Medicare Extra Help: how to lower your Part D drug costs
If prescription costs are stretching your budget, there is a federal program that can help: Medicare Extra Help, also called the Part D Low-Income Subsidy (LIS). It lowers — and for many people eliminates — the premium, deductible, and copays that come with Medicare Part D prescription drug coverage. A large number of people who qualify never apply, often because they assume their income is too high or do not know the program exists.
This is general education, not personalized advice, and it is not a complete description of every rule. The income and resource limits are updated every year, so for the current figures and an official decision, contact Social Security (ssa.gov or 1-800-772-1213), Medicare.gov, 1-800-MEDICARE, or your State Health Insurance Assistance Program (SHIP) for free, unbiased help.
What Extra Help pays for
Extra Help applies to Medicare Part D, the part of Medicare that covers outpatient prescription drugs. As of 2024, the older “partial” version of Extra Help was eliminated, so everyone who now qualifies receives the full benefit. For people who qualify, that generally means little or no monthly Part D premium (up to a benchmark amount set in your area), no yearly deductible, and low fixed copays for covered drugs instead of paying a percentage of the price.
Extra Help also works alongside recent Part D changes. Once your out-of-pocket spending on covered drugs reaches the annual cap ($2,100 in 2026), you pay $0 for covered drugs for the rest of the year — and people with Extra Help reach low or $0 costs well before that point. There is also no longer a coverage gap, the stage once known as the “donut hole.”
Who qualifies for Extra Help
Eligibility is based on two things: your income and your resources. Resources mean things like money in checking and savings, stocks, and bonds — your home, your car, and personal belongings do not count. The limits are set each year and tied to the federal poverty level, and they vary by household size. Because the numbers change annually, the only way to know for certain is to check the current limits on ssa.gov or simply apply.
Some people get Extra Help automatically and do not need to apply. If you have Medicare and also have full Medicaid, Supplemental Security Income (SSI), or are enrolled in a Medicare Savings Program, you are usually “deemed” eligible and will receive a notice in the mail. Everyone else can apply — and it is worth applying even if you are unsure, because many people qualify who assumed they earned too much.
How to apply
Applying for Extra Help is free, and you can do it in a few ways. The most common route is through Social Security: online at ssa.gov, by phone at 1-800-772-1213, or in person at a local office. You can also apply through your state Medicaid office, which may screen you for additional programs at the same time. No one should ever charge you to complete the application.
You will be asked about your income and resources. After a decision, you will receive a letter explaining whether you qualify and at what level. If your situation changes — your income, your marital status, or where you live — you can reapply, since a “no” in one year does not bar you from qualifying later.
Extra Help and related programs
Extra Help only lowers Part D drug costs. A separate set of programs, called Medicare Savings Programs (MSPs), can help pay your Part B premium and sometimes other Medicare costs. The two are connected: in many cases, qualifying for an MSP automatically qualifies you for Extra Help. When you apply for one, ask about the other.
If you do not qualify for Extra Help but still face high drug costs, you may be able to spread your yearly out-of-pocket prescription costs into smaller monthly payments through the Medicare Prescription Payment Plan. It does not lower your total cost, but it can make an expensive month more manageable. Ask your drug plan or pharmacist whether it makes sense for you.
What to do next
If there is any chance you might qualify, apply — it is free, and the difference in cost can be meaningful. Start at ssa.gov or call 1-800-772-1213 for Extra Help, and contact your State Health Insurance Assistance Program (SHIP) for free one-on-one counseling on Extra Help, Medicare Savings Programs, and how they fit with your drug plan.
A licensed Medicare agent can also help you understand whether Extra Help might apply to you and how it works with the specific Part D plans they represent, at no cost to you. You can find a local licensed agent through our directory.
Frequently asked questions
Who is eligible for Medicare Extra Help?
People with Medicare who have limited income and resources, based on annual limits tied to the federal poverty level. People with full Medicaid, Supplemental Security Income (SSI), or a Medicare Savings Program usually qualify automatically. Because the limits change each year, check ssa.gov or apply to know for sure.
Do I have to reapply every year?
Not usually. If you qualify, your Extra Help typically continues, though Social Security may occasionally ask you to confirm your information. If you were denied before, you can reapply any time your income or resources change.
Does applying for Extra Help affect my other benefits?
No. Applying does not reduce your Social Security or other benefits. In fact, applying can connect you to related help, such as a Medicare Savings Program that lowers your Part B premium.
Is there a fee to apply?
No. Applying for Extra Help through Social Security or your state Medicaid office is free. No one should charge you to complete the application.
This is general education, not personalized advice, and plan details change every year. For all of your options, contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Assistance Program (SHIP) at shiphelp.org.