2 min read

CMS updates resource, cost-sharing limits for Low-Income Subsidy in 2026

Picture of Action Benefits Action Benefits Updated on May 14, 2026

Medicare

4:58

Each year, the Centers for Medicare and Medicaid Services determines income and resource eligibility thresholds for the Low-Income Subsidy (LIS) program. LIS, or Extra Help, reduces the amount eligible Medicare beneficiaries spend on prescription drugs. The subsidy can pay for plan premiums and some or all of the cost-sharing responsibility the beneficiary might have. Medicare beneficiaries can apply for the subsidy at their local Social Security office or online.

It's important to define two key terms: income is exactly what you think it is -- liquid assets such as earned wages, and some other payments. Resources, though, have a broader definition. Generally, it's any asset that can be converted to cash within 20 days -- items like bank accounts, stocks, and bonds. Real estate assets beyond the beneficiary's primary residence will also count as a resource. See Medicare.gov for a more complete listing.

Low-Income Subsidy resource limits increase in 2026

CMS ties adjustments in the resource limits to the performance of the Consumer Price Index (CPI) -- a common measure of how prices change over time. When the CPI increases, the resource limits increase. When CPI decreases, so too do the resource limits. That said, the law limits the maximum increase in limits to 2.4% per year -- exactly what we'll see this year.

We should also point out beneficiaries may notify the Social Security Administration they intend to use some of their resources for burial expenses. After this notification, beneficiaries see a slight bump to their personal resource limits - $1,500 per individual.

For a full summary of the changes, check out the table below:

CY2026 Resource Limits for Determining LIS Eligibility
Marital status	2025 resource limit	2025 resource limit with burial expenses	2026 resource limit	2026 resource limit with burial expenses
Single	$16,100	$17,600	$16,590	$18,090
Married	$32,130	$35,130	$33,100	$36,100

Cost-sharing increases in 2026

CMS also calculates the maximum copayments subsidy-eligible enrollees can be responsible for each year. For beneficiaries whose income is greater than 100% of the federal poverty level (FPL), the change in copay is related to the change in how much Medicare spends on Part D drugs per eligible beneficiary. For beneficiaries whose income is less than 100% of the FPL, their copays are updated by the annual change in CPI.

The good news is that eligible beneficiaries making less than 100% of the federal poverty level will pay no more than $4.90 per prescription drug fill in 2026. Those making more than 100% of FPL, but less than 150%, will pay no more than $12.65 per prescription fill.

The chart below has a full breakdown:

Low-Income Subsidy Category	Deductible	Copayment up to the out-of-pocket threshold of $2,100
Low-Income Subsidy Category	Deductible	Generic	Brand
Full-Benefit Dual Eligible Beneficiaries Institutionalized or Receiving Home and Community-Based Services	$0	$0	$0
Full-Benefit Dual Eligible Beneficiaries with income ≤ 100% FPL (~$15,960 in 2026)	$0	$1.60	$4.90
Full-Benefit Dual Eligible Beneficiaries with income between 100% and 150% FPL (between $15,961 and $23,940 in 2026)	$0	$5.10	$12.65
Non-Full Benefit Dual Eligible Beneficiaries Applied or are eligible for Medicare Savings Program ( QMB-only, SLMB-only, or QI); or Supplemental Security Income (but not Medicaid)	$0	$5.10	$12.65
Non-Full Benefit Dual Eligible Beneficiaries Applied and with income ≤ 150% FPL ($23,940 in 2026) for 2024 and resources ≤ $17,600 ($35,130 if married)	$0	$5.10	$12.65

Key takeaways for LIS-eligible Medicare beneficiaries

The good news: LIS resource limits have increased.

The bad news: So has the price of everything else.

Because asset limits and copays are tied to the Consumer Price Index (CPI), these numbers will move in lockstep with most things beneficiaries regularly purchase. The overall result, generally speaking, should be a wash.

Social Security recently announced the cost-of-living adjustment (COLA) for 2026 will be 2.8%. Taking only the CPI and the COLA numbers into account, LIS beneficiaries should come out slightly ahead. However, if the beneficiary's responsibility for all or some of their Medicare Part B Premium (currently estimated to be $206.50 for 2026) could impact overall spending power.