In 2026, a married couple living together in Durham County qualifies for Medicare Extra Help if their combined annual income is at or below $32,460 ($2,705/month) and their countable assets are at or below $33,100. Your home, one car, and up to $1,500 per person for burial expenses don’t count toward assets. If you qualify, Extra Help eliminates your Part D deductible, caps copays at $0–$12.65 per prescription, and wipes out any late enrollment penalty. For your specific situation in Durham County, call Rob Simm at (828) 761-3326 — free, no obligation.

What Durham families ask

What do married couples in Durham County worry about most with Extra Help?

These are the four questions I hear most from married couples asking about Extra Help eligibility.

Does my spouse’s Social Security count too?

Yes. Social Security counts both spouses’ income when you live together. The $32,460 limit is your combined total — but SSA applies a $20 monthly disregard before calculating.

Does our house count as an asset?

No. Your primary home is excluded from the asset test. So is one vehicle, household items, personal belongings, and up to $1,500 per person set aside for burial expenses.

What if we’re just over the income limit?

Since the Inflation Reduction Act, there is no more partial Extra Help — you either qualify or you don’t. But SSA encourages everyone close to the limit to apply. Certain income exclusions may bring you under.

Will applying affect our other benefits?

Applying for Extra Help does not affect your Social Security benefits, your Medicare coverage, or any other federal benefits you currently receive. The application is free.

⚠️ Don’t assume you won’t qualify

About 4.3 million eligible Americans aren’t enrolled in Extra Help right now. Many assume their income is too high without accounting for exclusions like the $20 monthly disregard, earned income deductions, or the burial expense exclusion. A married couple earning $2,700/month with $30,000 in savings could qualify and save over $6,200/year on prescriptions. Call (828) 761-3326 — I’ll run the numbers in 10 minutes.

The difference

What’s the difference between checking Medicare.gov and calling a broker?

What do you need to know?	Medicare.gov	Rob Simm — NC #10447418
Income limit	Shows the federal number — $32,460 for couples	I check your actual income against exclusions to see if you qualify
Asset calculation	Lists general rules — doesn’t know your specific accounts	I walk through each account and apply burial + home exclusions
Application help	Links to SSA.gov form — you’re on your own	I pre-screen you so you know the outcome before you submit
Part D plan match	Can’t tell you which $0 premium plan covers your medications	I match your drugs to the best Extra Help–eligible plan in Durham County
Penalty removal	Mentions penalty elimination — doesn’t check if it applies to you	I identify if you have a Part D late penalty and confirm Extra Help removes it
Ongoing review	800 number, different agent every call	I review your plan every AEP — same broker, same phone number, every year

2026 Medicare numbers

What are the key Medicare numbers for Durham County in 2026?

$202.90

Part B premium per month

2026 standard rate. Higher with IRMAA surcharge based on income above $106,000.

$283

Part B annual deductible

You pay this before Medicare covers 80% of outpatient care.

$9,350

MA in-network out-of-pocket max

2026 cap on in-network Medicare Advantage spending.

$2,100

Part D out-of-pocket cap

No catastrophic Rx costs in 2026. Insulin capped at $35/month.

💡 Broker Tip — Durham County

Many Durham County couples on Medicare don’t realize that qualifying for Extra Help also gives you a Special Enrollment Period every month to switch Part D plans — you’re not locked into AEP. If your formulary changes mid-year, I can move you to a better plan immediately. And if you’ve been carrying a Part D late enrollment penalty, Extra Help wipes it out retroactively. Call me at (828) 761-3326 to check your eligibility.

— Rob Simm, Licensed Medicare Broker, NC #10447418

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Rob Simm · Licensed NC Medicare Broker · NPN #10447418

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Real scenario · Durham County

What does Extra Help actually save a married couple in Durham County?

Without Extra Help

$4,200+

Married couple on Part D paying full deductible, 25% coinsurance, plus $45/month premium. Four generic and two brand-name prescriptions. Annual drug costs exceed $4,200 — and that’s before hitting the $2,100 OOP cap.

With Extra Help

$0–$152

Same couple qualifies for Extra Help. $0 premium on a benchmark plan. $0 deductible. Copays of $0–$12.65 per prescription. Annual drug costs drop to $152 or less. Savings: over $4,000/year — and any Part D late penalty is eliminated.

It pays to talk to the right broker

Why doesn’t this cost anything?

It doesn’t — because I get paid by the insurance carrier to manage your plan. Most call centers get paid more to steer your business toward certain carriers based on volume and contracts. The only thing I’m optimizing for is making sure you’re covered correctly when you actually need it. That’s what keeps people coming back. And referring their neighbors.

Common questions

Frequently asked questions

What is the 2026 income limit for Medicare Extra Help for a married couple in Durham County?

In 2026, a married couple living together in Durham County NC can qualify for Medicare Extra Help if their combined annual income is at or below $32,460 ($2,705/month). This is based on 150% of the Federal Poverty Level for a household of two. Assets must also be at or below $33,100, not counting your home, one car, or up to $1,500 per person for burial expenses. Call Rob Simm at (828) 761-3326 for a free eligibility check.

What counts as income for Medicare Extra Help eligibility?

Extra Help counts wages, Social Security benefits, pensions, and most other income sources. However, Social Security applies a $20 monthly disregard, meaning $20 of unearned income is not counted. Earned income has additional exclusions. The income test is based on gross income before taxes, not your take-home pay. Call (828) 761-3326 to have Rob run your specific numbers.

What assets count toward the Extra Help resource limit?

Countable assets include checking and savings accounts, stocks, bonds, mutual funds, and IRAs. Your home, one vehicle, household items, personal belongings, and up to $1,500 per person set aside for burial expenses are excluded. For a married couple in 2026, the asset limit is $33,100 (plus the $3,000 combined burial exclusion, effectively $36,100).

Is there still partial Extra Help in 2026?

No. Thanks to the Inflation Reduction Act, starting in 2024 there is no longer a distinction between full and partial Extra Help. If you qualify at all, you receive the full benefit — no Part D deductible, copays capped at $0–$12.65, and your late enrollment penalty is eliminated.

How do I apply for Medicare Extra Help in Durham County NC?

You can apply online at ssa.gov/extrahelp, call Social Security at 1-800-772-1213, or visit your local Durham Social Security office. You can also call Rob Simm at (828) 761-3326 — he can help you determine eligibility before you apply and make sure your Part D plan is optimized for your medications if you qualify.

Related Medicare guides

Extra Help/LIS Eligibility NC 2026 Medicare Enrollment in NC – 2026 Guide Compare Medicare Advantage Plans in NC Extra Help / LIS in NC – 2026 Eligibility Guide Working Past 65 – Medicare Enrollment Special Enrollment Periods in NC Cheap Health Insurance Without Employer Coverage Free Medicare Quotes Online

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Robert Simm

Licensed Independent Medicare Broker

Helping NC families navigate Medicare since 2014. Independent — I work with all carriers and get paid the same regardless of which plan you choose. I verify provider networks with Duke Health directly and answer my own phone the next year when something changes.

📞 (828) 761-3326 📋 NC #10447418 🏥 AHIP Certified ⭐ 5.0 · 20+ reviews 📍 2731 Meridian Pkwy, Durham NC 27713 🕐 Mon–Fri 9am–7pm ET

Last Updated: 2026-05-04 | Reviewed By: Robert Simm, Licensed Medicare Broker, NC #10447418 | Next Review: October 2026

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