Home › Medicare Plans › Extra Help (Part D)
Extra HelpLow-Income SubsidyPart D CostsApply Through SSAExtra Help — also called the Low-Income Subsidy — lowers your Part D premium, deductible and copays. It is a different program from a Medicare Savings Program, run by a different agency, and confusing the two is the most common reason people miss out on one of them.
Extra Help lowers what you pay for Medicare prescription drug coverage — the Part D premium, the deductible, and what you hand over at the pharmacy counter. You will also see it called the Low-Income Subsidy (LIS). Same program, two names, which is itself part of why it gets missed.
It is run by Social Security. That is the single most useful fact about it, because the other big low-income Medicare program — Medicare Savings Programs — runs through your state Medicaid office instead. Different program, different agency, different application.
People routinely apply for one, get told no or get no answer, and conclude there is no help available. There are two doors here, and they are not the same door.
If you have Medicaid, a Medicare Savings Program, or SSI, you should get Extra Help without applying. If you have none of those, you need to apply through Social Security.
Qualifying opens a Special Enrollment Period. You are not locked in until the next October — and the best plan with a subsidy is often not the best plan without one.
They track the Federal Poverty Level and are revised annually. Social Security publishes the current figures; a number on a website is a snapshot, not a rule.
Standalone Part D plan or the drug coverage inside a Medicare Advantage plan — the subsidy applies either way.
Takes the Extra Help application — online at ssa.gov, by phone, or at a local office. They hold the current income limits.
Free, unbiased Medicare counseling in every state. They will sit with you through the application and they do not sell insurance.
For the other door — Medicare Savings Programs. Worth asking about both while you are at it.
We are licensed agents rather than a government agency, and we do not file these applications. What we can do is help you work out whether it is worth applying, and get the drug plan right once you know whether the subsidy applies — because the right plan genuinely changes depending on the answer.
Extra Help is a federal program that lowers what you pay for Medicare prescription drug coverage — your Part D premium, your deductible, and the copays at the pharmacy. It is also called the Low-Income Subsidy, or LIS. The two names refer to the same thing.
They cover different costs and they are run by different agencies. A Medicare Savings Program helps with your Medicare premiums and cost-sharing, and is administered by your state Medicaid office. Extra Help is about prescription drug costs specifically, and is administered by Social Security. The useful overlap: qualifying for an MSP automatically qualifies you for Extra Help.
It is automatic if you have Medicaid, a Medicare Savings Program, or Supplemental Security Income — you should be enrolled without doing anything. If none of those apply to you, you have to apply, and you do that through Social Security, either online, by phone, or at a local office.
They are tied to the Federal Poverty Level and are updated annually, so any figure written on a web page will eventually be wrong. Social Security publishes the current limits and takes the application, and your State Health Insurance Assistance Program can walk through it with you at no cost. Note that certain things are not counted the way people expect, which is another reason not to self-reject on a rough mental estimate.
Yes. Qualifying for Extra Help gives you a Special Enrollment Period, so you are not stuck with your current Part D plan until the next annual window. That matters, because the plan that was cheapest without the subsidy is often not the one that is cheapest with it.
Yes. Extra Help applies to the drug coverage inside a Medicare Advantage plan that includes Part D, just as it applies to a standalone drug plan. It does not restrict which type of coverage you choose.
If you might qualify, this is worth more to you than almost anything else on this site. And if the right answer is that your state office or a SHIP counselor should handle it, we will tell you that.
