What Is Extra Help for Medicare Prescription Drugs?
Key Points
- Extra Help can reduce or eliminate Part D premiums, deductibles, and copays for qualifying beneficiaries.
- Some people qualify automatically through Medicaid, SSI, or a Medicare Savings Program.
- Others need to apply through Social Security — and we can help guide you through that process.
Extra Help — also called the Low-Income Subsidy — is a federal program that can dramatically reduce what you pay for Medicare Part D prescription drug coverage. Many people who qualify don't know they're eligible.
What Is Extra Help?
Extra Help, officially called the Low-Income Subsidy (LIS), is a federal program administered by the Social Security Administration that helps Medicare beneficiaries with limited income and resources pay for their Part D prescription drug costs. It can reduce or eliminate monthly Part D premiums, annual deductibles, and the copayments or coinsurance you pay at the pharmacy.
In 2026, people with full Extra Help pay small fixed copays for covered generic and brand-name drugs, with no cost after reaching a certain drug spending level. The savings can be substantial — particularly for beneficiaries who take multiple medications or rely on brand-name drugs.
Who Qualifies Automatically?
Some people are automatically enrolled in Extra Help and never need to apply. If you receive full Medicaid benefits, Supplemental Security Income (SSI), or are enrolled in a Medicare Savings Program that pays your Part B premium — such as QMB, SLMB, or QI — you typically qualify for Extra Help automatically.
If you qualify automatically, Social Security will notify you by mail. You'll still need to choose a Part D plan, but your costs within that plan will be significantly reduced.
Who Needs to Apply?
People who don't qualify automatically but have limited income and resources can apply for Extra Help directly through Social Security — online at ssa.gov, by phone at 1-800-772-1213, or in person at a local Social Security office. Income and resource limits are updated annually.
For 2026, eligibility has been expanded to individuals with incomes up to 150% of the federal poverty level who meet the resource requirements — with resource limits of $18,090 for individuals and $36,100 for married couples. These figures are updated annually, and certain assets — like your home and one vehicle — are excluded from the resource calculation. If your income is close to these limits, it's still worth applying.
Don't Leave Prescription Savings on the Table
Extra Help is one of the most underutilized benefits in Medicare. Beneficiaries who qualify and are enrolled can save hundreds or even thousands of dollars per year on prescription drug costs — but they have to know it exists and take the step to apply.
We help our clients understand whether they may qualify for Extra Help and walk them through the application process at no cost. If you're on Medicare and struggling with drug costs, this is one of the first things we look at together.
Still Have Questions?
Our licensed Medicare brokers are here to help — at no cost to you.