Medicare Extra Help Program

Medicare Extra Help is a federal program that pays most or all of your Medicare Part D premium, deductible, and prescription copays if your income and resources fall below set limits. Also called the Part D Low Income Subsidy (LIS), Extra Help is run jointly by the Social Security Administration (SSA) and the Centers for Medicare & Medicaid Services (CMS). If you qualify, the subsidy covers your drug plan premium in most cases, eliminates your Part D deductible, and lowers what you pay at the pharmacy counter. There's no cost to apply, and once you're approved, Extra Help continues automatically each year, though SSA may review your income and resources periodically.

For seniors on a fixed income, prescription costs can add up fast enough that some people skip doses or delay refills to save money. Extra Help removes much of that pressure by covering the parts of Part D that hit hardest: the monthly premium, the deductible, and the coverage gap.

To qualify for full Extra Help, your annual income generally must be at or below 150% of the federal poverty level, and your countable resources, cash, stocks, bonds, and similar assets, must fall under set limits. According to the Social Security Administration, these income and resource thresholds are updated every year, so check the current amounts on the SSA Extra Help page before you apply.

Not everything you own counts against the resource limit. SSA generally excludes your primary home, one vehicle, personal belongings, and certain burial funds when calculating countable resources. What does count includes bank accounts, stocks, bonds, and any additional real estate you hold.

Since 2024, changes from the Inflation Reduction Act removed the old partial-subsidy tiers for Extra Help. Anyone who meets the income and resource limits now receives the full benefit, rather than a reduced subsidy based on where their income fell within the qualifying range.

Some people qualify automatically and don't need to file a separate application. You generally get Extra Help without applying if you're enrolled in Medicaid, a Medicare Savings Program, or Supplemental Security Income (SSI). SSA and your state Medicaid agency handle the paperwork for automatic enrollment and will notify you by mail if you qualify.

You can apply for Extra Help for free in several ways:

1. Apply online through the Social Security Administration's Extra Help application.
2. Call SSA's toll-free number to apply by phone.
3. Visit a local Social Security office in person.
4. Apply through your state Medicaid agency instead of SSA.

Have your Social Security number, income information, and details on savings, investments, and other resources ready before you start. SSA typically processes applications and mails a decision letter within a few weeks.

If approved, your Extra Help benefit applies going forward and stays in place automatically. You don't need to reapply every year, though SSA may periodically review your income and resources and ask you to confirm your information. If you're denied, you can request a reconsideration or reapply later if your financial situation changes. According to Medicare.gov, beneficiaries who receive Extra Help do not pay a Part D late enrollment penalty, even if they didn't sign up for drug coverage when they were first eligible.

Extra Help often works alongside other cost-saving programs. If you're enrolled in a Medicare Savings Program, which helps pay Part B premiums and other cost-sharing, you typically qualify for Extra Help automatically. The same is true if you have Medicaid coverage alongside Medicare.

Understanding how these programs interact matters because your total out-of-pocket Medicare costs come from several sources, not just your Part D plan. For a broader look at what Medicare actually costs across Parts A, B, C, and D, see our guide to Medicare costs.