024, everyone who qualifies for Extra Help gets the full benefit. There is no longer a partial level.
• No Part D late penalty. Medicare.gov says you won’t pay a Part D late enrollment penalty while you get Extra Help.
• More chances to change drug coverage. Since 2025, people with Extra Help can make a change once a month: move into Original Medicare with a stand-alone drug plan, or switch between stand-alone drug plans. Changes start the first day of the next month.
• The payment plan usually isn’t a fit. The Medicare Prescription Payment Plan spreads drug costs over the year, but it’s usually not helpful if you have Extra Help. Our article on the Part D out-of-pocket cap and payment plan explains why.

What the Medicare Savings Programs pay for

If you need help paying the Medicare Part B premium, a Medicare Savings Program may be the place to start. For 2026, CMS set the standard Part B premium at $202.90 a month, so help with that one cost can make a real difference in a monthly budget.

QMB

The Qualified Medicare Beneficiary program helps pay your Part B premium. It also helps pay Medicare deductibles, coinsurance and copays for services Medicare covers, and your Part A premium if you have to pay one.

SLMB

The Specified Low-Income Medicare Beneficiary program helps pay your Part B premium. You need both Part A and Part B.

QI

The Qualifying Individual program also helps pay your Part B premium. Medicare.gov notes that you must apply every year, and that states approve applications on a first-come, first-served basis, with priority for people who had QI the year before.

People in any of these three programs also get Extra Help for drug costs, so one application can help with two kinds of costs.

Who may qualify

Both programs look at your income and your resources, such as cash and investments, and the rules differ for each.

• Extra Help: Your income generally needs to be at or below 150% of the federal poverty level, and there are resource limits too. These limits change each year, so check ssa.gov or call Social Security for the current figures.
• Medicare Savings Programs: Each state runs its own programs. In California, they are part of Medi-Cal, and your county social services office decides who qualifies.

California’s asset limit is back in 2026

California brought back its Medi-Cal asset limit on January 1, 2026. According to the California Department of Health Care Services (DHCS letter ACWDL 25-14), the limit is $130,000 for one person, plus $65,000 for each additional household member. DHCS also says the limit drops on July 1, 2027, to $21,000 for one person and $31,000 for two.

The limit applies to “Non-MAGI” Medi-Cal, which includes most people 65 and older, people with Medicare, the Medicare Savings Programs and long-term care. Your home and one car are generally not counted. If you already have coverage, you report your assets at your first renewal in 2026. If you’re applying now, you need to meet the limit when you apply. People with SSI are not affected by this change.

For the details, read our guide to the Medi-Cal asset limit for people with Medicare, or ask your county office. Extra Help has its own federal resource limits, so this California change doesn’t set them.

Automatic eligibility for Extra Help

You don’t have to apply for Extra Help separately if you already have:

• Full Medi-Cal coverage
• A Medicare Savings Program (QMB, SLMB or QI)
• Supplemental Security Income (SSI)

In these cases, you get Extra Help automatically. If you think you should have it but aren’t sure, check the letters from your drug plan or call Medicare at 1-800-MEDICARE (TTY 1-877-486-2048).

How to apply

Extra Help: apply through Social Security

You can apply online at ssa.gov/extrahelp, by calling Social Security at 1-800-772-1213 (TTY 1-800-325-0778), or at a local Social Security office.

Medicare Savings Program in California: apply through your county

In California, you apply for the Medicare Savings Programs through Medi-Cal at your county social services office. You can find yours on the DHCS county offices page. You may be asked for proof of income and assets, so it helps to gather recent statements before you start.

If you’d like help with either application, HICAP, California’s Health Insurance Counseling & Advocacy Program (1-800-434-0222), offers counseling at no charge. If you have both Medicare and full Medi-Cal, you may also want to learn about Medi-Medi Plans.

Frequently asked questions

What’s the difference between Extra Help and a Medicare Savings Program?

Extra Help lowers your Part D prescription drug costs, and you apply through Social Security. The Medicare Savings Programs help pay the Part B premium and, for QMB, other Medicare costs; in California you apply through Medi-Cal. If you get a Medicare Savings Program, you also get Extra Help automatically.

What are the income limits for Medicare Extra Help in 2026?

Extra Help is for people with income at or below 150% of the federal poverty level, with resource limits as well. The exact dollar amounts change each year. Check ssa.gov or call Social Security for the current limits.

Do I need to apply for Extra Help if I have Medi-Cal?

Usually not. People with full Medi-Cal, a Medicare Savings Program or SSI get Extra Help automatically. If you’re not sure you have it, call 1-800-MEDICARE.

Does California’s 2026 asset limit apply to the Medicare Savings Programs?

Yes. The asset limit that returned on January 1, 2026 applies to Non-MAGI Medi-Cal, which includes the Medicare Savings Programs. Your home and one car are generally not counted, and your county office can tell you how the limit applies to you.

Can I get help paying my Medicare Part B premium?

You may, through a Medicare Savings Program. QMB, SLMB and QI all help pay the Part B premium if you qualify. In California, you apply through your county social services office.

Talk with a licensed Boomers agent

A licensed Boomers agent can go over the Medicare plans we represent in your area and check them against your doctors and prescriptions. If you get Extra Help or a Medicare Savings Program, we can also explain how that affects your plan choices. Our help is at no cost to you.

Find a licensed agent near you · See upcoming Medicare events

Or call 1-800-815-1943 (TTY 711), Monday – Friday, 9 AM – 5 PM Pacific.

Sources

• Get help paying costs (Medicare.gov)
• Medicare Savings Programs (Medicare.gov)
• Help with drug costs: Extra Help (Medicare.gov)
• Extra Help with Medicare prescription drug costs (SSA.gov)
• 2026 Medicare Parts A & B premiums and deductibles (CMS.gov)
• Medi-Cal (California Department of Health Care Services)
• County social services offices (California Department of Health Care Services)
• Medicare counseling: HICAP (California Department of Aging)