---
title: Medicare Extra Help & Savings Programs in NC (2026 Limits) | Triangle Life & Health
description: Do you qualify for Medicare Extra Help or a Medicare Savings Program in North Carolina? 2026 income and resource limits, what each program pays, and how to apply. Free help from a licensed Raleigh agent.
---

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Medicare help in North Carolina

# Medicare Extra Help & Medicare Savings Programs in North Carolina

Two programs that help pay your Medicare costs if your income and savings are limited. Here's who qualifies in 2026, what each one pays, and how to apply, in plain English.

[📅 Book a free 30-min call](https://trianglelifeandhealth.com/calendar?hsLang=en) [📞 (919) 689-6565](tel:+19196896565)

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#### The 60-second version

**Extra Help** is a Medicare program that lowers what you pay for prescription drugs. **Medicare Savings Programs** are run by NC Medicaid and pay your Part B premium, and sometimes much more. You apply for Extra Help through Social Security, which decides who qualifies. Many people qualify for both. If you're approved for a Medicare Savings Program, you get Extra Help automatically.

### 💊 Extra Help

Helps pay for Part D drug coverage: premiums, the deductible and copays.

**Apply through:** Social Security

### 🏥 Medicare Savings Programs

Pay the Part B premium ($202.90/month in 2026), and with QMB, deductibles and coinsurance too.

**Apply through:** NC Medicaid / your county DSS

## What is Medicare Extra Help?

Extra Help, also called the Part D Low-Income Subsidy (LIS), lowers the cost of Medicare prescription drug coverage. If you qualify, it helps pay your Part D premium, and in 2026:

- **$0 Part D deductible**
- **Copays of no more than $5.10** for generics and **$12.65** for brand-name drugs (lower for some people with full Medicaid)
- **In 2027:** copays of no more than **$5.80** for generics and **$14.40** for brand-name drugs, and $0 once your drug costs reach the $2,400 out-of-pocket cap. Some people with full Medicaid pay less (as little as $1.65 / $5.00, or $0 if you live in a nursing home or get home- and community-based services)
- **No Part D late-enrollment penalty** while you have Extra Help
- A **special enrollment period every month** (more on that below)

### 2026 Extra Help limits

|  | Yearly income below | Resources below |
| --- | --- | --- |
| **Individual** | $23,940 | $18,090 |
| **Married couple** | $32,460 | $36,100 |

The resource limits include up to $1,500 per person set aside for burial expenses. Sources: [Medicare.gov](https://www.medicare.gov/basics/costs/help/drug-costs), CMS CY2026 LIS guidance; 2027 copays: [CMS CY2027 Rate Announcement](https://www.cms.gov/files/document/2027-announcement.pdf).

**What counts as resources:** money in checking or savings, stocks, bonds, mutual funds, IRAs and real estate other than your home. **What doesn't count:** your home, one car, a burial plot, furniture, and household and personal items.

### You may already qualify automatically

You get Extra Help automatically, with no separate application, if you have **full NC Medicaid**, are enrolled in a **Medicare Savings Program**, or get **Supplemental Security Income (SSI)**. Medicare usually mails a letter confirming it.

### How to apply for Extra Help

Apply online at [SSA.gov/extrahelp](https://www.ssa.gov/extrahelp), call Social Security at 1-800-772-1213, or visit your local Social Security office. There's no cost to apply.

