medicare extra help

Medicare Extra Help is a federal program that helps people with limited income and resources pay their Medicare Part D prescription drug costs, including premiums, deductibles, and copays.

What Medicare Extra Help Is

• Medicare Extra Help (also called the Low‑Income Subsidy or LIS) reduces what you pay for a Medicare Part D drug plan.

• It can lower or eliminate your Part D monthly premium, reduce or remove your deductible, and cap your out‑of‑pocket costs for medications.

• People who qualify also avoid the Part D late‑enrollment penalty.

Who Qualifies

• In general, you must have Medicare and have limited income and resources below set limits that change each year.

• For 2026, articles discussing Extra Help project income limits around the low‑$20,000 range for single people and upper‑$20,000 range for couples, with resource limits in the mid‑$10,000s for singles and about double for couples; exact official amounts are set annually.

• You automatically qualify if you have full Medicaid, help from your state paying Medicare Part B premiums (Medicare Savings Program), or Supplemental Security Income (SSI).

What You Pay Under Extra Help

• With Extra Help, you may pay very low or no monthly premium and a much smaller deductible for your Part D plan.

• Your prescription copays are limited, and there is no coverage gap (“donut hole”) for those receiving full Extra Help, so your drug costs stay more predictable through the year.

• Some plan materials note that people with Extra Help may pay very small or no copayments at all for certain prescriptions, depending on income and level of subsidy.

How to Apply

• If you are not automatically enrolled, you apply through Social Security, either online, by phone, or in person at a Social Security office.

• The online application walks you step‑by‑step and lets you save and return before submitting; you can review a summary and correct information before you send it.

• You can also get free local counseling and help with the application from your State Health Insurance Assistance Program (SHIP).

What People Ask in Forums

• Common questions on forums include whether someone needs to enroll in Part D separately, how to confirm if Extra Help was actually awarded, and whether re‑application is needed each year.

• Many posters are reminded to carefully read their annual Medicare and plan mailings, which often show if Extra Help is applied and what their new costs will be for the coming year.

Information gathered from public forums or data available on the internet and portrayed here.