If your income is limited, two different programs may help. Extra Help is a Medicare program that helps pay Medicare drug coverage (Part D) premiums, deductibles, coinsurance and other drug costs. Medicare Savings Programs are run by the state and help with certain Part A and Part B costs — which costs depends on the specific program you qualify for. They are separate from Extra Help, eligibility for each rests on income and resource limits that can change from year to year, and you can apply for both at the same time. Applying is separate from enrolling in Medicare itself: nobody checks this for you automatically unless you already have full Medicaid, SSI, or QMB, SLMB or QI coverage.
Sourced directly from Medicare.gov’s Medicare Savings Programs page and Medicare.gov’s Extra Help page, and from NC Medicaid’s Medicare Savings Program guidance and the NC Department of Insurance’s SHIIP program.
- Extra Help lowers what you pay for Medicare Part D drug coverage — premium, deductible, and per-prescription costs — based on income and resource limits.
- North Carolina's Medicare Savings Programs (QMB, SLMB, QI, QDWI) are a separate, state-administered set of programs that can pay your Part A and/or Part B premiums.
- QMB, SLMB and QI automatically qualify you for Extra Help — you don't apply for both separately. QDWI does not, so it may need a separate Extra Help application.
- In NC, apply for Medicare Savings Programs through NC Medicaid; SHIIP (run by the NC Department of Insurance) offers counseling to help you figure out whether it's worth applying.
What Extra Help actually covers
Extra Help is the Part D Low-Income Subsidy — a federal program that can help with a Medicare drug plan’s premium up to the benchmark for your area, eliminates the Part D deductible, and limits what you pay for covered prescriptions filled at a participating pharmacy. If your plan’s premium is above that benchmark, you may still owe the difference. For 2026, the income limit is $23,940 for an individual and $32,460 for a married couple, with resource limits of $18,090 and $36,100. Resources generally mean savings, investments, and similar assets — not the home you live in or the vehicle you drive.
Some people get Extra Help automatically, without applying, if they already receive:
- Full Medicaid coverage
- Supplemental Security Income (SSI) payments
- Help through the QMB, SLMB, or QI programs below (QDWI does not qualify you automatically)
If you don’t get Extra Help automatically, you can apply through the Social Security Administration at any time of year, and reapply if your income or resources change.
Medicare Savings Programs: a separate set of help
Medicare Savings Programs are administered by the states, funded partly through Medicaid, and pay some or all of your Part A and/or Part B premiums. There are four, each with its own income and resource limits and its own scope:
| Program | What it pays for | 2026 federal monthly income limit (individual / couple) | 2026 federal resource limit (individual / couple) |
|---|---|---|---|
| QMB (Qualified Medicare Beneficiary) | Part A premium (if any), Part B premium, deductibles, coinsurance, and copayments | $1,350 / $1,824 | $9,950 / $14,910 |
| SLMB (Specified Low-Income Medicare Beneficiary) | Part B premium only | $1,616 / $2,184 | $9,950 / $14,910 |
| QI (Qualifying Individual) | Part B premium only — first-come, first-served, requires reapplying each year | $1,816 / $2,455 | $9,950 / $14,910 |
| QDWI (Qualified Disabled & Working Individual) | Part A premium only — for people with a disability who are working and lost their Social Security disability benefits and premium-free Part A because they returned to work | $5,405 / $7,299 | $4,000 / $6,000 |
These are the federal limits Medicare publishes for 2026, and they can change from year to year. They are not necessarily North Carolina’s cutoffs: according to Medicare.gov, you may still qualify in your state even if your income or resources are above these figures, because some states don’t count certain types or amounts of income or resources. If you’re close, it’s worth applying rather than ruling yourself out — NC Medicaid makes the actual determination. QMB is the most comprehensive of the four: providers generally can’t bill a QMB enrollee for the Medicare-covered costs the program takes on. SLMB and QI both require that you already have Part A and Part B in place — they pay the Part B premium going forward, but neither one gets you enrolled in Part B itself. QI also runs on limited annual funding and gives priority to people who were enrolled the year before, which is why applying early in the year matters if you think you qualify.
Applying in North Carolina
North Carolina runs its Medicare Savings Programs through NC Medicaid, and your county Department of Social Services (DSS) makes the eligibility decision. You can apply four ways:
- Online through ePASS. You’ll need an NCID — the state’s secure login, which you can create as part of the application — and Medicaid appears on the application as “Medical Assistance.”
- In person at your county DSS office. Walk-ins are accepted, or you can call ahead to schedule.
- By phone by calling your county DSS office.
- By mail, email, fax, or drop-off — download the application and send or bring it to your county DSS.
Not sure which county DSS office is yours? The NC Medicaid Contact Center at 1-888-245-0179 can point you to it.
You’ll generally need your Medicare card, recent proof of income (pay stubs or a Social Security award letter), and a bank statement or similar proof of resources.
If you’re not sure whether you’re in range, North Carolina’s Seniors’ Health Insurance Information Program (SHIIP) — a division of the NC Department of Insurance — offers unbiased counseling on exactly this kind of question, along with Medicare enrollment generally. SHIIP counselors don’t sell insurance and aren’t tied to any plan or carrier; you can reach them at 1-855-408-1212 or through ncdoi.gov. It’s a genuinely useful first call if the income limits above put you close to the line and you want a second opinion before gathering paperwork.
Why this is worth checking during Annual Enrollment
Medicare’s Annual Enrollment Period (AEP) runs October 15 through December 7. Cost-assistance eligibility is a separate question from plan choice, but it’s a natural one to check at the same time, since your income and expenses from the past year are already top of mind. Qualifying for Extra Help or a Medicare Savings Program doesn’t lock you into any particular Medicare Advantage or Part D plan, but Extra Help’s premium help is limited to the benchmark for your area, and its prescription-cost limits apply to covered drugs filled at a participating pharmacy. It’s worth confirming with your specific plan how the subsidy shows up on your bill.
If you’ve had a change this year — reduced hours, retirement, a spouse’s income ending, a move — it’s worth checking the limits above again even if you didn’t qualify before. Eligibility is based on your current numbers, not a one-time determination.
Extra Help and North Carolina’s Medicare Savings Programs exist specifically for people whose income makes Medicare’s ordinary costs a real strain, and applying is a separate step from enrolling in Medicare itself. If you want to talk through whether it’s worth applying, or how it fits with the rest of your Medicare coverage, book a call — and see our Medicare page for the broader picture of Charlotte-area Medicare planning, including what to review before AEP closes and the enrollment checklist for turning 65.
(This is program-level educational information, not a comparison of specific plans, carriers, or benefit amounts.)
