Extra Help by State
People often search for “Extra Help in my state.” The honest answer: the Extra Help income and resource limits are federal and the same in every state we serve. What does vary is the state programs around it. Here is what actually changes by location.
The limits are federal — and identical here
Extra Help (the Part D Low-Income Subsidy) uses federal income and resource limits tied to the Federal Poverty Level. In 2025 those limits are about $23,475 in annual income for a single person ($31,725 for a married couple) with resource limits of $17,600 and $35,130. These figures are exactly the same in all 48 contiguous states, including Florida, Texas, Arizona, Georgia, North Carolina, and South Carolina. Only Alaska and Hawaii differ, because they have higher Federal Poverty Level guidelines. See the full eligibility limits.
What actually differs by state
- Medicare Savings Programs (MSPs).QMB, SLMB, and QI are administered by each state’s Medicaid agency, and some states set their own — sometimes higher — income and resource limits. Because qualifying for an MSP automatically enrolls you in Extra Help, your state’s MSP rules can be your easiest path in. See Extra Help vs. Medicare Savings Programs.
- Medicaid expansion status. Whether a state expanded Medicaid affects who can become dual-eligible (Medicare + Medicaid), which in turn deems you eligible for Extra Help.
- Benchmark $0-premium plans. The set of Part D plans priced at or below the regional benchmark — the ones Extra Help fully covers — varies by region, so your $0-premium options differ by where you live.
Medicaid and dual-eligibility in the states we serve
Below is the state Medicaid program and expansion status for each state HealthPlan Connect serves. Remember: this affects your path to Medicaid or an MSP (and therefore automatic Extra Help) — it does not change the federal Extra Help limits above.
| State | Medicaid program | Medicaid expansion |
|---|---|---|
| Florida | Florida Medicaid | Not expanded |
| Texas | Texas Medicaid | Not expanded |
| Arizona | AHCCCS | Expanded |
| Georgia | Georgia Medicaid | Not expanded |
| North Carolina | NC Medicaid | Expanded |
| South Carolina | SC Medicaid | Not expanded |
In expansion states, more low-income residents can qualify for full Medicaid (and thus automatic Extra Help). In non-expansion states, a Medicare Savings Program is often the most realistic route to that automatic enrollment. Either way, the Extra Help benefit itself is the same federal program.
Source: Social Security Administration / CMS, 2025 Low-Income Subsidy guidelines (updated annually). Limits update annually; confirm the current year at ssa.gov/extrahelp.
Frequently Asked Questions
Do Extra Help income limits vary by state?
No. The Extra Help income and resource limits are federal and identical across the 48 contiguous states — including all six states we serve. In 2025 the single-person limit is $23,475 everywhere except Alaska and Hawaii, which have higher Federal Poverty Level figures.
What actually differs by state?
Three things: Medicare Savings Programs are run by each state with their own (sometimes higher) limits; whether a state expanded Medicaid affects dual-eligibility; and the menu of $0-premium benchmark Part D plans varies by region.
Does Medicaid expansion affect Extra Help?
Not the Extra Help limits themselves. But expansion affects how easily you can get full Medicaid or an MSP, and qualifying for either automatically enrolls you in Extra Help.
Which states have different Extra Help limits?
Only Alaska and Hawaii, because they have higher Federal Poverty Level guidelines. None of the six states HealthPlan Connect serves are affected — their limits are the standard contiguous-states amounts.
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Get My Free ReviewThis information is for educational purposes only and is not legal, tax, or insurance advice. Medicare rules, premiums, and income thresholds change annually — confirm current figures with Medicare.gov, the Social Security Administration, or a licensed advisor. HealthPlan Connect is not affiliated with or endorsed by the federal Medicare program or any government agency. Last reviewed 2026-06-11 by Lynsey Brennan, Licensed Medicare Advisor (FL #G007269).