What the Income Limits Are
Extra Help is a federal program that pays part or all of your Medicare prescription drug costs if your income and resources fall below certain thresholds. The income limit changes each year. For 2024, you can earn up to 150% of the federal poverty level and still be considered for Extra Help. For a single person, that is roughly $21,870 per year; for a married couple living together, it is roughly $29,430 per year. These figures shift annually, so the 2025 limits will be different.
The program also sets a resource limit—the total value of savings, investments, and other assets you own. For 2024, you can have up to $15,510 in resources as a single person or $31,020 as a married couple. Your home and one vehicle do not count toward this limit. Again, these amounts change each year.
Income includes wages, Social Security benefits, pensions, interest, and dividends. It does not include certain types of income like Supplemental Security Income (SSI) in most cases, or food stamps. The program counts household income, which means if you live with a spouse, both of your incomes are added together.
Key Takeaways
- Extra Help income limits are set at 150% of the federal poverty level, which is roughly $21,870 for a single person in 2024.
- Resource limits cap your savings and investments at $15,510 for individuals and $31,020 for married couples, though your home and one car do not count.
- Income limits and resource limits both increase each year, so you should check the current year's figures before determining whether you may be considered.
- If your income or resources are slightly above the limit, you may still be considered if you have high prescription drug costs or other circumstances.
How Income Is Counted
The Social Security Administration (SSA) counts gross income before taxes. If you receive Social Security, your full benefit amount counts, not what you take home after taxes. Wages count before deductions. Pensions and retirement account withdrawals count as income in the year you receive them.
Some income does not count. SSI payments are excluded. Food stamps and housing information do not count. Certain types of financial aid for education do not count. If you are unsure whether a particular income source counts, you can ask the SSA directly or contact your local Social Security office.
If you are married and living together, both spouses' income is combined to determine household income. If you are married but living apart, only your own income counts. The same rule applies to unmarried partners—only your individual income is counted.
Resource Limits and What Counts
Resources include bank accounts, savings accounts, money market accounts, certificates of deposit, stocks, bonds, and mutual funds. Real estate you own (other than your primary home) counts as a resource. A second vehicle counts, but your primary vehicle does not. Life insurance policies and burial plots do not count.
Your primary home does not count toward the resource limit, no matter how much it is worth. One vehicle does not count. Retirement accounts like IRAs and 401(k)s do count toward the resource limit, though some states have different rules. If you own a business, the value of that business counts as a resource.
If you are married, your spouse's resources count toward your household total. This applies whether you file taxes jointly or separately. If you have recently given away money or resources to family members or others, the SSA may count that as a resource depending on when the transfer occurred.
When Income Limits Are Waived or Overlooked
If your income is slightly above the 150% poverty level but your prescription drug costs are very high, you may still be considered for Extra Help under a different rule. This is called the spend-down provision. If your out-of-pocket drug costs are high enough, you can subtract them from your income to bring yourself below the limit.
Some states also have their own rules that may allow people slightly above the federal income limit to receive Extra Help. A few states use a higher income threshold than 150% of poverty. Your state's Medicaid office can tell you whether your state has a different rule.
If your income or resources change during the year—because you lost a job, started receiving Social Security, or had a major expense—you can report the change and be reconsidered. Extra Help is not locked in for the entire year; you can be approved or denied at any point if your circumstances change.
How to Find Out the Current Year's Limits
The Social Security Administration publishes the current year's income and resource limits on its official website. You can also call Social Security at 1-800-772-1213 to ask what the limits are for the current year. A representative can tell you the exact figures and whether your income and resources fall within the range.
Medicare.gov also lists the income and resource limits for Extra Help. You can search for "Extra Help income limits" and the current year to find the official figures. These are the only reliable sources; income limits posted on other websites may be outdated.
If you are unsure whether your income qualifies, you do not have to guess. You can contact Social Security or your local Medicaid office and describe your situation. They can tell you whether you are likely to be considered based on your actual numbers.
What Happens If Your Income Changes
If you earn more money during the year and your income rises above the limit, you should report the change to Social Security. Your Extra Help coverage may end, or your copayments and coinsurance amounts may increase. It is better to report the change yourself than to have it discovered later.
If your income drops—because you retired, lost a job, or had a reduction in hours—you can report that change and be reconsidered. You may become newly considered for Extra Help, or if you were already receiving it, your copayments may decrease.
Changes in resources also matter. If you sell a second home or liquidate investments, your resource total may drop below the limit. If you inherit money or receive a large gift, your resources may rise above the limit. Report significant changes to Social Security so your case can be reviewed.
Income Limits by Family Size and Year
| Family Size | 2024 Income Limit (150% of Poverty) | 2024 Resource Limit |
|---|---|---|
| Single person | Approximately $21,870 | $15,510 |
| Married couple | Approximately $29,430 | $31,020 |
| Family of three | Approximately $37,000 | Varies by state |
These figures are for 2024 and will increase in 2025. The exact amounts depend on the federal poverty guidelines, which the Department of Health and Human Services updates each year. If you are checking your may be able to access in a different year, use the current year's poverty guidelines to calculate 150%.
Frequently Asked Questions
Do I have to be on Medicare to use Extra Help income limits?
Yes. Extra Help is only for people already enrolled in Medicare Part D (prescription drug coverage). You must be 65 or older or disabled and already covered by Medicare. If you are not yet on Medicare, you cannot use Extra Help, though you may be considered for other prescription drug information programs.
If I am married but my spouse is not on Medicare, does their income count?
Yes. If you are married and living together, your spouse's income counts toward your household total for Extra Help, even if your spouse is not on Medicare. Your spouse's resources also count. This applies whether or not your spouse has any connection to Medicare.
What if I live with an adult child or parent—does their income count?
No. Only your income and your spouse's income count. Adult children, parents, or other relatives living in your home are not part of your household for Extra Help purposes, even if you share expenses or they contribute to household costs.
Can I be denied Extra Help if my income is exactly at the limit?
No. The limit is 150% of poverty, which means you can earn up to that amount and still be considered. If your income is at or below 150% of the poverty level for your family size, you meet the income requirement. You would still need to meet the resource limit and other program rules.
If I get a bonus or tax refund, does that count as income for Extra Help?
A bonus counts as income in the year you receive it. A tax refund does not count as income because it is a return of money you already earned and reported. If you receive a large one-time payment like an inheritance or insurance settlement, contact Social Security to ask how it affects your Extra Help status.