## What are Medicare Savings Programs?

Medicare Savings Programs (MSPs) are Medicaid programs that pay some or all of your Medicare costs. In North Carolina they're run by NC Medicaid, and you'll see them called "MQB." The Part B premium alone is $202.90 a month in 2026, so an MSP can put about **$2,435 a year** back in your pocket.

| Program (NC name) | What it pays | Monthly income limit (individual / couple) |
| --- | --- | --- |
| **QMB** (MQB-Q) | Part A and B premiums, deductibles, coinsurance and copays | $1,350 / $1,824 |
| **SLMB** (MQB-B) | Part B premium | $1,616 / $2,184 |
| **QI** (MQB-E) | Part B premium | $1,816 / $2,455 |
| **QDWI** | Part A premium for certain working people with disabilities | $5,405 / $7,299 |

**Resource limit for QMB, SLMB and QI:** $9,950 for an individual, $14,910 for a couple ($4,000 / $6,000 for QDWI).

These are the 2026 federal limits and include the standard $20 monthly income disregard. NC Medicaid makes the final eligibility decision, and some NC charts show the limits before the $20 disregard. Source: [SSA POMS HI 00815.023](https://secure.ssa.gov/poms.nsf/lnx/0600815023).

**Good to know about QI (MQB-E):** funding is limited, so states approve QI applications first-come, first-served, and you have to reapply every year.

### How to apply for a Medicare Savings Program in NC

Apply online through [NC Medicaid's ePASS](https://medicaid.ncdhhs.gov/apply), where Medicaid is called "Medical Assistance," or apply through your county Department of Social Services (DSS). It helps to have your Medicare card, proof of income (like your Social Security award letter) and recent bank statements ready.

## Extra Help and changing plans: the monthly special enrollment period

If you have Extra Help or Medicaid, you aren't limited to the fall enrollment season. **Once a calendar month**, you can switch to Original Medicare with a standalone Part D drug plan, or change from one Part D plan to another. The change starts the first day of the next month. If you have full Medicaid, you can also join or switch to an integrated Dual Eligible Special Needs Plan (D-SNP) once a month, if one is available in your area. This monthly option isn't available if your drug plan has identified you as "at-risk" under a Part D drug management program. You can still make any change during Annual Enrollment, **October 15 to December 7**, like everyone else.

Source: [Medicare.gov, Special Enrollment Periods](https://www.medicare.gov/basics/get-started-with-medicare/get-more-coverage/joining-a-plan/special-enrollment-periods).

## How I can help

I'm a licensed independent agent in Raleigh, licensed since 2013. Social Security and NC Medicaid decide who qualifies. I can't approve an application, and I'll never ask you to pay for help applying. What I can do:

- Go over your situation and tell you whether it looks worth applying
- Point you to the right application and what to have ready
- Once you're approved, compare plans with you, including plans built for people who have both Medicare and Medicaid, so you're using every benefit you've earned

There's no cost to you to work with me.

### Request a Quote

## Frequently asked questions

Can I get Extra Help and a Medicare Savings Program at the same time?

Yes. Many people get both. If North Carolina approves you for a Medicare Savings Program (QMB, SLMB or QI), you automatically qualify for Extra Help too. The same is true if you have full Medicaid or get SSI.

Does my house count against the resource limit?

No. Your home doesn't count. For Extra Help, Medicare also doesn't count one car, a burial plot, up to $1,500 you've set aside for burial expenses, furniture, or household and personal items.

My income is a little over the limit. Should I still apply?

Usually, yes. Some kinds of income aren't counted, and Social Security encourages people who are close to the limits to apply. Applying is free, and Social Security or NC Medicaid makes the final decision.

Do the limits change every year?

Yes. The limits are tied to the federal poverty level and are updated every year, usually early in the year. This page shows the 2026 figures, and we update it when the new numbers are published.

Does Extra Help change when I can switch plans?

Yes. If you have Extra Help or Medicaid, you can make a change once a calendar month: switch to Original Medicare with a standalone Part D drug plan, or change Part D plans. The change starts the first day of the next month. This monthly option isn't available if your drug plan has identified you as at-risk under a Part D drug management program. You can still use Annual Enrollment (October 15 to December 7) like everyone else.

Do you charge anything to help?

No. There's no cost to talk with me. I can help you figure out whether you might qualify and point you to the right application. Once you're approved, I'll compare plans with you so you're getting the most from your benefits.

## Related Medicare guides

More plain-English help.

