Extra Help (also called the Low Income Subsidy or LIS) is a federal program that pays most of your Medicare Part D prescription drug costs. As of 2024, Extra Help was expanded to provide full benefits to anyone earning up to 150% of the Federal Poverty Level (about $22,590 single / $30,660 married in 2026 figures).
What Extra Help pays in 2026:
- $0 monthly Part D premium (must enroll in a benchmark-priced plan)
- $0 annual deductible
- Maximum copays of $4.90 for generic drugs and $12.15 for brand-name drugs
- Total annual out-of-pocket capped at $0 for many enrollees (LIS effectively eliminates the $2,000 cap concern)
- No coverage gap or "donut hole"
Who qualifies for Extra Help (2026 estimates):
- Full subsidy: household income up to 150% FPL ($22,590 single / $30,660 married) AND resources (savings, investments excluding home and one car) below $17,220 single / $34,360 married
- Resource limits don't include: your primary home, one vehicle, life insurance, burial expenses up to $1,500, household goods, personal property
Automatic enrollment if you qualify for any of these:
- Full Medicaid (also called "dual-eligible")
- Supplemental Security Income (SSI)
- Medicare Savings Programs (QMB, SLMB, QI)
If you're in any of these programs, you automatically get Extra Help — no separate application needed. Look for the green-and-white "Extra Help" notice from Social Security.
How to apply if you're not auto-enrolled:
- Online: ssa.gov/medicare/part-d-extra-help
- Phone: 1-800-772-1213 (Social Security)
- In person at any Social Security office
- Free help from your local State Health Insurance Assistance Program (SHIP) — call 1-877-839-2675
Application takes 15–20 minutes. You'll need: your Medicare card, recent bank statements, investment statements, and tax returns or benefit award letters.
Common mistakes that disqualify people who would otherwise qualify:
- Not reporting that resources are below the limit (don't include the home or one car!)
- Not separating spouse's resources if filing single
- Not realizing that some pension income is excluded
- Not applying because they think "someone with a paid-off house can't qualify"
The Extra Help SEP:
If you have Extra Help, you get a continuous Special Enrollment Period to switch Part D or MA plans once per quarter (Jan–Mar, Apr–Jun, Jul–Sep). You don't have to wait for AEP. This makes it easier to find the best Part D plan for your specific drugs.
Related programs:
- Medicare Savings Programs (MSPs) — pay your Part B premium ($202.90/month savings) and sometimes Part A deductibles. Income limits slightly higher than Extra Help in many states.
- Medicaid — full health coverage; if you qualify, you become "dual-eligible" and get even more benefits
- State Pharmaceutical Assistance Programs (SPAPs) — additional drug help in some states
What to do next: Call (866) 534-1886. We screen you for Extra Help, MSPs, and dual-eligible status, help with the application paperwork, and pick the best Part D plan that maximizes your subsidy. Free.