Extra Help With Prescription Costs: Who May Qualify
Extra Help is a federal program that lowers Medicare Part D costs for people with limited income and resources. Here is how it works and how to apply.
The short version
- Extra Help, also called the Low-Income Subsidy, lowers Part D premiums, deductibles and copays.
- Eligibility expanded in 2024, so more people with limited income now qualify for full benefits.
- You can apply through Social Security online, by phone or in person.
In this guide
Prescription drugs can be one of the largest expenses for people with Medicare. Extra Help, also known as the Low-Income Subsidy (LIS), is a federal program that helps people with limited income and resources pay for Medicare Part D prescription drug coverage.
What Extra Help provides
People who qualify for Extra Help generally get:
- Lower or no monthly premiums for Part D plans (up to a certain amount)
- No deductible
- Low copays for covered generic and brand-name drugs
- No Part D late enrollment penalty
- More flexibility to change plans, including the ability to change drug plans once a month for certain plan types
Who may qualify
Extra Help is based on your income and resources. Since 2024, people with incomes up to 150 percent of the federal poverty level who meet resource limits can qualify for full benefits. The exact limits change each year, so check Social Security's website for current figures.
Resources typically counted include bank accounts, stocks, bonds and mutual funds. Resources usually not counted include:
- Your home
- Vehicles
- Personal possessions
- Life insurance policies
- Burial plots
- Retirement accounts may be treated differently; ask Social Security how yours is counted.
Automatic eligibility
You automatically qualify for Extra Help, and do not need to apply, if you have Medicare and:
- Full Medicaid coverage
- Help from your state paying your Medicare premiums (a Medicare Savings Program)
- Supplemental Security Income (SSI) benefits
If you automatically qualify, Medicare will send you a letter.
How to apply
If you do not automatically qualify, you can apply through Social Security:
- Online at ssa.gov
- By phone at 1-800-772-1213 (TTY 1-800-325-0778)
- In person at your local Social Security office
There is no cost to apply. Social Security may ask for information about your income and resources, such as bank statements, tax returns and pension information.
Applying for Extra Help also starts an application for a Medicare Savings Program with your state, unless you tell Social Security not to share your information.
After you qualify
- You still need to be enrolled in a Part D plan or a Medicare Advantage plan with drug coverage. If you are not, Medicare may enroll you in a plan.
- Check that your medications are on your plan's formulary.
- Keep your award letter as proof of eligibility.
- Report changes in income or resources to Social Security.
The out-of-pocket cap
All Part D enrollees benefit from the annual out-of-pocket cap on covered drugs, which is $2,100 in 2026. People with Extra Help often have very low costs and may reach the cap less often, but the cap provides protection if costs are high.
Get help with your application
Your State Health Insurance Assistance Program (SHIP) offers free assistance with Extra Help applications. Find yours at shiphelp.org. Your local Area Agency on Aging may also be able to help.
Terrameritavi is an independent publication and is not affiliated with Medicare, Social Security or any government agency.