### [Medicare Part D How drug plans work, and how to pick one for your medication list. Learn more →](https://trianglelifeandhealth.com/prescription-drug-plan-part-d?hsLang=en)

### [Medicare overview Parts A, B, C, D and Medigap, explained. Learn more →](https://trianglelifeandhealth.com/medicare-overview?hsLang=en)

### [2027 Annual Enrollment October 15 to December 7. Get a free plan review before the deadline. Learn more →](https://trianglelifeandhealth.com/medicare-aep?hsLang=en)

## Not sure if you qualify?

Book a free 30-minute call. We'll look at your situation together, and if it makes sense, I'll point you to the right application.

[📅 Book a free 30-min call](https://trianglelifeandhealth.com/calendar?hsLang=en) [📞 (919) 689-6565](tel:+19196896565)

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###### Disclaimer:

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1–800 MEDICARE (24 hours a day/7 days a week) to get information on all of your options. Not affiliated with the U.S. government or federal Medicare program. This is a solicitation for Insurance. Plans are insured or covered by a Medicare Advantage organization with a Medicare contract and/or a Medicare approved Part D sponsor. Enrollment in the plan depends on the plan’s contract renewal with Medicare.

Triangle Life and Health is an independent authorized agency licensed to sell and promote products from Blue Cross and Blue Shield of North Carolina (Blue Cross NC). The content contained in this site is maintained by Triangle Life and Health. Blue Cross NC is an independent licensee of the Blue Cross and Blue Shield Association®, SM Registered marks of the Blue Cross and Blue Shield Association.

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  "mainEntity" : [ {
    "@type" : "Question",
    "acceptedAnswer" : {
      "@type" : "Answer",
      "text" : "Yes. Many people get both. If North Carolina approves you for a Medicare Savings Program (QMB, SLMB or QI), you automatically qualify for Extra Help too. The same is true if you have full Medicaid or get SSI."
    },
    "name" : "Can I get Extra Help and a Medicare Savings Program at the same time?"
  }, {
    "@type" : "Question",
    "acceptedAnswer" : {
      "@type" : "Answer",
      "text" : "No. Your home doesn't count. For Extra Help, Medicare also doesn't count one car, a burial plot, up to $1,500 you've set aside for burial expenses, furniture, or household and personal items."
    },
    "name" : "Does my house count against the resource limit?"
  }, {
    "@type" : "Question",
    "acceptedAnswer" : {
      "@type" : "Answer",
      "text" : "Usually, yes. Some kinds of income aren't counted, and Social Security encourages people who are close to the limits to apply. Applying is free, and Social Security or NC Medicaid makes the final decision."
    },
    "name" : "My income is a little over the limit. Should I still apply?"
  }, {
    "@type" : "Question",
    "acceptedAnswer" : {
      "@type" : "Answer",
      "text" : "Yes. The limits are tied to the federal poverty level and are updated every year, usually early in the year. This page shows the 2026 figures, and we update it when the new numbers are published."
    },
    "name" : "Do the limits change every year?"
  }, {
    "@type" : "Question",
    "acceptedAnswer" : {
      "@type" : "Answer",
      "text" : "Yes. If you have Extra Help or Medicaid, you can make a change once a calendar month: switch to Original Medicare with a standalone Part D drug plan, or change Part D plans. The change starts the first day of the next month. This monthly option isn't available if your drug plan has identified you as at-risk under a Part D drug management program. You can still use Annual Enrollment (October 15 to December 7) like everyone else."
    },
    "name" : "Does Extra Help change when I can switch plans?"
  }, {
    "@type" : "Question",
    "acceptedAnswer" : {
      "@type" : "Answer",
      "text" : "No. There's no cost to talk with me. I can help you figure out whether you might qualify and point you to the right application. Once you're approved, I'll compare plans with you so you're getting the most from your benefits."
    },
    "name" : "Do you charge anything to help?"
  } ]
}
```